Performance and safety of volume guarantee ventilation in neonates using the fabian ventilator, a multicenter study.

Objective: To evaluate the performance (i.e., agreement between set and measured parameters) and safety (adverse events, device malfunctions, and ventilator alarms) of the fabian HFOi neonatal ventilator in volume guaranteed (VG) mode during conventional ventilation.

Performance and safety of the PRICO closed-loop oxygen saturation targeting system in neonates: pragmatic multicentre cross-over study (TarOx Study).

Objective: This study aims to evaluate the performance of the fabian-Predictive-Intelligent-Control-of-Oxygenation (PRICO) system for automated control of the fraction of inspired oxygen (FiO).

Design: Multicentre randomised cross-over study.

Setting: Five neonatal intensive care units experienced with automated control of FiO and the fabian ventilator.

Transcutaneous electromyography as a tool to assess recovery of hemidiaphragmatic paresis: A case report.

In this case report, we describe two repeated transcutaneous electromyography of the diaphragm (dEMG) measurements in an infant with suspected paresis of the right hemidiaphragm after cardiac surgery. The first measurement, performed at the time of diagnosis, showed a lower electrical activity of the right side of the diaphragm in comparison with the left side. The second measurement, performed after a period of expectative management, showed that electrical activity of the affected side had increased and was similar to the activity of the left diaphragm.

Prolonged use of closed-loop inspired oxygen support in preterm infants: a randomised controlled trial.

Objective: This randomised study in preterm infants on non-invasive respiratory support investigated the effectiveness of automated oxygen control (A-FiO) in keeping the oxygen saturation (SpO) within a target range (TR) during a 28-day period compared with manual titration (M-FiO).

Design: A single-centre randomised control trial.

Setting: A level III neonatal intensive care unit.

Cardiorespiratory monitoring with a wireless and nonadhesive belt measuring diaphragm activity in preterm and term infants: A multicenter non-inferiority study.

Introduction: We determined if the heart rate (HR) monitoring performance of a wireless and nonadhesive belt is non-inferior compared to standard electrocardiography (ECG). Secondary objective was to explore the belt's respiratory rate (RR) monitoring performance compared to chest impedance (CI).

Method: In this multicenter non-inferiority trial, preterm and term infants were simultaneously monitored with the belt and conventional ECG/CI for 24 h.

Diaphragmatic electromyography in infants: an overview of possible clinical applications.

Preterm infants often experience breathing instability and a hampered lung function. Therefore, these infants receive cardiorespiratory monitoring and respiratory support. However, the current respiratory monitoring technique may be unreliable for especially obstructive apnea detection and classification and it does not provide insight in breathing effort.

Influence of neonatal endotracheal tube dimensions on oscillometry-acquired reactance: a bench study.

To examine the influence of the endotracheal tube (ETT) on respiratory reactance (X) measured with the forced oscillation technique (FOT) and develop a correction method for it.In a bench study, the reactance of ETTs (X) with different dimensions was measured on a breathing test lung in various respiratory settings.Xcan be accurately predicted by a fitted formula, with an Rof 0.

Multicentre paired non-inferiority study of the cardiorespiratory monitoring performance of the wireless and non-adhesive Bambi® belt measuring diaphragm activity in neonates: study protocol.

Introduction: Cardiorespiratory monitoring is used in the neonatal intensive care unit (NICU) to assess the clinical status of newborn infants and detect critical deteriorations in cardiorespiratory function. Currently, heart rate (HR) is monitored by electrocardiography (ECG) and respiration by chest impedance (CI). Disadvantages of current monitoring techniques are usage of wired adhesive electrodes which may damage the skin and hinder care.

Simultaneous measurement of diaphragm activity, chest impedance, and ECG using three standard cardiorespiratory monitoring electrodes.

Introduction: Current cardiorespiratory monitoring in neonates with electrocardiogram (ECG) and chest impedance (CI) has limitations. Adding transcutaneous electromyography of the diaphragm (dEMG) may improve respiratory monitoring, but requires additional hardware. We aimed to determine the feasibility of measuring dEMG and ECG/CI simultaneously using the standard ECG/CI hardware, with its three electrodes repositioned to dEMG electrode locations.

Feasibility of wireless cardiorespiratory monitoring with dry electrodes incorporated in a belt in preterm infants.

