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Effect of maturity and infection on the rate of relaxation of the respiratory muscles in ventilated, newborn infants
Author(s) -
Dassios Theodore,
Kaltsogianni Ourania,
Dixon Paul,
Greenough Anne
Publication year - 2018
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14188
Subject(s) - medicine , interquartile range , gestational age , respiratory system , continuous positive airway pressure , birth weight , anesthesia , pregnancy , genetics , obstructive sleep apnea , biology
Aim To assess the respiratory muscle time constant of relaxation ( τ ), an index of respiratory muscle function in ventilated newborns. Methods Sixty‐two infants (42 born prematurely) with a median gestational age of 29 [interquartile range ( IQR ) 26–37] weeks were prospectively studied. Measurement of τ was taken during spontaneous breathing on endotracheal continuous positive airway pressure prior to extubation, and τ was calculated from the reciprocal of the slope of the airway pressure decline versus time. Infants were classified as having had systemic or respiratory infection (positive microbiology) if they had any positive bacterial blood or respiratory culture prior to measurement. Results Measurement of τ was taken at a median post‐natal age of 6 ( IQR 3–29) days. The median τ was higher in premature infants [17.4 ( IQR 7.7–28.3) sec/cmH 2 O] compared to term infants [6.8 ( IQR 4.4–8.7) sec/cmH 2 O, p < 0.001]. The median τ was higher in infants who had had positive microbiology [17.6 ( IQR 9.9–29.1) sec/cmH 2 O] compared to infants with negative microbiology [8.0 ( IQR 6.3–17.9) sec/cmH 2 O, p = 0.034]. τ was related to gestational age (r = −0.265, p = 0.003) and weight at measurement (r = −0.269, p = 0.002). Conclusion Respiratory muscle function in ventilated newborns is negatively affected by prematurity and previous systemic or respiratory infection.