Document Detail

Influence of nose and mouth leaks on peripheral oxygen saturation during continuous positive airway pressure in neonates.
MedLine Citation:
PMID:  24146180     Owner:  NLM     Status:  Publisher    
BACKGROUND: Nose and mouth leaks impair effective pressure transmission during neonatal continuous positive airway pressure (CPAP), but little is known about how these leaks affect physiological parameters. This study investigated the influence of nose leaks and spontaneous mouth opening on peripheral oxygen saturation (SpO2) and respiratory rate (RR) using nasopharyngeal CPAP.
METHODS: In 32 neonates with a gestational age of 30 (24-38) weeks and a birth weight of 1435 (710-2730) g, SpO2 and RR measurements were taken with and without occlusion of the contralateral nostril in a randomized cross-over trial in 1-minute intervals over a 10-minute period during each condition. Mouth opening and newborn activity were documented.
RESULTS: SpO2 with open nostril was comparable to that with occluded nostril [93 (78.5-99.5)% vs. 94 (80-100)%, P=0.20]. RR decreased from 51 (26-82)/min to 48 (32-85)/min (P=0.027). In infants with an SpO2 ≤93% during open nostril (n=17), SpO2 increased after nostril occlusion [91 (80-96)% vs. 89.5 (78.5-93)%, P=0.036]. The mouth was open in 78.5% of measurements with open nostril, and in 87.4% of measurements after nostril occlusion (P=0.005). No significant influence of mouth opening or closure on SpO2 or RR was detected.
CONCLUSIONS: In neonates on unilateral nasopharyngeal CPAP with an SpO2 ≤93%, occlusion of the contralateral nostril significantly increased SpO2 and reduced RR. The beneficial physiological effects further support using binasal prongs to minimize nose leaks in this population. Future studies should investigate the beneficial effects of reducing mouth leaks when applying CPAP to these infants.
Hendrik Stefan Fischer; Charles Christoph Roehr; Hans Proquitté; Gerd Schmalisch
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-21
Journal Detail:
Title:  World journal of pediatrics : WJP     Volume:  -     ISSN:  1867-0687     ISO Abbreviation:  World J Pediatr     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101278599     Medline TA:  World J Pediatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Neonatology, Charité University Medicine Berlin, Berlin, Germany,
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