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A randomised cross‐over study showed no difference in diaphragm activity during weaning from respiratory support
Author(s) -
Brenne Hilde,
Grunewaldt Kristine Hermansen,
Follestad Turid,
Bergseng Håkon
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.14303
Subject(s) - medicine , weaning , continuous positive airway pressure , anesthesia , respiratory rate , diaphragmatic breathing , respiratory system , diaphragm (acoustics) , heart rate , pediatrics , blood pressure , physics , alternative medicine , pathology , loudspeaker , obstructive sleep apnea , acoustics
Aim We measured electrical activity of the diaphragm (Edi) to compare the breathing effort in preterm infants during weaning from respiratory support with high‐flow nasal cannulae ( HFNC ) or nasal continuous positive airway pressure ( nCPAP ). Methods This randomised cross‐over study was carried out at St Olav's University Hospital, Trondheim, Norway, from December 2013 to June 2015. We gave 21 preterm infants weighing at least 1000 g HFNC 6 L/minute for four hours and nCPAP 3 cmH 2 O for four hours with a one‐hour wash‐out period. Measurements included diaphragmatic load, Edi, vital signs and a modified Silverman‐Andersen Retraction Score. Results We found no differences in HFNC and nCPAP in the median Edi peak (8.0 μ V versus 7.8 μ V, p = 0.095), median Edi min (1.1 μ V versus 1.2 μ V in, p = 0.958) or mean heart rate (157 versus 159, p = 0.300) in the 21 infants who took part. The mean respiratory rate was significantly lower during HFNC than nCPAP (47 versus 52, p = 0.012). The modified Silverman‐Andersen Retraction Score showed no significant differences. Conclusion This study of preterm infants found no difference in the breathing effort measured by Edi between HFNC 6 L/minute and nCPAP 3 cmH 2 O. HFNC could replace nCPAP when preterm infants are ready for weaning.