Early human development
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Early human development · Jul 1991
Inflating pressures for effective resuscitation of preterm infants.
The magnitude of inflating pressure necessary for effective resuscitation was examined in 70 preterm infants. The median pressure to cause adequate chest wall expansion was 22.8 cmH2O; no infant required a peak inflating pressure greater than 30 cmH2O. No further increase in inflation pressure was used during resuscitation and the median 5- and 10-min Apgar scores were 8 and 9, respectively.
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Early human development · Jul 1991
Patterns of oxygenation during periodic breathing in preterm infants.
The characteristics of the arterial oxygen saturation (SaO2) signal during episodes of hypoxaemia (SaO2 less than or equal to 80% for greater than or equal to 4 s) associated with periodic and non-periodic apnoeic pauses were studied in 16 preterm infants with cyanotic episodes (patients). and 15 asymptomatic preterm infants (controls), matched on birthweight and gestational age. The patients showed a significantly higher percentage of apnoeic pauses followed by a hypoxaemic episode (25 vs. 6%, P less than 0.01), and a two-fold increase in the slope of the desaturation curve (8.4 vs. 4.3% per s, P less than 0.005) in periodic compared with non-periodic breathing. All other characteristic of oxygenation (baseline SaO2 before episodes of hypoxaemia, delay between onset of apnoeic pause and onset of desaturation, lowest SaO2 during episodes of hypoxaemia) were similar for periodic and non-periodic breathing patterns. ⋯ An analysis of episodes of bradycardia (less than or equal to 100 beats per minute (bpm] showed that out of 121 episodes in the patients 118 were accompanied by a fall in SaO2 to less than or equal to 80%, and in the remaining three SaO2 fell to 82%, 85% and 86%, respectively. Thus all episodes of bradycardia (less than or equal to 100 bpm) were associated with a fall in SaO2 detected by beat-to-beat pulse oximetry. Examination of hypoxaemic episodes and their relationship with bradycardia and with apnoeic pauses, periodic and non-periodic, may help the further understanding of the control of arterial oxygenation in preterm infants with cyanotic episodes.