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Respiratory changes in term infants immediately after birth.

Authors :: Blank DA
Gaertner VD
Kamlin COF
Nyland K
Eckard NO
Dawson JA
Kane SC
Polglase GR
Hooper SB
Davis PG
Source :: Resuscitation [Resuscitation] 2018 Sep; Vol. 130, pp. 105-110. Date of Electronic Publication: 2018 Jul 10.
Publication Year :: 2018
Abstract: Introduction: Over 5% of infants worldwide receive breathing support immediately after birth. Our goal was to define references ranges for exhaled carbon dioxide (ECO <subscript>2</subscript> ), exhaled tidal volume (VTe), and respiratory rate (RR) immediately after birth in spontaneously breathing, healthy infants born at 36 weeks' gestational age or older.<br />Methods: This was a single-centre, observational study at the Royal Women's Hospital in Melbourne, Australia, a busy perinatal referral centre. Immediately after the infant's head was delivered, we used a face mask to measure ECO <subscript>2</subscript> , VTe, and RR through the first ten minutes after birth. Respiratory measurements were repeated at one hour.<br />Results: We analysed 14,731 breaths in 101 spontaneously breathing infants, 51 born via planned caesarean section and 50 born vaginally with a median (IQR) gestational age of 39 <superscript>1/7</superscript> weeks (38 <superscript>3/7</superscript> -39 <superscript>5/7</superscript> ). It took a median of 7 (4-10) breaths until ECO <subscript>2</subscript> was detected. ECO <subscript>2</subscript> quickly increased to peak value of 48 mmHg (43-53) at 143 s (76-258) after birth, and decreased to post-transitional values, 31 mmHg (28-24), by 7 min. VTe increased after birth, reaching a plateau of 5.3 ml/kg (2.5-8.4) by 130 s for the remainder of the study period. Maximum VTe was 19 ml/kg (16-22) at 257 s (82-360). RR values increased slightly over time, being higher from minute five to ten as compared to the first two minutes after birth.<br />Conclusions: This study provides reference ranges of exhaled carbon dioxide, exhaled tidal volumes, and respiratory rate for the first ten minutes after birth in term infants who transition without resuscitation.<br /> (Copyright © 2018. Published by Elsevier B.V.)