Effects of Breathing and Apnoea during Sustained Inflations in Resuscitation of Preterm Infants
2017; Karger Publishers; Volume: 111; Issue: 4 Linguagem: Inglês
10.1159/000454799
ISSN1661-7819
AutoresGianluca Lista, Francesco Cavigioli, Paola Azzurra La Verde, Francesca Castoldi, Ilia Bresesti, Colin J. Morley,
Tópico(s)Respiratory Support and Mechanisms
Resumo<b><i>Background:</i></b> A sustained inflation (SI) at birth in preterm babies may be ineffective unless the infants breathe. Gain in lung volume is associated with breathing during delivery room non-invasive management. <b><i>Objective:</i></b> To describe the breathing patterns of preterm infants during an SI and correlate to a calculated gain in lung volume. <b><i>Methods: </i></b>Retrospective observational study. Data collected from a respiratory function monitor during SI (25 cmH<sub>2</sub>O for 15 s then PEEP at 5 cmH<sub>2</sub>O) through a face mask in preterm infants (gestational age [GA] ≤31 weeks). Spontaneous breaths, inspiratory time (TI), inspiratory/expiratory tidal volume (Vti/Vte), and gain in lung volume were determined. <b><i>Results:</i></b> 30 SIs in 20 infants (mean GA 27 weeks; birth weight 825 g) were analysed and stratified in 2 groups according to spontaneous breathing: SIs without spontaneous breaths (apnoea: <i>n</i> = 11) and SIs with spontaneous breaths (breathing: <i>n</i> = 19). Mean GA was lower in the apnoea group versus the breathing group (25 vs. 27<sup>+5</sup> weeks; <i>p</i> = 0.01). Mean birth weight was lower in the apnoea group versus the breathing group (683 vs. 860 g; <i>p</i> = ns). In the breathing group, the mean number of spontaneous breaths was 4 with a mean TI of 0.52 min, the mean Vti/kg was 5.9 mL/kg, and the mean Vt<sub>e</sub> was 2.7 mL/kg. The calculated mean gain in lung volume was 7.5 mL/kg in the apnoea group and 17.8 mL/kg in the breathing group (<i>p</i> = 0.039). <b><i>Conclusions:</i></b> Actively breathing infants during an SI at birth showed a gain in lung volume higher than apnoeic infants. Spontaneous breathing during SI seems to be related to GA.
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