Postnatal physiological changes in electrical activity of the diaphragm in extremely preterm infants

Abstract

ObjectivesThis study aimed to describe postnatal physiological changes in maximum values of peak electrical activity of the diaphragm (Edi) in extremely preterm infants during the preterm period.Working HypothesisThe amplitude and frequency of neural sigh are different at each postmenstrual age in extremely preterm infants.Study DesignA retrospective, observational study.Patient‐subject selectionEdi values were evaluated in 14 extremely preterm infants with neurally‐adjusted ventilatory assist.MethodologyData of Edi peak and Edi minimum were collected from a ventilator. Edi‐sigh was defined as the Edi peak value that was more than twice as large as the median Edi peak at each postmenstrual week in each patient. The frequency of Edi‐sigh, and median values of Edi‐sigh, Edi peak, and Edi minimum were evaluated at each postmenstrual week. The Jonckheere‐Terpstra test was used to analyze the trend between postmenstrual weeks and Edi values.ResultsFrom 26 to 35 postmenstrual weeks, the number of Edi‐sighs per hour significantly increased as postmenstrual weeks increased (P < .001). Furthermore, the median values of Edi‐sigh significantly increased as postmenstrual weeks increased (16.9 µV at 26 weeks to 25.4 µV at 35 weeks, P < .001). There were no significant changes in the median values of Edi peak and Edi minimum at each week.ConclusionsThe amplitude and frequency of neural sigh in extremely preterm infants increase with the number of postmenstrual weeks.

Resultados de la ventilación asistida ajustada neuronalmente no invasiva y la presión positiva continua nasal en recién nacidos prematuros: revisión sistemática y metanálisis

“…6 Los recién nacidos, en especial los prematuros, podrían tener inmadurez del centro respiratorio, y los mecanismos de respuesta respiratoria podrían estar afectados por enfermedades respiratorias, las que pueden perturbar la AEdi. 7 Pocos estudios han comparado el pronóstico de la NAVA no invasiva (NAVA-NIV) y la NCPAP. Sin embargo, nunca se hizo una revisión sistemática y metanálisis centrada en los recién nacidos prematuros.…”

Outcomes of noninvasive neurally adjusted ventilatory assist and nasal continuous positive airway pressure in preterm infants: a systematic review and meta-analysis

“…6 Neonates, especially premature infants, may have immature respiratory centers and the respiratory feedback mechanisms may be affected by respiratory diseases, which can all be disruptive to EAdi. 7 Few studies have compared the prognosis of noninvasive NAVA (NIV-NAVA) and NCPAP. Nonetheless, a systematic review and metaanalysis focusing on preterm infants has never been performed.…”

Skin-to-Skin Contact and Diaphragm Electrical Activity in Preterm Infants During Noninvasive Pressure Control

“…9 Recently, the assessment of respiratory patterns in neonates and preterm infants has benefited from the use of the electrical activity of the diaphragm (Edi). 10,11 Edi serves as an indicator of diaphragmatic electromyography and can be measured using an Edi catheter, a specialized nasogastric tube equipped ABSTRACT Background: Skin-to-skin contact (SSC) is widely implemented in the neonatal intensive care unit (NICU) due to its established role in reducing mortality and morbidity. However, the impact of SSC on diaphragmatic electrical activity (Edi) in premature infants undergoing noninvasive pressure control (NIV-PC) for respiratory management remains insufficiently explored.…”

“…Recently, the assessment of respiratory patterns in neonates and preterm infants has benefited from the use of the electrical activity of the diaphragm (Edi) 10,11. Edi serves as an indicator of diaphragmatic electromyography and can be measured using an Edi catheter, a specialized nasogastric tube equipped with transesophageal electrodes 12.…”