Related Experiment Video

Updated: Oct 27, 2025

Application of an Amplitude-integrated EEG Monitor Cerebral Function Monitor to Neonates
05:58

Application of an Amplitude-integrated EEG Monitor Cerebral Function Monitor to Neonates

Published on: September 6, 2017

39.7K

A multi-centre randomised controlled trial of respiratory function monitoring during stabilisation of very preterm

Henriëtte A van Zanten1, Kristel L A M Kuypers1, Erik W van Zwet2

  • 1Division of Neonatology, Department of Paediatrics, Leiden University Medical Centre, Leiden, the Netherlands.

Resuscitation
|July 24, 2021
PubMed

Insights

Using a respiratory function monitor (RFM) during positive pressure ventilation (PPV) for extremely preterm infants did not improve the delivery of target tidal volumes. This study found no significant difference in the percentage of inflations within the desired range between groups.

Area of Science:

  • Neonatal Medicine
  • Pediatric Resuscitation
  • Respiratory Physiology

Background:

  • Positive pressure ventilation (PPV) is critical for preterm infants at birth.
  • Optimizing tidal volume delivery during PPV is essential for minimizing lung injury.
  • Respiratory function monitors (RFMs) offer real-time feedback on ventilation parameters.

Purpose of the Study:

  • To evaluate if using a respiratory function monitor (RFM) during PPV in extremely preterm infants increases the percentage of inflations with expiratory tidal volume (Vte) in the target range.
  • To compare the efficacy of PPV with and without RFM guidance in achieving target Vte.
  • To assess the impact of RFM use on other respiratory and clinical outcomes.

Main Methods:

  • An unmasked, randomized clinical trial was conducted in 7 neonatal intensive care units across 6 countries from October 2013 to May 2019.
  • Very preterm infants (24-27 weeks gestation) receiving PPV at birth were randomized to either have an RFM screen visible or not.
  • The primary outcome was the median proportion of inflations during manual PPV within the target Vte range (4-8 mL/kg).

Main Results:

  • A total of 51,352 inflations from 288 infants were analyzed.
  • The median percentage of inflations within the target Vte range was similar between the RFM visible group (30.0%) and the RFM non-visible group (30.2%) (p=0.721).
  • No significant differences were observed in other respiratory measurements or oxygen saturation; however, the incidence of intraventricular hemorrhage and/or cystic periventricular leukomalacia was lower in the RFM visible group (26.7% vs. 39.0%, RR 0.71).

Conclusions:

  • The use of a respiratory function monitor (RFM) as guidance for tidal volume delivery during PPV in very preterm infants did not increase the percentage of inflations within the predefined target range.
  • While RFM use did not improve tidal volume targeting, a potential benefit was observed in reduced rates of severe brain injury.
  • Further research is warranted to explore the specific mechanisms behind the observed reduction in intraventricular hemorrhage/cystic periventricular leukomalacia.
Abstract

Keywords:
MonitoringNeonatal resuscitationPreterm infantsRespirationTidal volume

More Related Videos

Investigation into Deep Breathing through Measurement of Ventilatory Parameters and Observation of Breathing Patterns08:34

Investigation into Deep Breathing through Measurement of Ventilatory Parameters and Observation of Breathing Patterns

Published on: September 16, 2019

11.8K
Evaluation of Respiratory Muscle Activation Using Respiratory Motor Control Assessment RMCA in Individuals with Chronic Spinal Cord Injury09:37

Evaluation of Respiratory Muscle Activation Using Respiratory Motor Control Assessment RMCA in Individuals with Chronic Spinal Cord Injury

Published on: July 19, 2013

10.5K

Related Concept Videos

Respiratory Assessment: Purpose and Indications01:19

Respiratory Assessment: Purpose and Indications

Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
1.4K
Assessment of Ventilation II: Respiratory Depth and Rhythm01:29

Assessment of Ventilation II: Respiratory Depth and Rhythm

Respiratory Depth
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
2.0K
Assessment of Respiration01:23

Assessment of Respiration

The respiratory system's basic structures and primary functions lay the foundation for nurses' comprehensive respiratory assessments. This assessment includes subjective and objective data to gauge the patient's respiratory health.
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
1.4K
Assessment of Ventilation I: Respiratory Rate01:20

Assessment of Ventilation I: Respiratory Rate

Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
1.5K