Page 39 - Physiological based CPAP for preterm infants at birth Tessa Martherus
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Supporting breathing of preterm infants at birth
P
1
35
r
Polglase Lambs et al. (32) n=11
127
MV
20 min
4 cmH2O
0, 8, 10, 12 cmH2O in random order, returning to 4 cmH2O in between vs 4 cmH2O
120 min; each level held for 20 min
Pulmonary vascular resistance, oxygenation, PBF and its’ waveform
PEEP of 8 and 12 cmH2O improved oxygenation, however increased pulmonary vascular resistance leading to lower PBF, adversely affecting the pulmonary hemodynamic
Crossley Lambs et al. (34) n=23
126
MV
20 min
4 cmH2O
0, 8, 10, 12 cmH2O in random order, returning to 4 cmH2O in between vs4 cmH2O 0-5-10-5-0 cmH2O vs 5-10-0-5-0 cmH2O vs 10-5-0-10-0 cmH2O
120 min; each level held for 20 min
Blood gases, PBF
Oxygenation improved with increasing PEEP levels ≥8 cmH2O, however these levels reduced PBF
Kitchen Rabbit et al. (35) s
28
MV
No
50 min; each level held for 10 min
Distribution of ventilation within the lung
PEEP of 10 cmH2O accelerates (uniform) lung aeration. Starting PEEP level determines air distribution, even after changing PEEP strategy
n=16
Lambs term GA ~147+/-3 days. Rabbits term gestational age ~32 days. *Age is presented as range.
