Division of Neonatology, Department of Paediatrics, Leiden University Medical Centre, Leiden, The Netherlands.
Division of Neonatology, Department of Obstetrics and Gynaecology, General Faculty Hospital and 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
Resuscitation. 2020 Dec;157:60-66. doi: 10.1016/j.resuscitation.2020.10.004. Epub 2020 Oct 17.
Applying a face mask could provoke a trigeminocardiac reflex. We compared the effect of applying bi-nasal prongs with a face mask on breathing and heart rate of preterm infants at birth.
In a retrospective matched-pairs study of infants <32 weeks of gestation, the use of bi-nasal prongs for respiratory support at birth was compared to the use of a face mask. Infants who were initially breathing at birth and subsequently received respiratory support were matched for gestational age (±4 days), birth weight (±300 g), general anaesthesia and gender. Breathing, heart rate and other parameters were collected before and after interface application and in the first 5 min thereafter.
In total, 130 infants were included (n = 65 bi-nasal prongs, n = 65 face mask) with a median (IQR) gestational age of 27 (25-28) vs 26 (25-28) weeks. The proportion of infants who stopped breathing after applying the interface was not different between the groups (bi-nasal prongs 43/65 (66%) vs face mask 46/65 (71%), p = 0.70). Positive pressure ventilation was given more often when bi-nasal prongs were used (55/65 (85%) vs 40/65 (62%), p < 0.001). Heart rate (101 (75-145) vs 110 (68-149) bpm, p = 0.496) and oxygen saturation (59% (48-87) vs 56% (35-84), p = 0.178) were similar in the first 5 min after an interface was applied in the infants who stopped breathing.
Apnoea and bradycardia occurred often after applying either bi-nasal prongs or a face mask on the face for respiratory support in preterm infants at birth.
佩戴面罩可能会引发三叉心反射。我们比较了在出生时使用双鼻插管与面罩对早产儿呼吸和心率的影响。
在一项回顾性配对研究中，纳入了胎龄<32 周的婴儿，比较了出生时使用双鼻插管进行呼吸支持与使用面罩的效果。最初在出生时呼吸且随后需要呼吸支持的婴儿，根据胎龄（±4 天）、出生体重（±300g）、全身麻醉和性别进行匹配。在应用接口之前和之后以及之后的前 5 分钟内收集呼吸、心率和其他参数。
共纳入 130 名婴儿（n=65 例双鼻插管，n=65 例面罩），中位（IQR）胎龄为 27（25-28）周与 26（25-28）周。应用接口后停止呼吸的婴儿比例在两组之间无差异（双鼻插管 43/65（66%）与面罩 46/65（71%），p=0.70）。当使用双鼻插管时，更常给予正压通气（55/65（85%）与 40/65（62%），p<0.001）。在停止呼吸的婴儿中，应用接口后的前 5 分钟内，心率（101（75-145）与 110（68-149）bpm，p=0.496）和氧饱和度（59%（48-87）与 56%（35-84），p=0.178）相似。
在出生时使用双鼻插管或面罩为早产儿提供呼吸支持时，面罩或双鼻插管都常引起呼吸暂停和心动过缓。
