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Physiological responses to facemask application in newborns immediately after birth
Vincent D Gaertner1, Christoph Martin Rüegger1, Eoin O'Currain2
1Newborn Research, Department of Neonatology, University Hospital and University of Zurich, Zurich, Switzerland.
Archives of Disease in Childhood. Fetal and Neonatal Edition
|December 10, 2020
Summary
Facemask application in newborns can cause apnea, with the first use being riskier than subsequent ones. Healthcare providers should monitor infants for trigeminocardiac reflex (TCR) during neonatal stabilization.
Area of Science:
- Neonatal resuscitation
- Pediatric physiology
- Cardiorespiratory monitoring
Background:
- The trigeminocardiac reflex (TCR) may cause apnea and bradycardia during facemask use.
- Understanding these effects is crucial for neonatal stabilization.
Purpose of the Study:
- To determine the incidence of apnea and bradycardia in term and late-preterm infants during facemask application.
- To compare the effects of the first facemask application versus subsequent applications.
Main Methods:
- A subgroup analysis of a prospective, randomized trial involving infants >34 weeks gestational age.
- Video recording of resuscitations with airway flow and pressure monitoring.
- Assessment of heart rate and flow waveforms before and after facemask application.
Main Results:
- Apnea occurred in 11% of facemask applications.
- The first facemask application was associated with a significantly higher rate of apnea (29%) compared to subsequent applications (8%).
- Heart rate dropped during apnea but recovered within 30 seconds; overall heart rate showed no significant change over time.
Conclusions:
- Facemask application in newborns is linked to apnea, particularly the initial use.
- Awareness of the TCR is essential for healthcare providers during neonatal stabilization to ensure infant safety.
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