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Ventilatory control and supplemental oxygen in premature infants with apparent chronic lung disease

Ferdinand Coste1, Thomas Ferkol2, Aaron Hamvas1

  • 1Departments of Pediatrics, Washington University School of Medicine, Saint Louis, Missouri, USA.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|February 27, 2015
PubMed

Insights

Reducing respiratory support in premature infants often reveals unstable breathing patterns. Many infants require ongoing respiratory support due to complex factors beyond just chronic lung disease.

Area of Science:

  • Neonatal physiology
  • Respiratory medicine
  • Premature infant care

Background:

  • Premature infants often require respiratory support due to immature respiratory systems.
  • Chronic lung disease of prematurity (CLD) is a common complication necessitating ongoing respiratory support.

Purpose of the Study:

  • To assess respiratory pattern changes in extremely premature infants (<29 weeks gestation) during a physiological challenge.
  • To evaluate infant responses to systematic reductions in supplemental oxygen and airflow at 36 weeks postmenstrual age.

Main Methods:

  • Continuous monitoring of rib cage and abdominal movements and oxygen saturation (SpO2%) in infants receiving respiratory support.
  • Subjects were infants enrolled in the Prematurity and Respiratory Outcomes Project meeting specific respiratory support criteria.

Main Results:

  • 75.5% of infants (37/49) failed the challenge, exhibiting significant drops in SpO2%.
  • Among those who failed, 43.2% (16/37) showed increased periodic breathing during the challenge.

Conclusions:

  • Decreasing respiratory support can unmask unstable respiratory patterns in many premature infants.
  • Current classifications of CLD based solely on respiratory support needs may not capture all underlying mechanisms contributing to respiratory instability.
Abstract

Keywords:
NeonatologyRespiratory

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