title: Tidal volumes in spontaneously breathing preterm infants supported with continuous positive airway pressure.
abstract: OBJECTIVE
  To describe changes in tidal volume (VT) and their correlation to changes in oxygen saturation and heart rate in spontaneously breathing preterm infants immediately after birth.
  
  
  METHODS
  In this prospective observational, 2-center study, a flow sensor was attached to the facemask of spontaneously breathing infants born at <37 weeks' gestational age who received continuous positive airway pressure (CPAP) immediately after birth. Respiratory function, heart rate, and oxygen saturation were continuously recorded during spontaneous breathing.
  
  
  RESULTS
  Fifty-five infants (mean [SD] gestational age 31 [26-36] weeks and birth weight 1647 [500] g) received mask CPAP in the delivery room. CPAP was started at a median (IQR) 90 (60-118) seconds after birth and was delivered for 720 (300-900) seconds. Median VT ranged between 4.2 and 5.8 mL/kg with the individual VT varied between 0.9 and 19.8 mL/kg. Overall, VT increased over the first few minutes after birth and decreased thereafter. The increase in saturation after birth lagged behind the published normal ranges for spontaneously breathing preterm infants without CPAP.
  
  
  CONCLUSIONS
  The 50th percentile for spontaneous VT in preterm infants during mask CPAP ranged from 4.2 to 5.8 mL/kg, with wide individual variation observed in the first minutes after birth. Preterm infants requiring CPAP after birth may take longer to achieve so-called "normal" saturation targets.
authors: Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Canada; Department of Pediatrics, University of Alberta, Edmonton, Canada.
authors: Qaasim N
authors: QN
authors: Mian
authors: Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Canada; Department of Pediatrics, University of Alberta, Edmonton, Canada; Division of Neonatology, Department of Pediatrics, Medical University, Graz, Austria.
authors: Gerhard
authors: G
authors: Pichler
authors: Division of Neonatology, Department of Pediatrics, Medical University, Graz, Austria.
authors: Corinna
authors: C
authors: Binder
authors: Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Canada; Department of Pediatrics, University of Alberta, Edmonton, Canada.
authors: Megan
authors: M
authors: O'Reilly
authors: Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Canada; Department of Pediatrics, University of Alberta, Edmonton, Canada.
authors: Khalid
authors: K
authors: Aziz
authors: Division of Neonatology, Department of Pediatrics, Medical University, Graz, Austria.
authors: Berndt
authors: B
authors: Urlesberger
authors: Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Canada; Department of Pediatrics, University of Alberta, Edmonton, Canada.
authors: Po-Yin
authors: PY
authors: Cheung
authors: Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Canada; Department of Pediatrics, University of Alberta, Edmonton, Canada; Division of Neonatology, Department of Pediatrics, Medical University, Graz, Austria.
authors: Georg M
authors: GM
authors: Schmölzer
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006339:Heart Rate; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008397:Masks; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000097:blood / Q000627:therapeutic use; D011446:Prospective Studies; D012119:Respiration; D013990:Tidal Volume / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010100:Oxygen