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Updated: Dec 1, 2025

Ex Vivo Porcine Experimental Model for Studying and Teaching Lung Mechanics
Published on: April 19, 2024
Optimizing noninvasive respiratory support during postnatal stabilization: video-based analysis of airway maneuvers
Lukas P Mileder1,2, Tanja Derler1, Nariae Baik-Schneditz1,2
1Research Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
Objective:
Noninvasive respiratory support during postnatal transition may be challenging. Thus, we aimed to analyze frequency and effects of maneuvers to improve noninvasive respiratory support in neonates immediately after birth.
Materials And Methods:
We included neonates born between September 2009 and January 2015 who were video recorded as part of prospective observational studies and required noninvasive respiratory support during the first 15 min after birth. Maneuvers to improve respiratory support were assessed by video analysis. Vital parameter measurement using pulse oximetry and near-infrared spectroscopy was supplemented by respiratory function monitoring.
Results:
One-hundred forty-three of 653 eligible neonates (21.9%) required respiratory support. Video recordings were analyzed in 76 preterm and 58 term neonates, showing airway maneuvers in 105 of them (78.4%). Repositioning of the face mask was the most common maneuver (56.9%). We observed a median of three maneuvers (0-22) in preterm and a median of two maneuvers (0-13) in term neonates (p = .01). Regional cerebral tissue oxygen saturation was significantly higher during the 60 s after the first airway maneuver.
Conclusion:
Maneuvers to improve respiratory support are commonly required during neonatal resuscitation, with a higher incidence in preterm neonates. The first airway maneuver was associated with an improvement of cerebral tissue oxygenation.
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