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The Breathing Effort of Very Preterm Infants at Birth

Tom J P Huberts1, Elizabeth E Foglia2, Ilona C Narayen1

  • 1Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.

The Journal of Pediatrics
|January 17, 2018
PubMed

Insights

Very preterm infants receiving positive pressure ventilation (PPV) show lower respiratory effort compared to those on continuous positive airway pressure (CPAP). This reduced breathing effort suggests PPV is appropriate for most infants needing respiratory support at birth.

Area of Science:

  • Neonatalogy
  • Pediatric Respiratory Medicine
  • Critical Care

Background:

  • Positive pressure ventilation (PPV) and continuous positive airway pressure (CPAP) are common respiratory support methods for preterm infants.
  • Assessing respiratory effort is crucial for optimizing ventilation strategies in neonates.

Purpose of the Study:

  • To compare the immediate respiratory effort of very preterm infants receiving PPV versus CPAP after birth.

Main Methods:

  • Retrospective analysis of recorded resuscitations in very preterm infants.
  • Evaluation of respiratory parameters including minute volume, recruitment breaths, heart rate, oxygen saturation, and oxygen requirement within the first five minutes of life.

Main Results:

  • Infants on PPV exhibited significantly lower minute volume and fewer recruitment breaths at 2 and 5 minutes compared to CPAP.
  • Lower heart rate and oxygen saturation were observed in the PPV group at 2 minutes, with no significant difference at 5 minutes.
  • Higher oxygen requirement was noted in the PPV group at both 2 and 5 minutes.

Conclusions:

  • Very preterm infants receiving PPV demonstrate reduced spontaneous respiratory effort compared to those on CPAP.
  • The observed lower respiratory effort in the PPV group supports its use in clinical practice for neonatal resuscitation.
Abstract

Keywords:
birthbreathing effortpreterm infantresuscitation

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