Evaluating tools for respiratory support of preterm infants at birth

Abstract

This thesis investigated the different factors influencing the effectiveness of non-invasive ventilation.

Specifically, there were three key conclusions

1) The high incidence of apnoea after face mask application and the association of higher exerted force by the caregiver with apnoea and bradycardia, illustrated the importance of gently applying a face mask while achieving sufficient mask seal and applying not too much force on the face mask.

2) The characteristics of different respiratory support systems, such as pressure stability, peak flow and lung deflation rates, should be considered when choosing a respiratory system to support breathing of preterm infants at birth, especially in the surfactant deficient and highly incompliant lungs of preterm infants as it might influence lung aeration and respiratory function. 3) While the use of RFM then has the potential to improve non-invasive ventilation by avoiding excessive tidal volumes, no differences in tidal volume delivery was observed in our multicentre trial. it is possible that training in using and interpretating an RFM is an important factor that could have contributed to the lack of showing efficacy in using RFM at birth.