Projects per year
Abstract
Objective: Application of a face mask may induce apnoea and bradycardia, possibly via the trigeminocardiac reflex (TCR). We aimed to describe rates of apnoea and bradycardia in term and late-preterm infants following facemask application during neonatal stabilisation and compare the effects of first facemask application with subsequent applications. Design: Subgroup analysis of a prospective, randomised trial comparing two face masks. Setting: Single-centre study in the delivery room Patients: Infants>34 weeks gestational age at birth Methods: Resuscitations were video recorded. Airway flow and pressure were measured using a flow sensor. The effect of first and subsequent facemask applications on spontaneously breathing infants were noted. When available, flow waveforms as well as heart rate (HR) were assessed 20 s before and 30 s after each facemask application. Results: In total, 128 facemask applications were evaluated. In eleven percent of facemask applications infants stopped breathing. The first application was associated with a higher rate of apnoea than subsequent applications (29% vs 8%, OR (95% CI)=4.76 (1.41-16.67), p=0.012). On aggregate, there was no change in median HR over time. In the interventions associated with apnoea, HR dropped by 38bpm [median (IQR) at time of facemask application: 134bpm (134-150) vs 96bpm (94-102) 20 s after application; p=0.25] and recovered within 30 s. Conclusions: Facemask applications in term and late-preterm infants during neonatal stabilisation are associated with apnoea and this effect is more pronounced after the first compared with subsequent applications. Healthcare providers should be aware of the TCR and vigilant when applying a face mask to newborn infants. Trial registration number: ACTRN12616000768493.
Original language | English |
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Article number | 320198 |
Number of pages | 5 |
Journal | Archives of Disease in Childhood: Fetal and Neonatal Edition |
Volume | 106 |
Issue number | 4 |
DOIs | |
Publication status | Published - Jul 2021 |
Keywords
- neonatology
- resuscitation
Projects
- 1 Finished
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Improving perinatal outcomes.
Hooper, S., Davis, P., Wallace, E., Flemmer, A., Gill, A., McDougall, A., te Pas, A. B., Manley, B. J., Kamlin, C. O. F., Morley, C., Tingay, D., Polglase, G., Jenkin, G., Dawson, J., Crossley, K., Kerr, L. T., Doyle, L. W., Owen, L. S., Kitchen, M., Thio, M., Kluckow, M., Tolcos, M., Wallace, M., Lim, R., Harding, R., Boland, R., Hodges, R., Miller, S., Cole, T. & Moss, T.
National Health and Medical Research Council (NHMRC) (Australia)
1/01/17 → 31/12/22
Project: Research