The impact of different modes of noninvasive ventilation on hemodynamics and regional cerebral and splanchnic oximetry in the premature newborn

Ali, Yaser A. H.; Elsayed, Yasser; Srinivasan, G.; Seshia, Mary; Al-Ethawi, Yahya; Baier, R J

doi:10.4103/2249-4847.191256

Cited by 2 publications

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“…Finally, in a study carried out by Elsayed et al, 10 neonates with less than 32 weeks of gestation who had undergone sigh positive airway pressure (SiPAP) and experienced cardiovascular stability were exposed to nCPAP and SiPAP for intermittent 3-hour periods. The aforementioned study did not show a significant difference in neonatal crSO 2 during these intermittent periods (21).…”

Section: Discussionmentioning

confidence: 55%

Sleep-Wake Cycle in Newborns with 28 - 32 Weeks of Gestation: A Comparative Study of Nasal Continuous Positive Airway Pressure and Nasal Intermittent Positive Pressure Ventilation

2022

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Background: Sleep is a central component of brain development. Preterm neonates follow an exclusive sleep-wake rhythm in a way that they can sleep up to 22 hours per day, 70% of which is spent during active sleep. Sleep can create a period of time for the production of active neurotransmitters, which can enhance brain development flexibility. Objectives: It is a matter of controversy whether the widespread use of nonsynchronized nasal intermittent positive pressure ventilation (NIPPV) in neonatal intensive care units and the concerns over the use of nonrespiratory support can affect the quantity and quality of the sleep-wake cycle (SWC). Therefore, the current study aimed to compare two types of intervention, nasal continuous positive airway pressure (nCPAP) and NIPPV, during the SWC. Methods: The present randomized controlled trial crossover study was conducted on neonates with 28 - 32 weeks of gestation receiving nCPAP who had been administered surfactant after being diagnosed with respiratory distress syndrome in Shahid Beheshti hospital in Isfahan, Iran, within March 2018 to August 2020. The SWC was monitored using cerebral function monitoring for all study participants. Results: The present study showed no significant difference between the number of SWCs during nCPAP and NIPPV. The duration of SWCs when participants received nCPAP was significantly higher than when they received NIPPV intervention. Rapid eye movement (REM) sleep duration was significantly longer during nCPAP respiratory support. Furthermore, NonREM sleep duration was significantly longer in nCPAP respiratory support. Conclusions: Noninvasive respiratory support modes can affect the SWC, with nCPAP being the favored in the present study. Nonetheless, further studies are required to be performed in this regard.

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Section: Discussionmentioning

confidence: 55%

Sleep-Wake Cycle in Newborns with 28 - 32 Weeks of Gestation: A Comparative Study of Nasal Continuous Positive Airway Pressure and Nasal Intermittent Positive Pressure Ventilation

2022

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Titration of inspired oxygen in preterm infants with hypoxemic respiratory failure using near‐infrared spectroscopy and pulse oximetry: A new approach

Elsayed

Dakshinamurti

2021

Pediatric Pulmonology

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Background: Titration of inspired oxygen is a challenge in preterm infants with hypoxemic respiratory failure (HRF). Monitoring of brain oxygen by near-infrared spectroscopy (NIRS) has been proven to minimize the burden of hyperoxia and hypoxemia; with a better understanding of cerebral autoregulation, integrating NIRS and pulse oximetry for titrating inspired oxygen in preterm infants is a novel approach.Methods: We studied the impact of integrated monitoring of oxygen saturation by pulse oximetry (SpO 2 ) and cerebral regional tissue oxygen (crRTO) by NIRS during a stepwise oxygen reduction test (ORT) on reducing oxygen requirement in preterm infants with HRF. The correlation between SpO 2 with crRTO, and fractional oxygen extraction (FOE) was assessed, concordance levels (r > 0.5) were determined during the assessment period and were considered as a sign of impaired autoregulation. The primary outcome was the achievement of significantly lower FiO 2 at 72 h after the start of the integrated monitoring.Results: A total of 38 preterm infants were included, 27 had normal cerebral autoregulation (CAR) (Group 1) in whom SpO 2 was poorly correlating with crRTO with (r < 0.5) and had a significantly greater percentage of reduction below baseline in FiO 2 (mean: 34%). Eleven infants had impaired CAR (Group 2) with SpO 2 significantly correlating with crRTO (r > 0.5) and had a linear trend of FOE inverse to SpO 2 and crRTO; this was considered as an arterial saturation dependent oxygen delivery (SadDO 2 ). Conclusion:Integrated monitoring of preterm infants by SpO 2 and crRTO was associated with easier weaning of oxygen with less burden of both hyperoxia and hypoxemia.

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The impact of different modes of noninvasive ventilation on hemodynamics and regional cerebral and splanchnic oximetry in the premature newborn

Cited by 2 publications

References 1 publication

Sleep-Wake Cycle in Newborns with 28 - 32 Weeks of Gestation: A Comparative Study of Nasal Continuous Positive Airway Pressure and Nasal Intermittent Positive Pressure Ventilation

Sleep-Wake Cycle in Newborns with 28 - 32 Weeks of Gestation: A Comparative Study of Nasal Continuous Positive Airway Pressure and Nasal Intermittent Positive Pressure Ventilation

Titration of inspired oxygen in preterm infants with hypoxemic respiratory failure using near‐infrared spectroscopy and pulse oximetry: A new approach

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