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Oxygenation and ventilation in spontaneously breathing very preterm infants with nasopharyngeal CPAP in the delivery room
Author(s) -
Lindner Wolfgang,
Pohlandt Frank
Publication year - 2007
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2006.00009.x
Subject(s) - medicine , hypercapnia , continuous positive airway pressure , anesthesia , gestational age , ventilation (architecture) , periventricular leukomalacia , oxygenation , mechanical ventilation , birth weight , mean airway pressure , pregnancy , acidosis , biology , obstructive sleep apnea , genetics , engineering , mechanical engineering
Aim: To provide data on ventilation, oxygenation and acid–base state from birth to 48 h in very preterm infants treated with lung recruitment manoeuvre and nasopharyngeal continuous positive airway pressure in the delivery room. Methods: Subjects of this prospective observational cohort study were 48 of 61 infants enrolled in a randomised controlled trial to test two lung recruitment manoeuvres after birth. The infants had received an arterial line in the delivery room. The outcome measures were data on oxygenation, ventilation and acid–base state during spontaneous breathing. Results: Data are presented as (n [%]; median [minimum‐maximum]). 22 of 48 (46%) infants (gestational age, 26.4 [25.0–28.9] weeks; birth weight 870 [540–1310] g) were never intubated during the study. The FiO 2 of these infants was low (0.4 [0.21–0.45] at 45 min and 0.21 [0.21‐0.5] at 48 h). P co 2 reached its maximum at 24 (11–44) min (8 [6.4–10.8] kPa) and decreased below 6.7 kPa (median) within 3 h. The incidence of intracranial haemorrhage/periventricular leukomalacia did not increase with hypercapnia (pCO 2 > 8 kPa). Conclusion: A transient period of hypercapnia after birth may occur in spontaneously breathing very preterm infants supported with nasopharyngeal continuous positive airway pressure in the delivery room. The incidence of cerebral damage was not increased in infants with hypercapnia.