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Evaluation of a Respiratory Function Monitor to Teach Mask Ventilation of the Newborn: A Randomised Controlled Trial
Author(s) -
Eoin O’Currain,
Marta Thio,
Jennifer Dawson,
Susan Donath,
Peter Davis
Publication year - 2018
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13882_100
Subject(s) - medicine , randomized controlled trial , ventilation (architecture) , anesthesia , intensive care medicine , pediatrics , mechanical engineering , engineering
O’Currain E, Chauhan H, Dawson JA, Thio M, Davis PG The Royal Women’s Hospital (RWH), Melbourne, Australia, University College Dublin, Ireland, University of Melbourne, Melbourne, Australia Email: eoin.ocurrain@thewomens.org.au Background: Up to 85% of extremely preterm infants (<750 g) require intubation during their hospitalisation in NICU. Pre-intubation medications induce apnoea and positive pressure ventilation (PPV) is provided before intubation to maintain physiological stability. Despite this, significant desaturation or bradycardia occurs in half of newborn intubations. We aimed to examine the time between the last spontaneous breath and initiation of PPV delivered before intubation, in preterm infants. Methods: We undertook an observational study of video and physiological recordings of preterm infants (<33 weeks gestational age) intubated from September 2014 – November 2017 under sedation and muscle relaxation in the RWH NICU. We measured the last breath, last effective breath and time of PPV commencement using a respiratory function monitor. We defined the breaths based on their expired tidal volume (VTe) as follows; last effective breath (VTe ≥ 2ml/kg). Results: 96 patients were analysed with a median (IQR) gestational age of 27 weeks (26, 29) and median weight at intubation of 967 g (820, 1262). The age at intubation was 26 hours (8.5 – 179). There was a median 12 second delay QR (4, 29) range (062) in initiation of PPV after the last effective breath. This delay was not correlated with oxygen saturation (r= -0.02, p= 0.78) or heart rate (r= -0.01, p= 0.98) during PPV. Conclusions: During elective intubation, though there is a delay between the onset of apnoea and the commencement of PPV, it does not affect physiological stability.