Effects of Nasal Respiratory Support on Laryngeal and Esophageal Reflexes in Preterm Lambs

Elsedawi, Basma F.; Samson, Nathalie; Nadeau, Charlène; Charette, Arianne; Lehoux, Angélique; Fortin-Pellerin, Étienne; Praud, Jean-Paul

doi:10.1038/s41390-023-02883-w

Pediatr Res

2023

DOI: 10.1038/s41390-023-02883-w

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Effects of Nasal Respiratory Support on Laryngeal and Esophageal Reflexes in Preterm Lambs

Basma F. Elsedawi,

Nathalie Samson,

Charlène Nadeau

et al.

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2024

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Cited by 2 publications

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Should nasal respiratory support in preterm infants be tailored for physiologic maturity?

Biniwale,

Ramanathan,

Minoo

2024

Pediatr Res

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Should nasal respiratory support in preterm infants be tailored for physiologic maturity?

Biniwale,

Ramanathan,

Minoo

2024

Pediatr Res

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Nasal continuous positive airway pressure inhibits gastroesophageal refluxes in the preterm lamb

Elsedawi,

Samson,

Taillandier-Pensarini

et al. 2024

American Journal of Physiology-Gastrointestinal and Liver Physi

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Background: Gastroesophageal refluxes (GERs) are universal in newborns and may induce deleterious consequences, especially in preemies. We have previously shown that nasal continuous positive airway pressure (nCPAP) inhibits GERs in full-term lambs, complementing similar results in adult humans. The effect of high-flow nasal cannula (HFNC) on GERs, however, remains unknown. This study aimed to assess the effects of nCPAP and HFNC on GERs in our preterm lamb model. Methods: Eleven preterm lambs born 14 days before full-term (~ 34 weeks of human gestation) were studied. Esophageal pH-impedancemetry and polysomnography recordings were performed simultaneously for six hours under three randomly ordered conditions: nCPAP 6 cmH2O, HFNC 7 L/min and no respiratory support (control). The indexes (/hour) of GERs and air-containing swallows were analyzed during each condition. The states of alertness and cardiorespiratory events were also analyzed during the identified GERs. Results: nCPAP significantly decreased the GER index compared to control and HFNC during both quiet wakefulness and non-rapid eye movement sleep, whereas HFNC did not alter the GER index. In addition, nCPAP significantly increased the air-containing swallow index compared to control and HFNC. No significant differences were observed between the tested conditions for GER-related cardiorespiratory events, which were nevertheless rarely observed. Conclusion: Similar to full-term lambs, nCPAP strongly inhibited GERs in the preterm lamb, despite an increase in air-containing swallows. In contrast, HFNC did not impact GERs. Our results are clinically relevant when discussing the use of CPAP in preemies with GERs.

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Effects of Nasal Respiratory Support on Laryngeal and Esophageal Reflexes in Preterm Lambs

Cited by 2 publications

References 46 publications

Should nasal respiratory support in preterm infants be tailored for physiologic maturity?

Should nasal respiratory support in preterm infants be tailored for physiologic maturity?

Nasal continuous positive airway pressure inhibits gastroesophageal refluxes in the preterm lamb

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