ASSESSING RESUSCITATION RESPONSES IN PREMATURELY BORN INFANTS

Abstract

Background: Infants born prematurely may need cardio pulmonary resuscitation soon after birth. The infant’s responses to resuscitation have rarely been monitored in real time, yet can influence the effectiveness of resuscitation. Aim: Using a respiratory function monitor to assess physiological responses during the resuscitation of prematurely born infants. Methods: A series of studies were undertaken and the main objectives were  To evaluate current resuscitation techniques and the physiological responses of prematurely born infants  To determine the efficacy of current resuscitation methods  To evaluate the use of respiratory function monitoring during the resuscitation of prematurely born infants Results: During the first five inflations delivered by a face mask, clinicians rarely maintained the inflations beyond two seconds. The median tidal volume was low with mechanical lung inflations but significantly increased when combined with the infant’s respiratory efforts (median 2.1 vs 5.6 ml/kg; p=0.007). Similarly, expired carbon dioxide levels were significantly higher with a combination of inflation and inspiratory effort (median 0.3 vs 2.3 kpa; p< 0.01). Similar findings were demonstrated when resuscitation was performed though an endotracheal tube. A survey of clinicians who used respiratory function monitoring (RFM) during preterm resuscitation, demonstrated that they thought that the RPM was useful, but their interventions were not evidence based. Conclusions: Respiratory function monitoring demonstrated variability in the initial resuscitation of preterm infants and highlighted the importance of the infants’ respiratory efforts contributing to the efficacy of resuscitation.

Date of Award	2016
Original language	English
Awarding Institution	King's College London
Supervisor	Anne Greenough (Supervisor)