The Effect of a Higher Bias Gas Flow on Imposed T-Piece Resistance and Breathing in Preterm Infants at Birth
ObjectiveThe resistance created by the PEEP-valve of a T-piece resuscitator is bias gas flow dependent and might affect breathing in preterm infants. In this study we investigated the effect of a higher bias gas flow on the imposed inspiratory and expiratory T-piece resistance and expiratory breakin...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.817010/full |
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| author | Kristel L. A. M. Kuypers Lieve A. Willemsen Sophie J. E. Cramer Aidan J. Kashyap Aidan J. Kashyap Thomas Drevhammar Thomas Drevhammar Stuart B. Hooper Stuart B. Hooper Arjan B. te Pas |
| author_facet | Kristel L. A. M. Kuypers Lieve A. Willemsen Sophie J. E. Cramer Aidan J. Kashyap Aidan J. Kashyap Thomas Drevhammar Thomas Drevhammar Stuart B. Hooper Stuart B. Hooper Arjan B. te Pas |
| author_sort | Kristel L. A. M. Kuypers |
| collection | DOAJ |
| description | ObjectiveThe resistance created by the PEEP-valve of a T-piece resuscitator is bias gas flow dependent and might affect breathing in preterm infants. In this study we investigated the effect of a higher bias gas flow on the imposed inspiratory and expiratory T-piece resistance and expiratory breaking manoeuvres (EBM) in preterm infants during spontaneous breathing on CPAP at birth.MethodsIn a retrospective pre-post implementation study of preterm infants <32 weeks gestation, who were stabilised with a T-piece resuscitator, a bias gas flow of 12 L/min was compared to 8 L/min. All spontaneous breaths on CPAP within the first 10 min of starting respiratory support were analysed on a breath-by-breath basis to determine the breathing pattern of each breath and to calculate the imposed inspiratory and expiratory T-piece resistance (Ri, Re), flow rates and tidal volume.ResultsIn total, 54 infants were included (bias gas flow 12 L/min: n = 27, 8 L/min: n = 27) with a median GA of 29+6 (28+4–30+3) and 28+5 (25+6–30+3), respectively (p = 0.182). Ri and Re were significantly lower in the 12 L/min compared to 8 L/min bias flow group [Ri: 29.6 (26.1–33.6) vs. 46.4 (43.0–54.1) cm H2O/L/s, p < 0.001; Re: 32.0 (30.0–35.1) vs. 48.0 (46.3–53.9) cm H2O/L/s, p < 0.001], while the incidence of EBM [77% (53–88) vs. 77% (58–90), p = 0.586] was similar.ConclusionDuring stabilisation of preterm infants at birth with a T-piece resuscitator, the use of a higher bias gas flow reduced both the imposed inspiratory and expiratory T-piece resistance for the infant, but this did not influence the incidence of EBMs. |
| first_indexed | 2024-12-13T02:17:41Z |
| format | Article |
| id | doaj.art-fb20b028ef8444cb9204b8d61f9f9f70 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-13T02:17:41Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-fb20b028ef8444cb9204b8d61f9f9f702022-12-22T00:02:51ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-03-011010.3389/fped.2022.817010817010The Effect of a Higher Bias Gas Flow on Imposed T-Piece Resistance and Breathing in Preterm Infants at BirthKristel L. A. M. Kuypers0Lieve A. Willemsen1Sophie J. E. Cramer2Aidan J. Kashyap3Aidan J. Kashyap4Thomas Drevhammar5Thomas Drevhammar6Stuart B. Hooper7Stuart B. Hooper8Arjan B. te Pas9Division of Neonatology, Department of Paediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Centre, Leiden, NetherlandsDivision of Neonatology, Department of Paediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Centre, Leiden, NetherlandsDivision of Neonatology, Department of Paediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Centre, Leiden, NetherlandsThe Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, AustraliaDepartment of Obstetrics and Gynaecology, Monash University, Melbourne, VIC, AustraliaDepartment of Women’s and Children’s Health, Karolinska Institutet, Stockholm, SwedenDepartment of Anaesthesiology, Östersund Hospital, Östersund, SwedenThe Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, AustraliaDepartment of Obstetrics and Gynaecology, Monash University, Melbourne, VIC, AustraliaDivision of Neonatology, Department of Paediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Centre, Leiden, NetherlandsObjectiveThe resistance created by the PEEP-valve of a T-piece resuscitator is bias gas flow dependent and might affect breathing in preterm infants. In this study we investigated the effect of a higher bias gas flow on the imposed inspiratory and expiratory T-piece resistance and expiratory breaking manoeuvres (EBM) in preterm infants during spontaneous breathing on CPAP at birth.MethodsIn a retrospective pre-post implementation study of preterm infants <32 weeks gestation, who were stabilised with a T-piece resuscitator, a bias gas flow of 12 L/min was compared to 8 L/min. All spontaneous breaths on CPAP within the first 10 min of starting respiratory support were analysed on a breath-by-breath basis to determine the breathing pattern of each breath and to calculate the imposed inspiratory and expiratory T-piece resistance (Ri, Re), flow rates and tidal volume.ResultsIn total, 54 infants were included (bias gas flow 12 L/min: n = 27, 8 L/min: n = 27) with a median GA of 29+6 (28+4–30+3) and 28+5 (25+6–30+3), respectively (p = 0.182). Ri and Re were significantly lower in the 12 L/min compared to 8 L/min bias flow group [Ri: 29.6 (26.1–33.6) vs. 46.4 (43.0–54.1) cm H2O/L/s, p < 0.001; Re: 32.0 (30.0–35.1) vs. 48.0 (46.3–53.9) cm H2O/L/s, p < 0.001], while the incidence of EBM [77% (53–88) vs. 77% (58–90), p = 0.586] was similar.ConclusionDuring stabilisation of preterm infants at birth with a T-piece resuscitator, the use of a higher bias gas flow reduced both the imposed inspiratory and expiratory T-piece resistance for the infant, but this did not influence the incidence of EBMs.https://www.frontiersin.org/articles/10.3389/fped.2022.817010/fullneonatal resuscitationpreterm infantsimposed resistanceT-piecebias gas flowbreathing |
| spellingShingle | Kristel L. A. M. Kuypers Lieve A. Willemsen Sophie J. E. Cramer Aidan J. Kashyap Aidan J. Kashyap Thomas Drevhammar Thomas Drevhammar Stuart B. Hooper Stuart B. Hooper Arjan B. te Pas The Effect of a Higher Bias Gas Flow on Imposed T-Piece Resistance and Breathing in Preterm Infants at Birth Frontiers in Pediatrics neonatal resuscitation preterm infants imposed resistance T-piece bias gas flow breathing |
| title | The Effect of a Higher Bias Gas Flow on Imposed T-Piece Resistance and Breathing in Preterm Infants at Birth |
| title_full | The Effect of a Higher Bias Gas Flow on Imposed T-Piece Resistance and Breathing in Preterm Infants at Birth |
| title_fullStr | The Effect of a Higher Bias Gas Flow on Imposed T-Piece Resistance and Breathing in Preterm Infants at Birth |
| title_full_unstemmed | The Effect of a Higher Bias Gas Flow on Imposed T-Piece Resistance and Breathing in Preterm Infants at Birth |
| title_short | The Effect of a Higher Bias Gas Flow on Imposed T-Piece Resistance and Breathing in Preterm Infants at Birth |
| title_sort | effect of a higher bias gas flow on imposed t piece resistance and breathing in preterm infants at birth |
| topic | neonatal resuscitation preterm infants imposed resistance T-piece bias gas flow breathing |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.817010/full |
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