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J Matern Fetal Neonatal Med. 2006 Jan;19(1):49-55.

Antecedents of respiratory pauses in extremely low birth weight infants supported by proportional assist ventilation.

Author information

1
Department of Gynecology & Obstetrics, Division of Neonatology, Klinikum Grosshadern, Ludwig Maximilian University of Munich, Munich, Germany. esther.fackeldey@med.uni-muenchen.de

Abstract

OBJECTIVE:

To determine characteristics of breathing patterns prior to respiratory pauses in extremely low birth weight (ELBW) infants breathing spontaneously under proportional assist ventilation (PAV).

METHODS:

Thirteen infants (mean +/- SD: gestational age 25 +/- 1 weeks; birth weight 753 +/- 149 g; age 4 +/- 3 days) were studied. Recordings were obtained under PAV over two-hour periods on two consecutive days. The last 10 breaths preceding respiratory pauses were analyzed.

RESULTS:

Tidal volume, inspiratory and expiratory peak flow, and mean inspiratory flow decreased in the last breaths prior to respiratory pauses compared to all other breaths (p < 0.001). Of all apneas 89% were preceded by a decrease in tidal volume of at least 33% (435/487; p < 0.001). The positive predictive value of a decrease in tidal volume to predict an apnea was 26% (435/1640; p < 0.001).

CONCLUSIONS:

Decreases in tidal volume of at least 33% and in airflow are the predominant changes in the breathing pattern prior to respiratory pauses in ELBW infants, preceding 89% of all respiratory pauses. Their low positive predictive value of 26% however, indicates that further variables of breathing need to be implemented to predict cessation of breathing with higher precision.

PMID:
16492592
DOI:
10.1080/14767050500497200
[Indexed for MEDLINE]

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