TITLE

Effects of Continuous Positive Airway Pressure on Diaphragm Dimensions in Preterm Infants

AUTHOR(S)
Rehan, Virender K; Laiprasert, Joann; Nakashima, James M; Wallach, Michael; McCool, Franklin D
PUB. DATE
December 2001
SOURCE
Journal of Perinatology;Dec2001, Vol. 21 Issue 8, p521
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVE: The use of continuous positive airway pressure (CPAP) in the treatment of a variety of neonatal respiratory conditions is associated with improvement in arterial oxygen saturation, decreased long-term morbidity, and an overall improvement in infant survival. We reasoned that CPAP might change diaphragm length by increasing end-expiratory lung volume (EEV), but the extent to which this occurs has not been assessed. This study was designed to evaluate (1) the extent to which CPAP shortens the diaphragm and (2) the relationship of diaphragm thickness and excursion with arterial oxygen saturation in spontaneously breathing preterm infants. STUDY DESIGN: Ultrasonographically (7.5 MHz transducer), diaphragm thickness and diaphragm excursion were measured in 12 stable preterm infants [birth weight 1120 � 225 g (mean � SD); study weight 1187 � 400 g; gestational age 29 � 1 week; postnatal age 10 � 8 days, six males and six females] at three levels of CPAP [1-3, 4-6, and 7-9 cm H[SUB2]O (low, medium, and high, respectively)]. Heart rate, respiratory rate, and arterial oxygen saturation were simultaneously recorded. RESULTS: We found that diaphragm thickness and arterial oxygen saturation increased, and diaphragm excursion decreased significantly at higher levels of CPAP (p < 0.05). The shortening of the diaphragm at the high levels of CPAP, calculated from the increase in diaphragm thickness, was 36% at EEV and 31% at end-inspiratory volume. CONCLUSION: We conclude that the improvement in arterial oxygen saturation with CPAP occurred despite the presence of a shorter and a less mobile diaphragm, and that other physiological and mechanical alterations accompanying the application of CPAP offset its negative effects on diaphragm function. We speculate that with excessive CPAP, however, diaphragm dysfunction along with the previously described adverse hemodynamic effects may outweigh its benefits on oxygenation.
ACCESSION #
8882271

 

Related Articles

  • Electrical activity of the diaphragm (Edi) values and Edi catheter placement in non-ventilated preterm neonates. Stein, H; Hall, R; Davis, K; White, D B // Journal of Perinatology;Sep2013, Vol. 33 Issue 9, p707 

    Objective:The electrical activity of the diaphragm (Edi) reflects neural respiratory drive. Edi peak correlates with inspiratory drive and Edi minimum (Edi min) correlates with the tonic activity of the diaphragm. Edi data in non-ventilated preterm neonates have not been determined.The primary...

  • Lipopolysaccharide-Induced Weakness in the Preterm Diaphragm Is Associated with Mitochondrial Electron Transport Chain Dysfunction and Oxidative Stress. Song, Yong; Pinniger, Gavin J.; Bakker, Anthony J.; Moss, Timothy J. M.; Noble, Peter B.; Berry, Clare A.; Pillow, Jane J. // PLoS ONE;Sep2013, Vol. 8 Issue 9, p1 

    Diaphragmatic contractility is reduced in preterm lambs after lipopolysaccharide (LPS) exposure in utero. The mechanism of impaired fetal diaphragm contractility after LPS exposure is unknown. We hypothesise that in utero exposure to LPS induces a deficiency of mitochondrial complex activity and...

  • Effect of Maternal Steroid on Developing Diaphragm Integrity. Song, Yong; Demmer, Denise L.; Pinniger, Gavin J.; Lavin, Tina; MacMillan, Mia V.; Pillow, Jane J.; Bakker, Anthony J. // PLoS ONE;Mar2014, Vol. 9 Issue 3, p1 

    Antenatal steroids reduce the severity of initial respiratory distress of premature newborn babies but may have an adverse impact on other body organs. The study aimed to examine the effect of maternal steroids on postnatal respiratory muscle function during development and elucidate the...

  • With signal pressures applied:  // Refrigeration Service & Contracting;Feb96, Vol. 64 Issue 2, p14 

    Presents information on how the signal pressures are applied. Importance of the switching-valve diaphragm; Details on the input pressure at S-2.

  • Internal operation of R504 series.  // Refrigeration Service & Contracting;Feb96, Vol. 64 Issue 2, p18 

    Presents information on the internal operation of R504 series. Importance of diaphragms; Details on ports.

  • Breathing: A DIY model. Stevens, Sarah // Journal of Biological Education (Society of Biology);Winter96, Vol. 30 Issue 4, p242 

    Presents a model for demonstrating the function of the diaphragm during inhalation and exhalation. Materials; Construction; Operation.

  • Duplicated right crus of the diaphragm: a cadaveric case report. Sirasanagandla, Srinivasa Rao; Nayak, Satheesha B.; Bhat, Kumar M. R.; Surendran, Sudarshan; Regunathan, Deepthinath; Kumar, Naveen; Shetty, Surekha D.; Patil, Jyothsna // Journal of the Canadian Chiropractic Association;2014, Vol. 58 Issue 1, p39 

    The lumbar part of the diaphragm arises from the lumbar vertebrae by right and left crura. The duplication of crura of the diaphragm is rarely reported in the past. During regular dissection classes to the medical students, we came across a case of duplicated right crus of the diaphragm. The...

  • Early babies.  // Australia's Parents;Apr/May97 Supplement Birth, Issue 98, p49 

    Focuses on early birth and why doctors are trying to delay them. Why some babies are born too early; Hospital treatment; Preventing preterm labor; Factors triggering preterm labor. INSET: Recommended reading..

  • Born too early.  // Australia's Parents;Apr/May97 Supplement Having a Baby, Issue 98, p53 

    Presents facts about premature babies. Premature babies born in Australia; Survival and normal development of premature babies; Preventing prematurity.

Share

Read the Article

Other Topics