Thoracoabdominal Asynchrony Is Not Associated with Oxyhemoglobin Saturation in Recovering Premature Infants

Neonatology. 2017;111(4):297-302. doi: 10.1159/000452787. Epub 2016 Dec 24.

Abstract

Background: Recovering premature infants are at risk for hypoxemia and lack of synchrony between their rib cage and abdomen due to airflow obstruction and poor respiratory compliance. Thoracoabdominal asynchrony (TAA) is a useful marker of resistive and elastic lung properties. Whether TAA predicts oxygenation is unknown.

Objectives: We investigated oxyhemoglobin saturation (SpO2%) and TAA (phase angle, φ) in preterm infants with/without high-humidity nasal cannula (HHNC).

Methods: A cross-sectional observational study was conducted in 92 infants at 32 weeks' postmenstrual age. We measured SpO2% with pulse oximetry and TAA with φ via respiratory inductance plethysmography in infants (mean gestational age: 26.4 + 1.3 weeks) who required room air (n = 18) or HHNC with/without supplemental oxygen (1-5 liters per minute, FiO2 0.21-0.33, n = 74). We calculated median SpO2% from 24.7 + 10.0 min of quiet sleep and median φ from up to 60 breaths.

Results: Infants breathing room air alone had marked TAA (φ = 83.6 + 32.9°, range: 10.9-148.5) as did those receiving varying degrees of ventilatory and oxygen support via HHNC (range of group means, φ = 47.0-90.0°). Infants breathing room air had statically greater median SpO2% than those receiving support (96.3 + 0.6% vs. 91.3 + 0.6%; ANOVA p = 0.001). SpO2% was not associated with TAA in either group (r2 = 0.09).

Conclusion: Recovering premature infants exhibited TAA regardless of need for ventilatory support and supplemental oxygen. TAA was not associated with SpO2% in either group. Maintenance of SpO2% does not require correction of TAA.

Keywords: High-humidity nasal cannula; Hypoxemia; Prematurity; Respiratory inductance plethysmography.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Abdomen / physiopathology*
  • Cross-Sectional Studies
  • Female
  • Gestational Age
  • Humans
  • Hypoxia / physiopathology*
  • Hypoxia / therapy
  • Infant, Extremely Premature
  • Infant, Newborn
  • Infant, Very Low Birth Weight
  • Male
  • Missouri
  • Noninvasive Ventilation / methods
  • Oximetry
  • Oxygen / administration & dosage*
  • Oxyhemoglobins / analysis*
  • Plethysmography
  • Regression Analysis
  • Respiratory Mechanics
  • Thorax / physiopathology*

Substances

  • Oxyhemoglobins
  • Oxygen