148 Partial Lung Aeration Causes Ventilation/Perfusion Mismatch in the Lungs at Birth

Hooper, SB; Lang, Janet M.; Pearson, JT; Wallace, MJ; Siew, ML; Kitchen, MJ; Fouras, Andreas; Wheeler, Kevin; Polglase, GJ; Pas, AB te

doi:10.1136/archdischild-2012-302724.0148

Archives of Disease in Childhood

2012

DOI: 10.1136/archdischild-2012-302724.0148

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148 Partial Lung Aeration Causes Ventilation/Perfusion Mismatch in the Lungs at Birth

SB Hooper

Janet M. Lang

JT Pearson

et al.

Abstract: methods of treatment such as Acupuncture, herbal medicine and massage therapy. The complementary and alternative medicine is a widespread phenomenon, In Europe, complementary therapies are used by 20-50% of the population. Among pediatric populations, Acupuncture is considered the backbone of the CAM modalities. Methods we applied the acupuncture sessions for 30 cases of children who suffering from asthma on their conventional medical treatment on certain points according to Traditional Chinese Medicine for 12… Show more

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“…D uring the transition after birth, lung aeration is pivotal for the changes in respiratory and cardiovascular function that are required for survival (1,2). Although most preterm infants breathe at birth, their respiratory drive is weak and often insufficient to aerate their lungs and establish gas exchange (3)(4)(5)(6)(7).…”

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Caffeine to improve breathing effort of preterm infants at birth: a randomized controlled trial

et al. 2017

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BackgroundCaffeine promotes spontaneous breathing by antagonizing adenosine. We assessed the direct effect of caffeine on respiratory effort in preterm infants at birth.MethodsThirty infants of 24-30 weeks of gestation were randomized for receiving caffeine directly after birth in the delivery room (caffeine DR group) or later in the neonatal intensive care unit (control group). Primary outcome was respiratory effort, expressed as minute volume, tidal volumes, respiratory rate, rate of rise to maximum tidal volume, and recruitment breaths at 7-9 min after birth.ResultsAfter correction for gestational age, minute volumes ((mean±SD; 189±74 vs. 162±70 ml/kg/min; P<0.05) and tidal volumes ((median (interquartile range (IQR)) 5.2 (3.9-6.4) vs. 4.4 (3.0-5.6) ml/kg) were significantly greater in the caffeine DR group. Although respiratory rates were similar ((mean±SD) 35±10 vs. 33±10), RoR increased significantly ((median (IQR) 14.3 (11.2-19.8) vs. 11.2 (7.9-15.2) ml/kg/s), and more recruitment breaths were observed (13 vs. 9%).ConclusionCaffeine increases respiratory effort in preterm infants at birth, but the effect on clinical outcomes needs further investigation.

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Caffeine to improve breathing effort of preterm infants at birth: a randomized controlled trial

et al. 2017

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Supporting breathing of preterm infants at birth: a narrative review

Martherus

Oberthuer

Dekker

et al. 2018

Arch Dis Child Fetal Neonatal Ed

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Most very preterm infants have difficulty aerating their lungs and require respiratory support at birth. Currently in clinical practice, non-invasive ventilation in the form of continuous positive airway pressure (CPAP) and positive pressure ventilation (PPV) is applied via facemask. As most very preterm infants breathe weakly and unnoticed at birth, PPV is often administered. PPV is, however, frequently ineffective due to pressure settings, mask leak and airway obstruction. Meanwhile, high positive inspiratory pressures and spontaneous breathing coinciding with inflations can generate high tidal volumes. Evidence from preclinical studies demonstrates that high tidal volumes can be injurious to the lungs and brains of premature newborns. To reduce the need for PPV in the delivery room, it should be considered to optimise spontaneous breathing with CPAP. CPAP is recommended in guidelines and commonly used in the delivery room after a period of PPV, but little data is available on the ideal CPAP strategy and CPAP delivering devices and interfaces used in the delivery room. This narrative review summarises the currently available evidence for why PPV can be inadequate at birth and what is known about different CPAP strategies, devices and interfaces used the delivery room.

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148 Partial Lung Aeration Causes Ventilation/Perfusion Mismatch in the Lungs at Birth

Cited by 2 publications

References 0 publications

Caffeine to improve breathing effort of preterm infants at birth: a randomized controlled trial

Caffeine to improve breathing effort of preterm infants at birth: a randomized controlled trial

Supporting breathing of preterm infants at birth: a narrative review

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