Thomann J, Rüegger CM, Gaertner VD, O'Currain E, Kamlin OF, Davis PG, Springer L. Tidal volumes during delivery room stabilization of (near) term infants.
BMC Pediatr 2022;
22:543. [PMID:
36100886 PMCID:
PMC9469594 DOI:
10.1186/s12887-022-03600-y]
[Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/31/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND
We sought to assess tidal volumes in (near) term infants during delivery room stabilization.
METHODS
Secondary analysis of a prospective study comparing two facemasks used for positive pressure ventilation (PPV) in newborn infants ≥ 34 weeks gestation. PPV was provided with a T-piece device with a PIP of 30 cmH2O and positive end-expiratory airway pressure of 5 cmH2O. Expired tidal volumes (Vt) were measured with a respiratory function monitor. Target range for Vt was defined to be 4 - 8 ml/kg.
RESULTS
Twenty-three infants with a median (IQR) gestational age of 38.1 (36.4 - 39.0) weeks received 1828 inflations with a median Vt of 4.6 (3.3 - 6.2) ml/kg. Median Vt was in the target range in 12 infants (52%), lower in 9 (39%) and higher in 2 (9%). Thirty-six (25-27) % of the inflations were in the target rage over the duration of PPV while 42 (25 - 65) % and 10 (3 - 33) % were above and below target range.
CONCLUSIONS
Variability of expiratory tidal volume delivered to term and late preterm infants was wide. Reliance on standard pressures and clinical signs may be insufficient to provide safe and effective ventilation in the delivery room.
TRIAL REGISTRATION
This is a secondary analysis of a prospectively registered randomized controlled trial (ACTRN12616000768493).
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