A review of carbon dioxide monitoring in preterm newborns in the delivery room

Hawkes, Gavin A.; Kelleher, John C.; Ryan, C. Anthony; Dempsey, Eugene M.

doi:10.1016/j.resuscitation.2014.07.012

Cited by 27 publications

(20 citation statements)

References 35 publications

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“…8,[10][11][12][21][22][23][24] Several studies reported the use of ECO 2 monitoring during neonatal transition to: (1) determine correct tube placement 22,25,26 ; (2) identify airway obstruction 23,24 ; (3) utilize CO 2 targeting during mask ventilation 21 ; or (4) assess lung aeration in preterm infants. [10][11][12]27 These studies and our data suggest that targeting V T and ECO 2 to normal values may be an effective means of regulating the administration of PPV to high-risk newborns who require respiratory assistance. Studies conducted in preterm animals have shown that delivery of excessive volume during resuscitation may be responsible for the lung injury commonly found in these infants.…”

Section: Discussionsupporting

confidence: 55%

Spontaneously Breathing Preterm Infants Change in Tidal Volume to Improve Lung Aeration Immediately after Birth

Mian

Cheung

O’Reilly

et al. 2015

The Journal of Pediatrics

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Section: Discussionsupporting

confidence: 55%

Spontaneously Breathing Preterm Infants Change in Tidal Volume to Improve Lung Aeration Immediately after Birth

Mian

Cheung

O’Reilly

et al. 2015

The Journal of Pediatrics

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“…There, respiratory function monitors and capnography are being used to access and optimize tidal volumes and lung aeration during positive pressure ventilation, which is considered key to successful resuscitation. Whether or not this new focus will have an impact on pulmonary outcome needs to be tested with further and larger prospective randomized clinical trials …”

Section: Discussionmentioning

confidence: 99%

Evaluation of bedside pulmonary function in the neonate: From the past to the future

Reiterer

Sivieri

Abbasi

2015

Pediatric Pulmonology

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Pulmonary function testing and monitoring plays an important role in the respiratory management of neonates. A noninvasive and complete bedside evaluation of the respiratory status is especially useful in critically ill neonates to assess disease severity and resolution and the response to pharmacological interventions as well as to guide mechanical respiratory support. Besides traditional tools to assess pulmonary gas exchage such as arterial or transcutaenous blood gas analysis, pulse oximetry, and capnography, additional valuable information about global lung function is provided through measurement of pulmonary mechanics and volumes. This has now been aided by commercially available computerized pulmonary function testing systems, respiratory monitors, and modern ventilators with integrated pulmonary function readouts. In an attempt to apply easy-to-use pulmonary function testing methods which do not interfere with the infant́s airflow, other tools have been developed such as respiratory inductance plethysmography, and more recently, electromagnetic and optoelectronic plethysmography, electrical impedance tomography, and electrical impedance segmentography. These alternative technologies allow not only global, but also regional and dynamic evaluations of lung ventilation. Although these methods have proven their usefulness for research applications, they are not yet broadly used in a routine clinical setting. This review will give a historical and clinical overview of different bedside methods to assess and monitor pulmonary function and evaluate the potential clinical usefulness of such methods with an outlook into future directions in neonatal respiratory diagnostics.

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“…1,2 Since then changes have been made to the guidelines 3 and there has been interest in the role of carbon dioxide (CO2) monitoring during neonatal resuscitation. 4 Our aim was to determine if these changes had altered resuscitation practice in the delivery suite across the UK. Methods An online questionnaire was sent to the lead consultants of 189 units.…”

mentioning

confidence: 99%

G202(P) Outcomes of extremely low birth weight infants – the effect of being small for gestational age

Charles

Harris

Hickey

et al. 2018

British Association of Perinatal Medicine

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AimsPrematurely-born infants who are small for gestational age (SGA) have worse outcomes than those who are born appropriate for gestational age (AGA).1,2 There has, however, been little focus on SGA infants born at extremely low birth weights (BW <750 g).MethodsA retrospective study was undertaken of all babies BW <750 gm born between 2012 and 2016. Centiles and z-scores were calculated using the UK WHO preterm reference ranges (British 1990 reference data, reanalysed 2009). The infants were divided into SGA (<10 th centile) and AGA (10th – 90th centile) groups. Multiple logistic regression analysis was performed to adjust for gestational age to relate individual outcome variables to SGA.ResultsEighty-four infants were included, 35 (42%) were SGA. The SGA infants were more mature (median gestational age 26.9 versus 24.3 weeks, p<0.001), had a lower birth weight centile (median 1 versus 26, p<0.001); their mothers were more likely to have received antenatal steroids (94% versus 78%, p=0.022), had hypertension (49% versus 8%, p<0.001) and be delivered by caesarean section (69% versus 8%, p<0.001). Neither the mortality (31% versus 32%) nor the incidence of NEC (17% versus 16%) differed significantly between the two groups, but more of the SGA developed severe BPD (p=0.025). The SGA infants achieved full enteral feeds at an older postnatal age (median 54 versus 48 days, p=0.019). The length of stay was similar in the two groups (127 versus 131 days), but the weight z score at discharge was lower in the SGA group (−3.6 versus −1.7) (p=0.001). Indeed, there was no significant difference in the change in z score from birth between the two groups (median −1.53 versus −1.07, p=0.306).ConclusionsAmongst infants with a BW <750 gm, SGA compared to AGA suffered greater morbidity, but not mortality. These data are important for counselling parents as, in this population, any advantage of later gestation may be negated by being SGA.References. Peacok JL, et al. Pediatr Res2013;73:457–63.. Tsai L-Y, et al. Pediatr Neonatol2015;56:101–7.

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A review of carbon dioxide monitoring in preterm newborns in the delivery room

Cited by 27 publications

References 35 publications

Spontaneously Breathing Preterm Infants Change in Tidal Volume to Improve Lung Aeration Immediately after Birth

Spontaneously Breathing Preterm Infants Change in Tidal Volume to Improve Lung Aeration Immediately after Birth

Evaluation of bedside pulmonary function in the neonate: From the past to the future

G202(P) Outcomes of extremely low birth weight infants – the effect of being small for gestational age

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