Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Pediatr Pulmonol. 2022 Jun;57(6):1483-1488. doi: 10.1002/ppul.25889. Epub 2022 Mar 23.
This study aimed to evaluate the change in the waveform pattern of the electrical activity of the diaphragm (Edi) following the administration of doxapram in extremely preterm infants ventilated with neurally adjusted ventilatory assist (NAVA).
We conducted this retrospective cohort study in our neonatal intensive care unit between November 2019 and September 2021. The study participants were extremely preterm infants under the gestational age of 28 weeks who were ventilated with NAVA and administered doxapram. We collected the data of the Edi waveform pattern and calculated the proportion. To analyze the change in the proportion of the Edi waveform pattern, we compared the proportion of the data for 1 h before and after doxapram administration.
Ten extremely preterm infants were included. Almost all the patients' respiratory condition improved after doxapram administration. The ventilatory parameters-Edi peak, Edi minimum, peak inspiratory pressure, time in backup ventilation, and number of switches to backup ventilation-did not change significantly. However, the proportion of phasic pattern significantly increased (before: 46% vs. after: 72%; p < 0.05), whereas the central apnea pattern significantly decreased after doxapram administration (before: 31% vs. after: 8.3%; p < 0.05). The proportion of irregular low-voltage patterns tended to decrease, albeit with no significant changes.
Our results indicated that the proportion of Edi waveform patterns changed following doxapram administration. Edi waveform pattern analysis could be a sensitive indicator of effect with other intervention for respiratory conditions.
本研究旨在评估在接受神经调节辅助通气（NAVA）通气的极早产儿中给予多沙普仑后膈肌电活动（Edi）的波形模式变化。
我们在 2019 年 11 月至 2021 年 9 月期间在我们的新生儿重症监护病房进行了这项回顾性队列研究。研究参与者为胎龄小于 28 周且接受 NAVA 通气和多沙普仑治疗的极早产儿。我们收集了 Edi 波形模式的数据并计算了比例。为了分析 Edi 波形模式比例的变化，我们比较了多沙普仑给药前后 1 小时的数据比例。
共纳入 10 名极早产儿。几乎所有患者的呼吸状况在多沙普仑给药后均有所改善。通气参数-Edi 峰值、Edi 最小值、吸气峰压、后备通气时间和后备通气切换次数-无明显变化。然而，相位移态模式的比例显著增加（给药前：46%比给药后：72%；p<0.05），而中枢性呼吸暂停模式的比例在多沙普仑给药后显著降低（给药前：31%比给药后：8.3%；p<0.05）。不规则低电压模式的比例趋于减少，但无显著变化。
我们的结果表明，多沙普仑给药后 Edi 波形模式的比例发生了变化。Edi 波形模式分析可能是反映呼吸状况其他干预效果的敏感指标。
