Ventilation and spontaneous breathing at birth of infants with congenital diaphragmatic hernia.
J Pediatr
; 154(3): 369-73, 2009 Mar.
Article
em En
| MEDLINE
| ID: mdl-19038404
OBJECTIVE: To describe the interaction of spontaneous breaths, manual ventilation, and tidal volumes (V(T)) during stabilization of infants with congenital diaphragmatic hernia (CDH) in the delivery room. STUDY DESIGN: We studied infants with CDH receiving respiratory support at birth. Airway pressure, flow, and volume were measured, and each breath or inflation was analyzed. Each V(T) was classified as a manual inflation, a spontaneous breath, or a spontaneous breath coinciding with manual inflation on the basis of the timing of the pressure and flow waves. RESULTS: Twelve infants had 2957 breaths suitable for analysis, with spontaneous breathing in 11 infants (92%). The mean (+/-SD) proportion of manual inflations was 41% (+/-24%), spontaneous breaths 43% (+/-25%), spontaneous but coinciding with manual inflation 16% (+/-12%). V(T) was significantly different for spontaneous breaths (3.8 +/- 1.9 mL/kg), spontaneous breaths coinciding with manual inflation (4.7 +/- 2.5 mL/kg), and manual inflations alone (2.6 +/- 1.6 mL/kg). CONCLUSIONS: Most infants with CDH breathed spontaneously, and manual ventilation was mostly asynchronous. We observed large differences in tidal volumes between spontaneous breaths, manual inflations, or where these coincided, with manual inflations having the lowest V(T). Monitoring the respiratory pattern of these infants could improve respiratory support.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Respiração
/
Respiração Artificial
/
Ventilação Pulmonar
/
Hérnias Diafragmáticas Congênitas
/
Hérnia Diafragmática
/
Doenças do Recém-Nascido
Limite:
Humans
/
Newborn
Idioma:
En
Revista:
J Pediatr
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Austrália
País de publicação:
Estados Unidos