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Year : 2016  |  Volume : 5  |  Issue : 3  |  Page : 179-182

The impact of different modes of noninvasive ventilation on hemodynamics and regional cerebral and splanchnic oximetry in the premature newborn

Department of Paediatrics and Child Health, University of Manitoba, CE 408 Health Sciences Centre, Winnipeg, Manitoba, R3A 1R9 Canada

Correspondence Address:
Dr. Yasser N Elsayed
Department of Paediatrics and Child Health, Women's Hospital, 735 Notre Dame Avenue, Winnipeg, Manitoba
R3A 1R9 Canada
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2249-4847.191256

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Objective: The objective of this study was to compare the effects of triggered pressure assist (TrPA) to nasal continuous positive airway pressure (nCPAP) on cerebral and splanchnic regional blood flow and tissue oxygenation. Methods: Stable preterm neonates (<32 weeks gestation) receiving nCPAP had echocardiographic determination of hemodynamics and cerebral and splanchnic regional tissue oxygenation monitoring using near-infrared spectroscopy before and 3 h after switching to TrPA. Results: Ten neonates (birth weight; 1120 ± 450 g, gestation; 27.6 ± 1.5 weeks) were studied at 13.3 ± 12.4 days (mean ± standard deviation). The end-expiratory pressure was 5 ± 1 cm H 2 O in both modes. There were no significant differences in any of the hemodynamic measurements between nCPAP and TrPA. Cerebral regional tissue oxygen saturation (CrSO 2 ; 74.5 ± 6.9 vs. 73.1 ± 5.8; P < 0.001) and splanchnic rSO 2 (72.4 ± 10.4 vs. 68.0 ± 10.8; P < 0.001) were greater during TrPA compared to nCPAP. In addition, the splanchnic/CrSO 2 ratio was higher on TrPA (0.97 ± 0.15 vs. 0.92 ± 0.15; P < 0.001). The measurements of splanchnic and CrSO 2 were not affected by feedings. Conclusions: Switching from nCPAP to TrPA did not result in significant changes in cardiac output or hemodynamics when the end-expiratory pressure was held constant. TrPA was associated with a small increase in CrSO 2 and a larger increase in splanchnic rSO 2 . These changes were independent of feeding. The clinical significance of these small magnitude changes is uncertain.

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