Jeroen J van Vonderen1, Gianluca Lista2, Francesco Cavigioli2, Stuart B Hooper3, Arjan B te Pas1. 1. Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands. 2. Department of Neonatology, V. Buzzi Children's Hospital ICP, Milan, Italy. 3. The Ritchie Center, Monash institute for Medical Research, Monash University, Melbourne, Victoria, Australia.
Abstract
OBJECTIVE: To measure tidal volume, plethysmography changes and gas exchange during respiratory support at birth. DESIGN: The following parameters were measured: (1) expired tidal volumes (Vte (mL/kg)) using respiratory function monitoring, (2) changes in plethysmography (AU/kg) per breath using respiratory inductance plethysmography (bands placed around rib cage (RC) and abdomen (AB)) and (3) expired CO2 (ECO2) levels using a volumetric CO2 monitor. For respiratory support, a T-piece resuscitator and facemask were used with peak inspiratory pressure (PIP) 25 cm H2O and positive end expiratory pressure 5 cm H2O. Data were analysed during the sustained inflation (SI), positive pressure ventilation (PPV) and breathing on continuous positive airway pressure (CPAP). SETTING: The delivery rooms of the Leiden University Medical Center, Leiden, and V. Buzzi, Milan. PATIENTS: 15 preterm infants with a gestational age 28 (27-31) weeks and a birth weight of 1080 (994-1300) g. RESULTS: Vte for PPV inflations, PPV inflations with breathing and spontaneous breathing were significantly different (4.4 (2.5-8.6) vs 8.8 (5.7-11.4) vs 5.7 (3.3-9.8); p<0.0001)). Spontaneous breathing led to the highest ECO2 levels and during PPV, ECO2 levels were higher when the inflations coincided with breathing (32 (23-38) vs 20 (13-25) vs 2 (3-11) mm Hg; p<0.0001). Little change in plethysmography amplitude occurred during the SI, PPV and breathing at the RC. There was gain in plethysmography amplitude at the AB during the SI, PPV, but most with breathing. CONCLUSIONS: While Vte during breathing on CPAP was lower compared with PPV coinciding with breathing, breathing on CPAP was most effective in gas exchange and plethysmography amplitude gain compared with PPV and PPV coinciding with breathing. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVE: To measure tidal volume, plethysmography changes and gas exchange during respiratory support at birth. DESIGN: The following parameters were measured: (1) expired tidal volumes (Vte (mL/kg)) using respiratory function monitoring, (2) changes in plethysmography (AU/kg) per breath using respiratory inductance plethysmography (bands placed around rib cage (RC) and abdomen (AB)) and (3) expired CO2 (ECO2) levels using a volumetric CO2 monitor. For respiratory support, a T-piece resuscitator and facemask were used with peak inspiratory pressure (PIP) 25 cm H2O and positive end expiratory pressure 5 cm H2O. Data were analysed during the sustained inflation (SI), positive pressure ventilation (PPV) and breathing on continuous positive airway pressure (CPAP). SETTING: The delivery rooms of the Leiden University Medical Center, Leiden, and V. Buzzi, Milan. PATIENTS: 15 preterm infants with a gestational age 28 (27-31) weeks and a birth weight of 1080 (994-1300) g. RESULTS: Vte for PPV inflations, PPV inflations with breathing and spontaneous breathing were significantly different (4.4 (2.5-8.6) vs 8.8 (5.7-11.4) vs 5.7 (3.3-9.8); p<0.0001)). Spontaneous breathing led to the highest ECO2 levels and during PPV, ECO2 levels were higher when the inflations coincided with breathing (32 (23-38) vs 20 (13-25) vs 2 (3-11) mm Hg; p<0.0001). Little change in plethysmography amplitude occurred during the SI, PPV and breathing at the RC. There was gain in plethysmography amplitude at the AB during the SI, PPV, but most with breathing. CONCLUSIONS: While Vte during breathing on CPAP was lower compared with PPV coinciding with breathing, breathing on CPAP was most effective in gas exchange and plethysmography amplitude gain compared with PPV and PPV coinciding with breathing. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Elizabeth E Foglia; Haresh Kirpalani; Sarah J Ratcliffe; Peter G Davis; Marta Thio; Helmut Hummler; Gianluca Lista; Francesco Cavigioli; Georg M Schmölzer; Martin Keszler; Arjan B Te Pas Journal: J Pediatr Date: 2021-08-25 Impact factor: 4.406
Authors: Jeroen J van Vonderen; Henriëtte A van Zanten; Kim Schilleman; Stuart B Hooper; Marcus J Kitchen; Ruben S G M Witlox; Arjan B Te Pas Journal: Front Pediatr Date: 2016-04-18 Impact factor: 3.418
Authors: Ilia Bresesti; Marlies Bruckner; Christian Mattersberger; Nariae Baik-Schneditz; Bernhard Schwaberger; Lukas Mileder; Alexander Avian; Berndt Urlesberger; Gerhard Pichler Journal: Front Pediatr Date: 2020-01-29 Impact factor: 3.418
Authors: Haresh Kirpalani; Martin Keszler; Elizabeth E Foglia; Peter Davis; Sarah Ratcliffe Journal: Front Pediatr Date: 2019-11-27 Impact factor: 3.418