Cornelia G de Waal1, Gerard J Hutten1, Frans H de Jongh1, Anton H van Kaam1,2. 1. Department of Neonatology, Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands. 2. Department of Neonatology, VU University Medical Center, Amsterdam, the Netherlands.
Abstract
BACKGROUND: Minimally invasive surfactant therapy (MIST) is increasingly used to treat preterm infants with respiratory distress syndrome (RDS). However, the effect of MIST on breathing effort is poorly studied. OBJECTIVES: To describe the effect of MIST on neural breathing effort assessed with transcutaneous electromyography of the diaphragm (dEMG) in preterm infants with RDS. METHODS: Preterm infants with a gestational age < 37 weeks treated with MIST for RDS were included. dEMG measurements were done from 15 min before to 1 h after MIST. The percentage change in dEMG activity after MIST and the clinical response were analyzed. RESULTS: Twenty preterm infants (mean gestational age 29.3 [SD 2.1] weeks; mean birth weight 1,230 [SD 391] g) were included. Seventeen infants did complete the 1-h measurement. Eleven (65%) infants had a decrease in their peakdEMG activity (median change -11.8% [IQR -26.8 to 5.8, p = 0.08]) 1 h after MIST. TonicdEMG activity decreased in 12 (71%) infants, with a median reduction of 6.3% (IQR -29.2 to 9.0, p = 0.07). FiO2 showed a rapid decrease following MIST (before, 0.47 [IQR 0.38-0.84]; 1 h after, 0.25 [IQR 0.21-0.30], p < 0.001). CONCLUSION: In addition to improved oxygenation, MIST results in a decrease in neural breathing effort measured by dEMG activity in the majority of preterm infants with RDS.
BACKGROUND: Minimally invasive surfactant therapy (MIST) is increasingly used to treat preterm infants with respiratory distress syndrome (RDS). However, the effect of MIST on breathing effort is poorly studied. OBJECTIVES: To describe the effect of MIST on neural breathing effort assessed with transcutaneous electromyography of the diaphragm (dEMG) in preterm infants with RDS. METHODS: Preterm infants with a gestational age < 37 weeks treated with MIST for RDS were included. dEMG measurements were done from 15 min before to 1 h after MIST. The percentage change in dEMG activity after MIST and the clinical response were analyzed. RESULTS: Twenty preterm infants (mean gestational age 29.3 [SD 2.1] weeks; mean birth weight 1,230 [SD 391] g) were included. Seventeen infants did complete the 1-h measurement. Eleven (65%) infants had a decrease in their peakdEMG activity (median change -11.8% [IQR -26.8 to 5.8, p = 0.08]) 1 h after MIST. TonicdEMG activity decreased in 12 (71%) infants, with a median reduction of 6.3% (IQR -29.2 to 9.0, p = 0.07). FiO2 showed a rapid decrease following MIST (before, 0.47 [IQR 0.38-0.84]; 1 h after, 0.25 [IQR 0.21-0.30], p < 0.001). CONCLUSION: In addition to improved oxygenation, MIST results in a decrease in neural breathing effort measured by dEMG activity in the majority of preterm infants with RDS.
Authors: Martijn Miedema; Frans H de Jongh; Inez Frerichs; Mariëtte B van Veenendaal; Anton H van Kaam Journal: Am J Respir Crit Care Med Date: 2011-04-14 Impact factor: 21.405
Authors: Juliette V Kraaijenga; Cornelia G de Waal; Gerard J Hutten; Frans H de Jongh; Anton H van Kaam Journal: Arch Dis Child Fetal Neonatal Ed Date: 2016-10-31 Impact factor: 5.747
Authors: Wolfgang Göpel; Angela Kribs; Andreas Ziegler; Reinhard Laux; Thomas Hoehn; Christian Wieg; Jens Siegel; Stefan Avenarius; Axel von der Wense; Matthias Vochem; Peter Groneck; Ursula Weller; Jens Möller; Christoph Härtel; Sebastian Haller; Bernhard Roth; Egbert Herting Journal: Lancet Date: 2011-09-29 Impact factor: 79.321
Authors: Janneke Dekker; Anton H van Kaam; Charles C Roehr; Andreas W Flemmer; Elizabeth E Foglia; Stuart B Hooper; Arjan B Te Pas Journal: Pediatr Res Date: 2019-06-19 Impact factor: 3.756