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

The Effect of Initial High vs. Low FiO2 on Breathing Effort in Preterm Infants at Birth: A Randomized Controlled Trial

“…In a recent study, the average minute volume of preterm infants over the first 100 breaths was 150 ± 70 mL/kg/min (16). The study of van Vonderen et al (17) shows an 80% relative increase in respiratory drive when FiO 2 was switched from 0.21 to 1.0, in the first minute after FiO 2 was increased (from 134 to 240 mL/kg/min).…”

Exhaled Carbon Dioxide and Neonatal Breathing Patterns in Preterm Infants after Birth

“…7 Since then, several studies have examined the usefulness of CO 2 monitoring in the delivery room and demonstrated a gradual increase in ECO 2 from birth suggesting that ECO 2 combined with V T monitoring will play an important role to guide respiratory support in the delivery room. 6,[10][11][12][13]18 This may correspond with changes in lung aeration, gas exchange, and pulmonary vasculature vasodilation within the newborn lung. 9,18 CO 2 is only present in expired gas if effective gas exchange occurs, which suggests that ECO 2 levels indicate the degree of lung aeration.…”

“…As carbon dioxide (CO 2 ) can only be present in the expired gas, exhaled CO 2 (ECO 2 ) potentially indicates the process of gas exchange and is correlated with lung aeration. 6,[10][11][12][13] However, the ECO 2 produced with the spontaneous breathing patterns used to establish FRC and lung aeration have not been described. Therefore, the aim of our study was to examine the amount of ECO 2 produced with neonatal breathing patterns in spontaneously breathing, preterm infants in the immediate postnatal period.…”

Tools to assess lung aeration in neonates with respiratory distress syndrome

“…10 Clinical studies on premature neonates at birth have also demonstrated a rise in carbon dioxide at delivery, correlated to an increase in tidal volume. [11][12][13] One study focused on premature neonates who had not established spontaneous ventilation and required positive pressure ventilation in the delivery room.…”

“…Mian (2015) 12 Hawkes (2016) 11 Murthy (2012) 13 Characterise the changes in end-tidal carbon dioxide after birth 114 End-tidal carbon dioxide increases after birth and is correlated with an increase in tidal volume Hooper (2013) 10 Blank (2014) 15 Compares rise in end carbon tidal dioxide to increase in neonatal heart rate during resuscitation 51…”