Exhaled Carbon Dioxide and Neonatal Breathing Patterns in Preterm Infants after Birth

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• 作者：Jessica Nicoll ; MD¹ ; ² ; Po-Yin Cheung ; MBBS ; PhD ; FRCP (Can ; Edin)¹ ; ² ; Khalid Aziz ; MD ; BA ; MA ; Med ; FRCPC ; FRCPCH ; FAAP¹ ; ² ; Vishaal Rajani ; MSc³ ; Megan O'Reilly ; PhD¹ ; ² ; Gerhard Pichler ; MD¹ ; ² ; ⁴ ; Georg M. Schmö ; lzer ; MD ; PhD¹ ; ²
• 关键词：CO2 ; Carbon dioxide ; CPAP ; Continuous positive airway pressure ; ECO2 ; Exhaled carbon dioxide ; FRC ; Functional residual capacity ; PIF ; Peak inspiratory flows ; PPV ; Positive pressure ventilation ; VT ; Tidal volume
• 刊名：The Journal of Pediatrics
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：167
• 期：4
• 页码：829-833.e1
• 全文大小：875 K

文摘

To examine the amount of exhaled carbon dioxide (ECO₂) with different breathing patterns in spontaneously breathing preterm infants after birth.

Study design

Preterm infants had a facemask attached to a combined carbon dioxide/flow sensor placed over their mouth and nose to record ECO₂ and gas flow. A breath-by-breath analysis of the first 5 minutes of the recording was performed.

Results

Thirty spontaneously breathing preterm infants, gestational age (mean ± SD) 30 ± 2 weeks and birth weight 1635 ± 499 g were studied. ECO₂ from normal breaths and slow expirations was significantly larger than with other breathing patterns (P < .001). ECO₂ per breath also increased with gestational age P < .001. The expiratory hold pattern was the most prevalent breathing pattern both during the first minute of recording and overall. Breathing pattern proportions also varied by gestational age. Finally, ECO₂ from the fifth minute of recording was significantly greater than that produced during the first 4 minutes of recording (P ≤ .029).

Conclusions

ECO₂ varies with different breathing patterns and increases with gestational age and over time. ECO₂ may be an indicator of lung aeration and that postnatal ECO₂ monitoring may be useful in preterm infants in the delivery room.