Douglas A Blank1, Vincent D Gaertner2, C Omar F Kamlin3, Kevyn Nyland4, Neal O Eckard5, Jennifer A Dawson6, Stefan C Kane7, Graham R Polglase8, Stuart B Hooper9, Peter G Davis10. 1. Newborn Research, The Royal Women's Hospital, Melbourne, Australia; The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia. Electronic address: douglas.blank@thewomens.org.au. 2. Newborn Research, The Royal Women's Hospital, Melbourne, Australia; School of Medicine, University Medical Center, Regensburg, Germany. Electronic address: vgaertner@web.de. 3. Newborn Research, The Royal Women's Hospital, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia. Electronic address: omar.kamlin@thewomens.org.au. 4. Newborn Research, The Royal Women's Hospital, Melbourne, Australia. Electronic address: kevyn5@icloud.com. 5. Newborn Research, The Royal Women's Hospital, Melbourne, Australia. Electronic address: nealeckard@gmail.com. 6. Newborn Research, The Royal Women's Hospital, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia. Electronic address: Jennifer.Dawson@thewomens.org.au. 7. The University of Melbourne, Department of Obstetrics and Gynaecology, Australia; Department of Maternal Fetal Medicine, The Royal Women's Hospital, Melbourne, Australia. Electronic address: Stefan.Kane@thewomens.org.au. 8. The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia. Electronic address: graeme.polglase@monash.edu. 9. The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia. Electronic address: stuart.hooper@monash.edu. 10. Newborn Research, The Royal Women's Hospital, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia. Electronic address: pgd@unimelb.edu.au.
Abstract
INTRODUCTION: Over 5% of infants worldwide receive breathing support immediately after birth. Our goal was to define references ranges for exhaled carbon dioxide (ECO2), exhaled tidal volume (VTe), and respiratory rate (RR) immediately after birth in spontaneously breathing, healthy infants born at 36 weeks' gestational age or older. METHODS: This was a single-centre, observational study at the Royal Women's Hospital in Melbourne, Australia, a busy perinatal referral centre. Immediately after the infant's head was delivered, we used a face mask to measure ECO2, VTe, and RR through the first ten minutes after birth. Respiratory measurements were repeated at one hour. RESULTS: We analysed 14,731 breaths in 101 spontaneously breathing infants, 51 born via planned caesarean section and 50 born vaginally with a median (IQR) gestational age of 391/7 weeks (383/7-395/7). It took a median of 7 (4-10) breaths until ECO2 was detected. ECO2 quickly increased to peak value of 48 mmHg (43-53) at 143 s (76-258) after birth, and decreased to post-transitional values, 31 mmHg (28-24), by 7 min. VTe increased after birth, reaching a plateau of 5.3 ml/kg (2.5-8.4) by 130 s for the remainder of the study period. Maximum VTe was 19 ml/kg (16-22) at 257 s (82-360). RR values increased slightly over time, being higher from minute five to ten as compared to the first two minutes after birth. CONCLUSIONS: This study provides reference ranges of exhaled carbon dioxide, exhaled tidal volumes, and respiratory rate for the first ten minutes after birth in term infants who transition without resuscitation.
INTRODUCTION: Over 5% of infants worldwide receive breathing support immediately after birth. Our goal was to define references ranges for exhaled carbon dioxide (ECO2), exhaled tidal volume (VTe), and respiratory rate (RR) immediately after birth in spontaneously breathing, healthy infants born at 36 weeks' gestational age or older. METHODS: This was a single-centre, observational study at the Royal Women's Hospital in Melbourne, Australia, a busy perinatal referral centre. Immediately after the infant's head was delivered, we used a face mask to measure ECO2, VTe, and RR through the first ten minutes after birth. Respiratory measurements were repeated at one hour. RESULTS: We analysed 14,731 breaths in 101 spontaneously breathing infants, 51 born via planned caesarean section and 50 born vaginally with a median (IQR) gestational age of 391/7 weeks (383/7-395/7). It took a median of 7 (4-10) breaths until ECO2 was detected. ECO2 quickly increased to peak value of 48 mmHg (43-53) at 143 s (76-258) after birth, and decreased to post-transitional values, 31 mmHg (28-24), by 7 min. VTe increased after birth, reaching a plateau of 5.3 ml/kg (2.5-8.4) by 130 s for the remainder of the study period. Maximum VTe was 19 ml/kg (16-22) at 257 s (82-360). RR values increased slightly over time, being higher from minute five to ten as compared to the first two minutes after birth. CONCLUSIONS: This study provides reference ranges of exhaled carbon dioxide, exhaled tidal volumes, and respiratory rate for the first ten minutes after birth in term infants who transition without resuscitation.
Authors: Leonie Plastina; Vincent D Gaertner; Andreas D Waldmann; Janine Thomann; Dirk Bassler; Christoph M Rüegger Journal: Pediatr Res Date: 2021-08-31 Impact factor: 3.953
Authors: Janine Thomann; Christoph M Rüegger; Vincent D Gaertner; Eoin O'Currain; Omar F Kamlin; Peter G Davis; Laila Springer Journal: BMC Pediatr Date: 2022-09-13 Impact factor: 2.567
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