Evaluating manual inflations and breathing during mask ventilation in preterm infants at birth

Kim Schilleman, Corinne J M van der Pot, Stuart B Hooper, Enrico Lopriore, Frans J Walther, Arjan B te Pas
Journal of Pediatrics 2013, 162 (3): 457-63

OBJECTIVE: To investigate inflations (initial sustained inflations and consecutive inflations) and breathing during mask ventilation in preterm infants at birth.

STUDY DESIGN: Resuscitation of infants <32 weeks' gestation receiving mask ventilation at birth were recorded. Recorded waveforms were divided into inflations (sustained and consecutive inflations), breaths in between inflations, breaths coinciding with an inflation, and breaths on continuous positive airway pressure (during evaluation moments in between and after ventilation) and expiratory tidal volume (V(Te)) was compared. Inflations were analyzed for leak, low V(Te) (<2.5 mL/kg), high V(Te) (>15 mL/kg in sustained inflations, >10 mL/kg in consecutive inflations), and airway obstruction.

RESULTS: In 27 infants, we analyzed 1643 inflations, 110 breaths in between inflations, 133 breaths coinciding with an inflation, and 1676 breaths on continuous positive airway pressure. A large mask leak frequently resulted in low V(Te). Breathing during positive pressure ventilation occurred in 24 of 27 infants (89%). Median (IQR) V(Te) of inflations, breaths in between inflations, and breaths coinciding with an inflation were 0.8 mL/kg (0.0-5.6 mL/kg), 2.8 mL/kg (0.7-4.6 mL/kg), and 3.9 mL/kg (0.0-7.7 mL/kg) during sustained inflations and 3.7 mL/kg (1.4-6.7 mL/kg), 3.3 mL/kg (2.1-6.6 mL/kg), and 4.6 mL/kg (2.1-7.8 mL/kg) during consecutive inflations, respectively. The V(Te) of breaths were significantly lower than the V(Te) of inflations or breaths coinciding with an inflation.

CONCLUSIONS: We often observed large leak and low V(Te), especially during sustained inflations. Most preterm infants breathe when receiving mask ventilation and this probably contributed to the stabilization of the infants after birth.


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"