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Tidal volume monitoring during initial resuscitation of extremely prematurely born infants

Research output: Contribution to journalArticle

Katie A. Hunt, Vadivelam Murthy, Prashanth Bhat, Grenville F. Fox, Morag E. Campbell, Anthony D. Milner, Anne Greenough

Original languageEnglish
Pages (from-to)665-670
Number of pages6
JournalJournal of Perinatal Medicine
Volume47
Issue number6
Early online date20 May 2019
DOIs
Accepted/In press14 Apr 2019
E-pub ahead of print20 May 2019
Published1 Aug 2019

King's Authors

Abstract

Airway obstruction can occur during facemask (FM) resuscitation of preterm infants at birth. Intubation bypasses any upper airway obstruction. Thus, it would be expected that the occurrence of low expiratory tidal volumes (VTes) would be less in infants resuscitated via an endotracheal tube (ETT) rather than via an FM. Our aim was to test this hypothesis. Analysis was undertaken of respiratory function monitoring traces made during initial resuscitation in the delivery suite to determine the peak inflating pressure (PIP), positive end expiratory pressure (PEEP), the VTe and maximum exhaled carbon dioxide (ETCO2) levels and the number of inflations with a low VTe (less than 2.2 mL/kg). Eighteen infants were resuscitated via an ETT and 11 via an FM, all born at less than 29 weeks of gestation. Similar inflation pressures were used in both groups (17.2 vs. 18.8 cmH2O, P = 0.67). The proportion of infants with a low median VTe (P = 0.6) and the proportion of inflations with a low VTe were similar in the groups (P = 0.10), as was the lung compliance (P = 0.67). Infants with the lowest VTe had the stiffest lungs (P < 0.001). Respiratory function monitoring during initial resuscitation can objectively identify infants who may require escalation of inflation pressures.

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