Effects of nasal continuous positive airway pressure (NCPAP) on breathing pattern in spontaneously breathing premature newborn infants.
OBJECTIVE
The aim of the study was to assess the influence of nasal continuous positive airway pressure (NCPAP) on breathing pattern in preterm newborns.


METHODS
Prospective study.


METHODS
Neonatal intensive care unit.


METHODS
Ten premature newborn infants on NCPAP (gestational age range from 27 to 32 weeks, mean birth weight 1300+/-460 g) admitted in our neonatal intensive care unit (NICU) for respiratory distress syndrome.


METHODS
Breathing patterns and changes in lung volumes level were obtained using respiratory inductive plethysmography (RIP), at random CPAP levels (0, 2, 4, 6 and 8 cmH2O). Raw data were analysed for end-expiratory lung volume level (EELV-level), tidal volume (Vt), respiratory rate, phase angle and labour breathing index (LBI).


RESULTS
CPAP increased EELV-level by 2.1+/-0.3xVt from 0 to 8 cmH2O ( p<0.01). Vt increased by 43% from CPAP of 0 cmH2O to CPAP of 8 cmH2O ( p<0.01). We also found that CPAP lowered the phase angle (from 76+/-21 degrees at CPAP of 0 cmH2O to 30+/-15 degrees at CPAP of 8 cmH2O; p<0.01 ) and LBI (from 1.7+/-0.8 at CPAP of 0 cmH2O to 1.2+/-0.3 at CPAP of 8 cmH2O; p<0.05).


CONCLUSIONS
NCPAP improves the breathing strategy of premature infants with respiratory failure, as reflected by improved thoraco-abdominal synchrony, increased Vt and reduction of the LBI. This effect is associated with an increase in EELV-level with CPAP level. However, further investigations are necessary to establish the best CPAP level that ensures both safety and efficiency.
Elgellab
A
A
Department of Neonatology, Centre Hospitalier et Universitaire, 59037, Lille cédex, France.
Riou
Y
Y
Abbazine
A
A
Truffert
P
P
Matran
R
R
Lequien
P
P
Storme
L
L
D000704:Analysis of Variance; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy*; D007363:Intensive Care Units, Neonatal; D008171:Lung Diseases / Q000628:therapy*; D010991:Plethysmography; D011175:Positive-Pressure Respiration / Q000379:methods*; D011446:Prospective Studies; D015656:Respiratory Mechanics; D016896:Treatment Outcome