Role of abdominal muscles activity on duration and severity of hypoxemia episodes in mechanically ventilated preterm infants

Cristian Esquer, Nelson Claure, Carmen D'Ugard, Yoshiro Wada, Eduardo Bancalari

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Background: Episodes of hypoxemia are often observed in ventilated preterm infants. The factors that determine their duration, severity and the failure of the mechanical breaths to maintain ventilation have not been fully defined. Objective: To determine the relation between activity of the abdominal muscles and the duration and severity of hypoxemia episodes in ventilated preterm infants. Methods: Clinically stable ventilated preterm infants weighing between 500 and 1,000 g at birth, who presented with frequent episodes of hypoxemia, were studied. Recordings of arterial oxygen saturation (SpO2), tidal volume and abdominal surface electromyography were obtained during 4 h to assess the temporal relationship between activation of abdominal musculature with the onset, duration and severity of hypoxemia episodes. Results: In 15 infants, GA (mean ± SD) 25 ± 1.5 weeks, BW 697 ± 141 g, age 37 ± 14 days, synchronized intermittent mandatory ventilation rate 17 ± 6 breaths/min, peak inspiratory pressure 18 ± 1.9 cm H2O, positive end-expiratory pressure 4.8 ± 0.6 cm H2O, and fraction of inspired oxygen (FiO2) 0.4 ± 0.1 were studied. These infants presented with 7.2 ± 4.4 episodes of hypoxemia (SpO 2 <88%) per hour. The number of abdominal muscle contractions per episode correlated with the duration and severity of the episodes of hypoxemia. The episode duration increased by 14 ± 18 s per abdominal muscle contraction. The lowest SpO2 reached during an episode of hypoxemia decreased by 1.7 ± 1.4% for every abdominal muscle contraction. Conclusions: These data document a relationship between abdominal muscles contraction and the duration and severity of hypoxemia episodes in ventilated preterm infants. These findings can explain the failure of mechanical ventilation to prevent their occurrence or decrease their severity.

Original languageEnglish (US)
Pages (from-to)182-186
Number of pages5
JournalNeonatology
Volume92
Issue number3
DOIs
StatePublished - Sep 1 2007

Keywords

  • Episodes of hypoxemia
  • Forced exhalation
  • Intermittent hypoxia, hypoxia
  • Preterm infants

ASJC Scopus subject areas

  • Developmental Biology
  • Pediatrics, Perinatology, and Child Health

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