Methods of Assessment and Findings Regarding Pulmonary Function in Infante Less than 1000 Grams

Cunningham,; Ns, Desai

doi:10.1016/s0095-5108(18)30822-4

Cited by 10 publications

(5 citation statements)

References 20 publications

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“…The unit policy for very low‐birthweight infants ventilated in the nursery at the Royal Women's Hospital, Brisbane, is to use the volume guarantee ventilation mode with the tidal volume set at 4 mL/kg: a compromise between the findings of Davies et al 11 and tidal volumes of approximately 5–8 mL/kg. Tidal volumes from 5 to 8 mL/kg are those reported in the literature for ventilating preterm infants with hyaline membrane disease 12–19 . Despite the fact that volume‐targeted ventilation is increasingly used both clinically and in randomized controlled trials, there exists no generally accepted tidal volume to target.…”

mentioning

confidence: 99%

“…Tidal volumes from 5 to 8 mL/kg are those reported in the literature for ventilating preterm infants with hyaline membrane disease. [12][13][14][15][16][17][18][19] Despite the fact that volume-targeted ventilation is increasingly used both clinically and in randomized controlled trials, there exists no generally accepted tidal volume to target. There are also scant data on the PaCO 2 levels that result from such tidal volumes.…”

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confidence: 99%

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Volume‐targeted ventilation and arterial carbon dioxide in neonates

Dawson

Davies

2005

J Paediatrics Child Health

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Objectives: To review the arterial carbon dioxide tensions (PaCO 2 ) in newborn infants ventilated using synchronized intermittent mandatory ventilation (SIMV) in volume guarantee mode (using the Dräger Babylog 8000+) with a unit policy targeting tidal volumes of approximately 4 mL/kg. Methods: Data on ventilator settings and arterial (PaCO 2 levels were collected on all arterial blood gases (ABG; n = 288) from 50 neonates (<33 weeks gestational age) ventilated using the Dräger Babylog 8000+ ventilator (Dräger Medizintechnik GmbH, Lübeck, Germany) in SIMV plus volume guarantee mode. Data were analysed for all blood gases done on the entire cohort in the first 48 h of life and a subanalysis was done on the first gas for each infant (n = 38) ventilated using volume guarantee from admission to the nursery. The number of ABG showing severe hypocapnoea ((PaCO 2 < 25 mmHg) and/or severe hypercapnoea ((PaCO 2 > 65 mmHg) were determined. Results: The mean (SD) (PaCO 2 during the first 48 h was 46.6 (9.0) mmHg. The mean (SD) (PaCO 2 on the first blood gas of those infants commenced on volume guarantee from admission was 45.1 (12.5) mmHg. Severe hypo-or hypercapnoea occurred in 8% of infants at the time of their first blood gas measurement, and in <4% of blood gas measurements in the first 48 h. Conclusions: Infants ventilated with volume guarantee ventilation targeting approximately 4 mL/kg (range: 2.9-5.1) have acceptable PaCO 2 levels at the first blood gas measurement and during the first 48 h of life; and avoid severe hypo-or hypercapnoea over 90% of the time.

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confidence: 99%

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confidence: 99%

Volume‐targeted ventilation and arterial carbon dioxide in neonates

Dawson

Davies

2005

J Paediatrics Child Health

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“…The findings of the present study are also consistent with the values for C L and R L at 28 days in a series of less preterm with HMD (mean birth weight: 1900 g; gestation: 32 weeks) as reported by Abassi et al 24 R L values in the present study were also generally lower than those previously reported in a heterogeneous group of case reports and small series involving ELBW infants born over a 20-year period, as summarized by Cunningham and Desai. 25 We conclude that the groups of ELBW infants in the present study have less disordered lung function, possibly attributable to greater use of antenatal corticosteroids, earlier intervention with respiratory support, superior methods of mechanical ventilation, improved nutrition, and qualitative improvements in nursing care.…”

Section: Discussionmentioning

confidence: 57%

Pulmonary Outcome in Extremely Low Birth Weight Infants

et al. 2000

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“…Assisted ventilation simulation: the simulated infant can breathe autonomously but without supplying adequate oxygenation; the effort triggers the mechanical breaths of the ventilator, according to the selected ventilation modality 32,33 and trigger level (0.2–5 L/min).…”

Section: Methodsmentioning

confidence: 99%

“…where Δ P is the pressure oscillation around the baseline due to autonomous breathing (mean value 10 cmH 2 O 33 ). If the pressure measured at the level of each plunger is smaller than S, the motor follows the active-breathing features, otherwise the rod motion is linked to the pressure wave P according to the relation V = CP .…”

Section: Methodsmentioning

confidence: 99%

A novel simulator for mechanical ventilation in newborns: MEchatronic REspiratory System SImulator for Neonatal Applications

Baldoli

Cuttano

Scaramuzzo

et al. 2015

Proc Inst Mech Eng H

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Respiratory problems are among the main causes of mortality for preterm newborns with pulmonary diseases; mechanical ventilation provides standard care, but long-term complications are still largely reported. In this framework, continuous medical education is mandatory to correctly manage assistance devices. However, commercially available neonatal respiratory simulators are rarely suitable for representing anatomical and physiological conditions; a step toward high-fidelity simulation, therefore, is essential for nurses and neonatologists to acquire the practice needed without any risk. An innovative multi-compartmental infant respirator simulator based on a five-lobe model was developed to reproduce different physio-pathological conditions in infants and to simulate many different kinds of clinical scenarios. The work consisted of three phases: (1) a theoretical study and modeling phase, (2) a prototyping phase, and (3) testing of the simulation software during training courses. The neonatal pulmonary simulator produced allows the replication and evaluation of different mechanical ventilation modalities in infants suffering from many different kinds of respiratory physio-pathological conditions. In particular, the system provides variable compliances for each lobe in an independent manner and different resistance levels for the airway branches; moreover, it allows the trainer to simulate both autonomous and mechanically assisted respiratory cycles in newborns. The developed and tested simulator is a significant contribution to the field of medical simulation in neonatology, as it makes it possible to choose the best ventilation strategy and to perform fully aware management of ventilation parameters.

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Methods of Assessment and Findings Regarding Pulmonary Function in Infante Less than 1000 Grams

Cited by 10 publications

References 20 publications

Volume‐targeted ventilation and arterial carbon dioxide in neonates

Volume‐targeted ventilation and arterial carbon dioxide in neonates

Pulmonary Outcome in Extremely Low Birth Weight Infants

A novel simulator for mechanical ventilation in newborns: MEchatronic REspiratory System SImulator for Neonatal Applications

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