Monitoring heart rate (HR) and respiratory rate (RR) is essential in preterm infants and is currently measured with ECG and chest impedance (CI), respectively. However, in current clinical practice these techniques use wired adhesive electrodes which can cause skin damage and hinder parent-infant interaction. Moreover, CI is not always reliable.

Prolonged Continuous Monitoring of Regional Lung Function in Infants with Respiratory Failure.

Electrical impedance tomography (EIT) allows instantaneous and continuous visualization of regional ventilation and changes in end-expiratory lung volume at the bedside. There is particular interest in using EIT for monitoring in critically ill neonates and young children with respiratory failure. Previous studies have focused only on short-term monitoring in small populations.

Diaphragm Activity Pre and Post Extubation in Ventilated Critically Ill Infants and Children Measured With Transcutaneous Electromyography.

Objectives: Swift extubation is important to prevent detrimental effects of invasive mechanical ventilation but carries the risk of extubation failure. Accurate tools to assess extubation readiness are lacking. This study aimed to describe the effect of extubation on diaphragm activity in ventilated infants and children.

Transcutaneous monitoring of diaphragm activity as a measure of work of breathing in preterm infants.

Objective: Monitoring work of breathing (WOB) is important to assess the pulmonary condition and adjust respiratory support in preterm infants. Conventional WOB measurement (esophageal pressure, tidal volume) is invasive and we hypothesized that monitoring diaphragm activity could be a noninvasive alternative to estimate WOB. The objective was to determine the correlation between conventional WOB measures and diaphragm activity, in preterm infants.

Cardiorespiratory monitoring in the delivery room using transcutaneous electromyography.

Objective: To assess feasibility of transcutaneous electromyography of the diaphragm (dEMG) as a monitoring tool for vital signs and diaphragm activity in the delivery room (DR).

Design: Prospective observational study.

Setting: Delivery room.

The Effect of Initial High vs. Low FiO on Breathing Effort in Preterm Infants at Birth: A Randomized Controlled Trial.

Infants are currently stabilized at birth with initial low FiO which increases the risk of hypoxia and suppression of breathing in the first minutes after birth. We hypothesized that initiating stabilization at birth with a high O concentration, followed by titration, would improve breathing effort when compared to a low O concentration, followed by titration. In a bi-center randomized controlled trial, infants <30 weeks gestation were stabilized at birth with an initial O concentration of 30 or 100%, followed by oxygen titration.

Diaphragmatic electromyography in preterm infants: The influence of electrode positioning.

Objective: To determine the effect of changing electrode positions on vital signs and respiratory effort parameters measured with transcutaneous electromyography of the diaphragm (dEMG) in preterm infants.

Methods: In this observational study, simultaneous dEMG measurements were performed at the standard position and at one alternative electrode position (randomly assigned to lateral, superior, medial, inferior to the standard placement, or dorsal). The activity of the diaphragm was measured for 1 hour at both positions.

Processing transcutaneous electromyography measurements of respiratory muscles, a review of analysis techniques.

Transcutaneous electromyography (tc-EMG) has been used to measure the electrical activity of respiratory muscles during inspiration in various studies. Processing the raw tc-EMG signal of these inspiratory muscles has shown to be difficult as baseline noise, cardiac interference, cross-talk and motion artefacts can influence the signal quality. In this review we will discuss the most important sources of signal noise in tc-EMG of respiratory muscles and the various techniques described to suppress or reduce this signal noise.

Patient-ventilator asynchrony in preterm infants on nasal intermittent positive pressure ventilation.

Objective: To describe the incidence of patient-ventilator asynchrony and different types of asynchrony in preterm infants treated with non-synchronised nasal intermittent positive pressure ventilation (nIPPV).

Design: An observational study was conducted including preterm infants born with a gestational age (GA) less than 32 weeks treated with non-synchronised nIPPV. During 1 hour, spontaneous breathing was measured with transcutaneous electromyography of the diaphragm simultaneous with ventilator inflations.

The Mozart study: a relation between dynamic hyperinflation and physical activity in patients with chronic obstructive pulmonary disease?

Background: Many patients with chronic obstructive pulmonary disease (COPD) experience dyspnoea during exercise, resulting in a reduction of physical activity (PA). Dynamic hyperinflation (DH) is seen as a major cause of dyspnoea in COPD.

Objective: The objective of the current study was to investigate the relationship between DH, in terms of the amount of DH and the development and recovery rate of DH in patients with COPD, and PA.