Newborn Research Centre, The Royal Women's Hospital, Parkville, Victoria, Australia.
The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia.
Neonatology. 2023;120(5):624-632. doi: 10.1159/000531739. Epub 2023 Aug 2.
Recent reports have raised concerns of cardiorespiratory deterioration in some infants receiving respiratory support at birth. We aimed to independently determine whether respiratory support with a facemask is associated with a decrease in heart rate (HR) in some late-preterm and term infants.
Secondary analysis of data from infants born at ≥32+0 weeks of gestation at 2 perinatal centres in Melbourne, Australia. Change in HR up to 120 s after facemask placement, measured using 3-lead electrocardiography, was assessed every 3 s until 60 s and every 5 s thereafter from video recordings.
In the 15 s after facemask placement, 10/68 (15%) infants had a decrease in mean HR by >10 beats per minute (bpm) compared with their individual baseline mean HR in the 15 s before facemask placement. In 4 (6%) infants, HR decreased to <100 bpm. Nine out of 68 (13%) infants had an increase in mean HR by >10 bpm; 7 of these infants had a baseline HR <120 bpm. In univariable comparisons, the following characteristics were found not to be risk factors for a decrease in HR by >10 bpm: prematurity; type of respiratory support; hypoxaemia; early cord clamping; mode of birth; HR <120 bpm before mask placement. Six out of 63 infants (10%) who had HR ≥120 bpm after facemask placement had a late decrease in HR to <100 bpm between 30 and 120 s after facemask placement.
Facemask respiratory support at birth is temporally associated with a decrease in HR in a subset of late-preterm and term infants.
最近的报告引起了人们对一些接受出生时呼吸支持的婴儿心肺功能恶化的担忧。我们旨在独立确定在一些晚期早产儿和足月儿中，使用面罩进行呼吸支持是否与心率（HR）下降有关。
对澳大利亚墨尔本的 2 个围产中心出生胎龄≥32+0 周的婴儿进行数据的二次分析。使用 3 导联心电图在面罩放置后 120 秒内每 3 秒测量一次 HR 变化，直至 60 秒，之后每 5 秒测量一次。
在面罩放置后的 15 秒内，与面罩放置前 15 秒的个体基线平均 HR 相比，10/68（15%）名婴儿的平均 HR 下降了>10 次/分钟（bpm）。在 4 名（6%）婴儿中，HR 降至<100 bpm。9/68（13%）名婴儿的平均 HR 增加了>10 bpm；其中 7 名婴儿的基线 HR <120 bpm。在单变量比较中，以下特征未被发现是 HR 下降>10 bpm 的危险因素：早产；呼吸支持类型；低氧血症；早期脐带夹闭；分娩方式；面罩放置前 HR <120 bpm。在面罩放置后 HR ≥120 bpm 的 63 名婴儿中，有 6 名（10%）婴儿在面罩放置后 30-120 秒之间 HR 出现晚期下降至<100 bpm。
出生时使用面罩进行呼吸支持与一部分晚期早产儿和足月儿的心率下降有关。
