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Respiratory changes in term infants immediately after birth.

Douglas A Blank1, Vincent D Gaertner2, C Omar F Kamlin3

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Summary

This study establishes normal breathing ranges for healthy newborns, providing crucial data on exhaled carbon dioxide (ECO2), exhaled tidal volume (VTe), and respiratory rate (RR) in the first ten minutes after birth.

Keywords:
Delivery roomExhaled carbon dioxideNewbornRespiratory rateResuscitationTidal volume

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Area of Science:

  • Neonatal Physiology
  • Respiratory Medicine
  • Pediatric Research

Background:

  • Over 5% of infants globally require respiratory support at birth.
  • Establishing normative data is essential for identifying deviations from typical cardiorespiratory transition.
  • Healthy term infants provide a baseline for understanding normal physiological adaptation.

Purpose of the Study:

  • To define reference ranges for exhaled carbon dioxide (ECO2), exhaled tidal volume (VTe), and respiratory rate (RR).
  • To analyze these parameters in the first ten minutes after birth.
  • To focus on spontaneously breathing, healthy infants born at 36 weeks' gestational age or older.

Main Methods:

  • Single-centre observational study conducted at the Royal Women's Hospital, Melbourne.
  • Non-invasive measurement of ECO2, VTe, and RR using a face mask immediately after birth.
  • Measurements were taken during the first ten minutes and repeated at one hour.

Main Results:

  • Analysis of 14,731 breaths from 101 healthy term infants (median gestational age 39 1/7 weeks).
  • Exhaled carbon dioxide (ECO2) peaked at 48 mmHg around 2.5 minutes and normalized by 7 minutes.
  • Exhaled tidal volume (VTe) reached a plateau of 5.3 ml/kg by 2 minutes, with maximums up to 19 ml/kg.
  • Respiratory rate (RR) showed a slight increase over the first ten minutes.

Conclusions:

  • The study successfully established reference ranges for ECO2, VTe, and RR in the first ten minutes post-birth.
  • These findings are applicable to term infants transitioning to breathing without resuscitation.
  • Provides essential data for neonatal care and research on infant respiratory adaptation.