Document Detail


Antecedents of respiratory pauses in extremely low birth weight infants supported by proportional assist ventilation.
MedLine Citation:
PMID:  16492592     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine characteristics of breathing patterns prior to respiratory pauses in extremely low birth weight (ELBW) infants breathing spontaneously under proportional assist ventilation (PAV). METHODS: Thirteen infants (mean +/- SD: gestational age 25 +/- 1 weeks; birth weight 753 +/- 149 g; age 4 +/- 3 days) were studied. Recordings were obtained under PAV over two-hour periods on two consecutive days. The last 10 breaths preceding respiratory pauses were analyzed. RESULTS: Tidal volume, inspiratory and expiratory peak flow, and mean inspiratory flow decreased in the last breaths prior to respiratory pauses compared to all other breaths (p < 0.001). Of all apneas 89% were preceded by a decrease in tidal volume of at least 33% (435/487; p < 0.001). The positive predictive value of a decrease in tidal volume to predict an apnea was 26% (435/1640; p < 0.001). CONCLUSIONS: Decreases in tidal volume of at least 33% and in airflow are the predominant changes in the breathing pattern prior to respiratory pauses in ELBW infants, preceding 89% of all respiratory pauses. Their low positive predictive value of 26% however, indicates that further variables of breathing need to be implemented to predict cessation of breathing with higher precision.
Authors:
Esther Rieger-Fackeldey; Annegret Hofmiller; Andreas Schulze
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  19     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-02-22     Completed Date:  2006-08-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  49-55     Citation Subset:  IM    
Affiliation:
Department of Gynecology & Obstetrics, Division of Neonatology, Klinikum Grosshadern, Ludwig Maximilian University of Munich, Munich, Germany. esther.fackeldey@med.uni-muenchen.de
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MeSH Terms
Descriptor/Qualifier:
Apnea / physiopathology*,  therapy*
Female
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / physiopathology
Infant, Very Low Birth Weight*
Inspiratory Capacity / physiology
Male
Monitoring, Physiologic
Peak Expiratory Flow Rate / physiology
Positive-Pressure Respiration*
Predictive Value of Tests

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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