Laryngeal closure impedes non-invasive ventilation at birth
| العنوان: | Laryngeal closure impedes non-invasive ventilation at birth |
|---|---|
| المؤلفون: | Katie Lee, Megan J. Wallace, Andreas W. Flemmer, Lauren T. Kerr, Stuart B. Hooper, Genevieve Buckley, Marcus J. Kitchen, Marta Thio, Jessica R. Crawshaw, Peter G Davis, CC Roehr, Arjan B. te Pas, Corinna Binder-Heschl |
| المصدر: | Archives of Disease in Childhood. Fetal and Neonatal Edition Archives of disease in childhood. Fetal and neonatal edition, 103(2), F112-F119 |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Larynx, medicine.medical_specialty, Epiglottis, Glottis, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, medicine, Animals, 030212 general & internal medicine, Respiratory system, Lung, larynx, Noninvasive Ventilation, business.industry, Obstetrics and Gynecology, General Medicine, Airway obstruction, medicine.disease, apnoea, Surgery, medicine.anatomical_structure, Animals, Newborn, preterm newborn, Anesthesia, Pediatrics, Perinatology and Child Health, Breathing, Non-invasive ventilation, Original Article, Rabbits, business, Neonatal resuscitation |
| الوصف: | BackgroundNon-invasive ventilation is sometimes unable to provide the respiratory needs of very premature infants in the delivery room. While airway obstruction is thought to be the main problem, the site of obstruction is unknown. We investigated whether closure of the larynx and epiglottis is a major site of airway obstruction.MethodsWe used phase contrast X-ray imaging to visualise laryngeal function in spontaneously breathing premature rabbits immediately after birth and at approximately 1 hour after birth. Non-invasive respiratory support was applied via a facemask and images were analysed to determine the percentage of the time the glottis and the epiglottis were open.HypothesisImmediately after birth, the larynx is predominantly closed, only opening briefly during a breath, making non-invasive intermittent positive pressure ventilation (iPPV) ineffective, whereas after lung aeration, the larynx is predominantly open allowing non-invasive iPPV to ventilate the lung.ResultsThe larynx and epiglottis were predominantly closed (open 25.5%±1.1% and 17.1%±1.6% of the time, respectively) in pups with unaerated lungs and unstable breathing patterns immediately after birth. In contrast, the larynx and the epiglottis were mostly open (90.5%±1.9% and 72.3%±2.3% of the time, respectively) in pups with aerated lungs and stable breathing patterns irrespective of time after birth.ConclusionLaryngeal closure impedes non-invasive iPPV at birth and may reduce the effectiveness of non-invasive respiratory support in premature infants immediately after birth. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d65828585ea8eec6d0fbd9c492689ada https://hdl.handle.net/1887/76145 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....d65828585ea8eec6d0fbd9c492689ada |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |