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剖宫产足月儿出生后稳定期的呼出潮气量和呼吸频率

Expired Tidal Volume and Respiratory Rate During Postnatal Stabilization of Newborn Infants Born at Term via Cesarean Delivery.

作者信息

Baixauli-Alacreu Susana, Padilla-Sánchez Celia, Hervás-Marín David, Lara-Cantón Inmaculada, Solaz-García Alvaro, Alemany-Anchel Maria José, Vento Maximo

机构信息

Neonatal Research Group, Health Research Institute La Fe, Valencia, Spain.

Nursing School, University of Valencia, Valencia, Spain.

出版信息

J Pediatr X. 2020 Dec 25;6:100063. doi: 10.1016/j.ympdx.2020.100063. eCollection 2021 Spring.

Abstract

OBJECTIVE

To retrieve evolving respiratory measures in the first minutes after birth in normal neonates born at term using a respiratory function monitor.

STUDY DESIGN

We evaluated newborn babies delivered at term via cesarean after uncomplicated pregnancies. Immediately after birth, a respiratory function monitor with an adapted flowmeter and a face mask were applied at 2, 5, and 10 minutes after birth for 90 seconds in each period. We analyzed expired and inspired tidal volume, respiratory rate (RR), percentage of leakage, and number of analyzed breaths in each individual infant's recording using a respiratory research software.

RESULTS

A total of 243 infants completed the study. The final data set included 59 058 (48.35%) valid observations for each of the variables representing the analysis of 32 801 breaths. With these data, we constructed a reference range with 10th, 25th, 50th, 75th, and 90th percentiles for expired tidal volume and RR. Tidal volumes plateaued earlier in female than in male infants. No correlation with delayed cord clamping, gestational age, maternal morbidity, or indication for cesarean delivery were established.

CONCLUSIONS

We have constructed a reference range with percentiles for inspired and expired tidal volumes and RR in newborn babies born at term for the first 10 minutes after birth. Reference ranges can be employed for research and can be useful in the clinical setting to guide positive pressure ventilation in the delivery room.

摘要

目的

使用呼吸功能监测仪获取足月出生的正常新生儿出生后最初几分钟内不断变化的呼吸指标。

研究设计

我们评估了妊娠过程无并发症、足月剖宫产出生的新生儿。出生后立即在出生后2分钟、5分钟和10分钟使用配备适配流量计和面罩的呼吸功能监测仪,每个时间段监测90秒。我们使用呼吸研究软件分析每个婴儿记录中的呼出和吸入潮气量、呼吸频率(RR)、漏气百分比以及分析的呼吸次数。

结果

共有243名婴儿完成了研究。最终数据集包括代表对32801次呼吸分析的每个变量的59058条(48.35%)有效观察数据。利用这些数据,我们构建了呼出潮气量和RR的第10、25、50、75和90百分位数的参考范围。女性婴儿的潮气量比男性婴儿更早趋于平稳。未发现与延迟脐带结扎、胎龄、母亲发病率或剖宫产指征存在相关性。

结论

我们构建了足月出生的新生儿出生后最初10分钟内吸入和呼出潮气量以及RR的百分位数参考范围。参考范围可用于研究,在临床环境中有助于指导产房的正压通气。

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