The first breath during resuscitation of prematurely born infants

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    Abstract

    Background:
    The first five initial inflation pressures and times during resuscitation of prematurely born infantsare frequently lower than those recommended and rarely result in tidal volumes exceeding the anatomicaldead space. Greater volumes were produced when the infant was provoked to inspire by an inflation (activeinflation).

    Aims:
    To assess factors associated with a shorter time to the first active inflation.

    Study design:
    Respiratory function monitoring was undertaken during resuscitation, peak inflation pressures(PIP), inflation times and the infant's respiratory activity were simultaneously recorded.Subjects: Infants with a gestational age b 34 weeks requiring resuscitation at birth.Outcome measures: The relationships of the PIP and inflation time of the first five inflations and first activeinflation to the time to the first active inflation.

    Results:
    Recordings from 47 infants, median gestational age of 29 (23–34) weeks, were analysed. The median PIPof the first five inflations was 27 (range 9–37) cmH2O and inflation time 1.22 (range 0.32–4.08) s. The median PIPof the first active inflation was 25 (range 19–37) cmH2O and inflation time 1.35 (0.35–3.67) s. The median time tothe first active inflation was 7 (range 0–50) seconds and was inversely correlated with the PIP (p = 0.001) andinflation time (p = 0.018) of the first five inflations and the PIP (p = 0.001) and inflation time (p = 0.008) of thefirst active inflation.

    Conclusion:
    The magnitude of the inflation pressures and times of the first five inflations inversely correlate withthe time to the first breath during resuscitation.
    Original languageEnglish
    Pages (from-to)7
    Number of pages10
    JournalEarly Human Development
    Volume100
    Early online date2 Jul 2016
    DOIs
    Publication statusPublished - Sept 2016

    Keywords

    • Resuscitation; preterm infant; Head’s paradoxical reflex

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