Background and objectives Delivery of inadvertent high tidal volume (V T) during positive pressure ventilation (PPV) in the delivery room is common. High V T delivery during PPV has been associated with haemodynamic brain injury in animal models. We examined if V T delivery during PPV at birth is associated with brain injury in preterm infants <29 weeks' gestation. Methods A flow-sensor was placed between the mask and the ventilation device. V T values were compared with recently described reference ranges for V T in spontaneously breathing preterm infants at birth. Infants were divided into two groups: V T <6mL/kg or V T >6 mL/kg (normal and high V T, respectively). Brain injury (eg, intraventricular haemorrhage (IVH)) was assessed using routine ultrasound imaging within the first days after birth. Results A total of 165 preterm infants were included, 124 (75%) had high V T and 41 (25%) normal V T. The mean (SD) gestational age and birth weight in high and normal V T group was similar, 26 (2) and 26 (1) weeks, 858 (251) g and 915 (250) g, respectively. IVH in the high V T group was diagnosed in 63 (51%) infants compared with 5 (13%) infants in the normal V T group (P=0.008). Severe IVH (grade III or IV) developed in 33/124 (27%) infants in the high V T group and 2/41 (6%) in the normal V T group (P=0.01). Conclusions High V T delivery during mask PPV at birth was associated with brain injury. Strategies to limit V T delivery during mask PPV should be used to prevent high V T delivery.
|Number of pages||6|
|Journal||Archives of Disease in Childhood: Fetal and Neonatal Edition|
|Publication status||Published - 1 Jan 2019|
- brain injury
- delivery room
- neonatal resuscitation
- respiratory functions tests