Maximal airway pressures during crying in healthy preterm and term neonates

Dimitriou, Gabriel; Greenough, Anne; Dyke, Hazel J.; Rafferty, Gerrard F.

doi:10.1016/s0378-3782(99)00075-4

Cited by 28 publications

(31 citation statements)

References 30 publications

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“…cPI,max provides a simple noninvasive, easy to perform, reproducible test of global respiratory muscle strength, the respiratory efforts being produced during crying are considered to be maximal [33]. The values of TwPdi in the current study are broadly comparable to those reported previously in these patient groups [6], particularly the reduction in TwPdi observed on the affected side in CDH.…”

Section: Discussionsupporting

confidence: 83%

Diaphragm electromyogram in infants with abdominal wall defects and congenital diaphragmatic hernia

Kassim

Jolley

Moxham

et al. 2010

European Respiratory Journal

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Measurement of the diaphragm electromyogram (EMGdi) elicited by phrenic nerve stimulation could be useful to assess neonates suffering from respiratory distress due to diaphragm dysfunction, as observed in infants with abdominal wall defects (AWD) or congenital diaphragmatic hernia (CDH). The study aims were to assess the feasibility of recording EMGdi using a multipair oesophageal electrode catheter and examine whether diaphragm muscle and/or phrenic nerve function was compromised in AWD or CDH infants.Diaphragm compound muscle action potentials elicited by magnetic phrenic nerve stimulation were recorded from 18 infants with surgically repaired AWD (n513) or CDH (n55), median (range) gestational age 36.5 (34-40) weeks. Diaphragm strength was assessed as twitch transdiaphragmatic pressure (TwPdi).One AWD patient had prolonged phrenic nerve latency (PNL) bilaterally (left 9.31 ms, right 9.49 ms) and two CDH patients had prolonged PNL on the affected side (10.1 ms and 10.08 ms). There was no difference in left and right TwPdi in either group. PNL correlated significantly with TwPdi in CDH (r50.8; p50.009).Oesophageal EMG and magnetic stimulation of the phrenic nerves can be useful to assess phrenic nerve function in infants. Reduced phrenic nerve conduction accompanies the reduced diaphragm force production observed in infants with CDH.

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Section: Discussionsupporting

confidence: 83%

Diaphragm electromyogram in infants with abdominal wall defects and congenital diaphragmatic hernia

Kassim

Jolley

Moxham

et al. 2010

European Respiratory Journal

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“…Our results emphasise that to predict extubation outcome more accurately, it is essential to examine the load imposed on the respiratory muscles relative to their capacity. In addition, TTmus and TTdi reflect the respiratory drive modulated load/capacity balance of the diaphragm/respiratory muscles and, therefore, are ideally suited for use in infants, as they are independent of the differences in respiratory muscle strength that occur with increasing maturity 21 22…”

Section: Discussionmentioning

confidence: 99%

Prediction of extubation outcome in infants using the tension time index

Currie

Patel

Rafferty

et al. 2010

Archives of Disease in Childhood - Fetal and Neonatal Edition

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“…Thirteen infants were less than 30 weeks of gestational age at birth (table 2). Their median gestational age was 28 weeks (range 25-99), birth weight 1018 g (range 685-1606), and postnatal age 5 days (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). The study was approved by the research ethics committee of King's Healthcare National Health Service Trust.…”

Section: Patientsmentioning

confidence: 99%

Prediction of extubation failure in preterm infants

Dimitriou

Greenough²,

Endo³

et al. 2002

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Objective: To identify whether the results of assessment of respiratory muscle strength or respiratory load were better predictors of extubation failure in preterm infants than readily available clinical data. Patients: Thirty six infants, median gestational age 31 (range 25-36) weeks and postnatal age 3 (1-14) days; 13 were < 30 weeks of gestational age. Methods: Respiratory muscle strength was assessed by measurement of maximum inspiratory pressure generated during airway occlusion, and inspiratory load was assessed by measurement of compliance of the respiratory system. Results: Overall, seven infants failed extubation-that is, they required reintubation within 48 hours. These infants were older (p < 0.01), had a lower gestational age (p < 0.01), and generated lower maximum inspiratory pressure (p < 0.05) than the rest of the cohort. Similar results were found in the infants < 30 weeks of gestational age. Overall and in those < 30 weeks of gestational age, gestational age and postnatal age had the largest areas under the receiver operator characteristic curves. Conclusion: In very premature infants, low gestational age and older postnatal age are better predictors of extubation failure than assessment of respiratory muscle strength or respiratory load.

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Maximal airway pressures during crying in healthy preterm and term neonates

Cited by 28 publications

References 30 publications

Diaphragm electromyogram in infants with abdominal wall defects and congenital diaphragmatic hernia

Diaphragm electromyogram in infants with abdominal wall defects and congenital diaphragmatic hernia

Prediction of extubation outcome in infants using the tension time index

Prediction of extubation failure in preterm infants

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