AimTo verify the added value of respiratory function monitor (RFM) to assess ventilation and the heart rate (HR) changes during stabilization of preterm infants. MethodsPreterm infants <32 weeks... Show moreAimTo verify the added value of respiratory function monitor (RFM) to assess ventilation and the heart rate (HR) changes during stabilization of preterm infants. MethodsPreterm infants <32 weeks' gestation, bradycardic at birth and in need for positive pressure ventilation (PPV) were included. The first 15 min of stabilization was monitored with RFM. Three time points were identified according to HR values (T0 the start of mask PPV; T1 the HR rise >100 bpm; T2 the delivery of the last PPV). For each inflation, PIP, PEEP, MAP, expired tidal volume/kg (Vte/kg), and mean dynamic compliance (Cdyn) were analyzed. ResultsPIP and MAP values were significantly higher at T1 (27.09 +/- 5.37 and 17.47 +/- 3.85 cmH(2)O) and at T2 (24.7 +/- 3.86 and 15.2 +/- 3.78 cmH(2)O) compared to T0 (24.05 +/- 2.27 and 15.85 +/- 2.77 cmH(2)O). PEEP at T1 was significantly higher (6.27 +/- 2.17 cmH(2)O) compared to T2 (5.61 +/- 1.50 cmH(2)O). Vte/kg showed significantly lower T0 values (3.57 +/- 2.14 ml/kg) compared to T1 (6.18 +/- 2.51 ml/kg) and T2 (6.89 +/- 2.40 ml/kg). There was a significant effect of time on Cdyn. ConclusionsA clear correspondence between HR rise and adequate Vte/kg during stabilization of very preterm infants was highlighted. RFM might be useful to tailor ventilation, following real-time changes of lung compliance. Show less
Aim The aim of this study was to assess the resuscitators' opinions of the usefulness and clinical value of using a respiratory function monitor (RFM) when resuscitating extremely preterm infants... Show moreAim The aim of this study was to assess the resuscitators' opinions of the usefulness and clinical value of using a respiratory function monitor (RFM) when resuscitating extremely preterm infants with positive pressure ventilation. Methods The link to an online survey was sent to 106 resuscitators from six countries who were involved in a multicentre trial that compared the percentage of inflations within a predefined target range with and without the RFM. The resuscitators were asked to assess the usefulness and clinical value of the RFM. The survey was online for 4 months after the trial ended in May 2019. Results The survey was completed by 74 (70%) resuscitators of which 99% considered the RFM to be helpful during neonatal resuscitation and 92% indicated that it influenced their decision-making. The majority (76%) indicated that using the RFM improved their practice and made resuscitation more effective, even when the RFM was not available. Inadequate training was the key issue that limited the effectiveness of the RFM: 45% felt insufficiently trained, and 78% felt more training in using and interpreting the RFM would have been beneficial. Conclusion Resuscitators considered the RFM to be helpful to guide neonatal resuscitation, but sufficient training was required to achieve the maximum benefit. Show less
