Effect of doxapram on the electrical activity of the diaphragm waveform pattern of preterm infants

Effect of doxapram on the electrical activity of the diaphragm waveform pattern of preterm infants
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多沙普仑对早产儿膈肌波形图电活动的影响

DOI:
10.1002/ppul.25889
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发表时间:
2022
期刊:
Pediatr Pulmonol
影响因子:
--
通讯作者:
Kawai M
Kawai M
中科院分区:
--
文献类型:
--
作者:
Araki R;Tomotaki S;Akita M;Motokura K;Tomobe Y;Shimotsuma T;Hanaoka S;Tomotaki H;Iwanaga K;Niwa F;Takita J;Kawai M

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本研究旨在评估在使用神经调节辅助通气(纳瓦)的极早产儿中给予多沙普仑后膈肌电活动(Edi)波形模式的变化。研究设计我们于2019年11月至2021年9月在我们的新生儿重症监护室进行了这项回顾性队列研究。研究参与者是胎龄28周以下的极早产儿,他们使用纳瓦通气并给予多沙普仑。我们收集了Edi波形模式的数据并计算了比例。要分析的埃迪波形模式的比例的变化,我们比较了1小时前和后doxapramadministration.Results10极早产儿的数据的比例。多沙普仑给药后,几乎所有患者的呼吸状况均得到改善。说明性参数Edi峰值、Edi最小值、吸气峰压、备用通气时间和切换到备用通气的次数没有显著变化。然而,多沙普仑给药后,阶段性模式的比例显著增加(给药前:46% vs.给药后:72%;p< 0.05),而中枢性呼吸暂停模式显著减少(给药前:31% vs.给药后:8.3%;p< 0.05)。不规则的低电压模式的比例趋于下降,虽然没有显着changes.ConclusionOur结果表明,比例的EDI波形模式改变后doxapram管理。Edi波形模式分析可能是其他呼吸疾病干预效果的敏感指标。
ObjectiveThis study aimed to evaluate the change in the waveform pattern of the electrical activity of the diaphragm (Edi) following the administration of doxapram in extremely preterm infants ventilated with neurally adjusted ventilatory assist (NAVA).Study DesignWe conducted this retrospective cohort study in our neonatal intensive care unit between November 2019 and September 2021. The study participants were extremely preterm infants under the gestational age of 28 weeks who were ventilated with NAVA and administered doxapram. We collected the data of the Edi waveform pattern and calculated the proportion. To analyze the change in the proportion of the Edi waveform pattern, we compared the proportion of the data for 1 h before and after doxapram administration.ResultsTen extremely preterm infants were included. Almost all the patients’ respiratory condition improved after doxapram administration. The ventilatory parameters—Edi peak, Edi minimum, peak inspiratory pressure, time in backup ventilation, and number of switches to backup ventilation—did not change significantly. However, the proportion of phasic pattern significantly increased (before: 46% vs. after: 72%;p< 0.05), whereas the central apnea pattern significantly decreased after doxapram administration (before: 31% vs. after: 8.3%;p< 0.05). The proportion of irregular low‐voltage patterns tended to decrease, albeit with no significant changes.ConclusionOur results indicated that the proportion of Edi waveform patterns changed following doxapram administration. Edi waveform pattern analysis could be a sensitive indicator of effect with other intervention for respiratory conditions.
DOI: 10.1016/j.jpeds.2011.10.014
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