Detection of respiratory activity in newborn infants using a noncontact vision-based monitor.

Objective: To examine the effectiveness of a noncontact vision-based infrared respiratory monitor (IRM) in the detection of authentic respiratory motion in newborn infants.

Study Design: Observational study in a neonatal intensive care unit.

Methods: Eligible infants lay supine with torso exposed under the IRM's infrared depth-map camera and torso images were recorded at 30 frames/s.

Surfactant therapy via thin catheter in preterm infants with or at risk of respiratory distress syndrome.

Background: Non-invasive respiratory support is increasingly used for the management of respiratory dysfunction in preterm infants. This approach runs the risk of under-treating those with respiratory distress syndrome (RDS), for whom surfactant administration is of paramount importance. Several techniques of minimally invasive surfactant therapy have been described.

Volume-targeted versus pressure-limited ventilation in neonates.

Background: Damage caused by lung overdistension (volutrauma) has been implicated in the development of bronchopulmonary dysplasia (BPD). Modern neonatal ventilation modes can target a set tidal volume as an alternative to traditional pressure-limited ventilation (PLV) using a fixed inflation pressure. Volume-targeted ventilation (VTV) aims to produce a more stable tidal volume in order to reduce lung damage and stabilise the partial pressure of carbon dioxide (pCO).

Development and preclinical testing of an adaptive algorithm for automated control of inspired oxygen in the preterm infant.

Objective: To assess the performance of a novel algorithm for automated oxygen control using a simulation of oxygenation founded on in vivo data from preterm infants.

Methods: A proportional-integral-derivative (PID) control algorithm was enhanced by (i) compensation for the non-linear SpO-PaO relationship, (ii) adaptation to the severity of lung dysfunction and (iii) error attenuation within the target range. Algorithm function with and without enhancements was evaluated by iterative linking with a computerised simulation of oxygenation.

Clinical evaluation of a novel adaptive algorithm for automated control of oxygen therapy in preterm infants on non-invasive respiratory support.

Objective: To evaluate the performance of a novel rapidly responsive proportional-integral-derivative (PID) algorithm for automated oxygen control in preterm infants with respiratory insufficiency.

Design: Interventional study of a 4-hour period of automated oxygen control compared with combined data from two flanking periods of manual control (4 hours each).

Setting: Neonatal intensive care unit.

Characterisation of the Oxygenation Response to Inspired Oxygen Adjustments in Preterm Infants.

Background: Oxygen saturation (SpO2) targeting in the preterm infant may be improved with a better understanding of the SpO2 responses to changes in inspired oxygen (FiO2).

Objective: We investigated the first-order FiO2-SpO2 relationship, aiming to quantify the parameters governing that relationship, the influences on these parameters and their variability.

Methods: In recordings of FiO2 and SpO2 from preterm infants on continuous positive airway pressure and supplemental oxygen, we identified unique FiO2 adjustments and mapped the subsequent SpO2 responses.

Lost without trace: oximetry signal dropout in preterm infants.

Oxygen saturation (SpO2) signal dropout leaves caregivers without a reliable measure to guide oxygen therapy. We studied SpO2 dropout in preterm infants on continuous positive airway pressure, noting the SpO2 values at signal loss and recovery and thus the resultant change in SpO2, and the factors influencing this parameter. In 32 infants of median gestation 26 weeks, a total of 3932 SpO2 dropout episodes were identified (1.

Ventilation/perfusion mismatch during lung aeration at birth.

At birth, the transition to newborn life is triggered by lung aeration, which stimulates a large increase in pulmonary blood flow (PBF). Current theories predict that the increase in PBF is spatially related to ventilated lung regions as they aerate after birth. Using simultaneous phase-contrast X-ray imaging and angiography we investigated the spatial relationships between lung aeration and the increase in PBF after birth.

Oxygen saturation targeting in preterm infants receiving continuous positive airway pressure.

Objective: The precision of oxygen saturation (SpO2) targeting in preterm infants on continuous positive airway pressure (CPAP) is incompletely characterized. We therefore evaluated SpO2 targeting in infants solely receiving CPAP, aiming to describe their SpO2 profile, to document the frequency of prolonged hyperoxia and hypoxia episodes and of fraction of inspired oxygen (FiO2) adjustments, and to explore the relationships with neonatal intensive care unit operational factors.

Study Design: Preterm infants <37 weeks' gestation in 2 neonatal intensive care units were studied if they were receiving CPAP and in supplemental oxygen at the beginning of each 24-hour recording.

Volume-targeted versus pressure-limited ventilation for preterm infants: a systematic review and meta-analysis.

Background: The causes of bronchopulmonary dysplasia (BPD) are multifactorial. Overdistension of the lung (volutrauma) is considered an important contribution. As an alternative to traditional pressure-limited ventilation (PLV), modern neonatal ventilators offer modes which can target a set tidal volume.

Comparison of two ventilator circuits for Dräger Babylog high-frequency ventilation.

Aim: The Dräger Babylog 8000plus ventilator (Dräger Medical Systems, Lübeck, Germany) can provide both conventional and high-frequency ventilation (HFV). Dräger recommends specific circuits for each of these modes. We investigated the performance of the Babylog ventilator in HFV mode when used with the recommended circuits for both conventional and HFV.

An international survey of volume-targeted neonatal ventilation.

Objective: To evaluate clinical practice of volume-targeted ventilation (VTV).

Design: Internet-based survey of all 50 tertiary neonatal units in Australia, New Zealand, Sweden, Denmark, Finland and Norway.

Results: Response rate was 100%.