<\/figure>\n\n\n\nLastly, there was an inverse correlation seen between gestational age and likelihood of apnea after facemask application of 1.424 (1.281 – 1.583 95% CI)<\/p>\n\n\n\n
What are the implications here?<\/h2>\n\n\n\n The TCR appears to happen in preterm infants when you apply a mask to support respiration more commonly than at term and the risk increases as GA decreases. This is not a good combination as it means that those that are at increasing risk of lung injury from positive pressure ventilation may be at higher risk of going apneic soley from placement of a mask over the mouth and nose. Yet this has been a staple of neonatal resuscitation for as long as I and I suspect almost anyone can remember.<\/p>\n\n\n\n
What I think this really begs for is a follow-up study on the use of nasal prongs placed in the nares to provide CPAP right after delivery. This approach is what we in our centre strive to do anyway but there are many centres I suspect that still employ the mask and bag to provide CPAP either through a PEEP valve or manually compressing the exit flow end of the anaesthesia bag. If compression of the tissues around the mouth and nose could be averted, could the TCR be avoided as well with the use of prongs in this fashion. If a patient goes apneic after a mask is placed over the mouth and nose and then goes on to require PPV with provision of large tidal volumes to a 26 week infants lungs the damage is likely done and the die cast that this infant will develop enough lung injury to potentially be labelled as having BPD down the road.<\/p>\n\n\n\n
I would like to thank the authors again for picking up on research that is over 35 years old and sparking new life into this area of Neonatology!<\/p>\n","protected":false},"excerpt":{"rendered":"
Let me start off by giving thanks to John Minski for this article and in fact for many others that have been reviewed on this blog. John is a registered respiratory therapist in Winnipeg with a passion for respiratory care like no other. John frequently sends articles my way to think about for our unit […]<\/p>\n","protected":false},"author":2,"featured_media":6498,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"off","_et_pb_old_content":"","_et_gb_content_width":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[119],"tags":[83,252],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/allthingsneonatal.com\/wp-content\/uploads\/2020\/09\/images-1.jpg","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p91QDZ-1GJ","jetpack_likes_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/allthingsneonatal.com\/wp-json\/wp\/v2\/posts\/6493"}],"collection":[{"href":"https:\/\/allthingsneonatal.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/allthingsneonatal.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/allthingsneonatal.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/allthingsneonatal.com\/wp-json\/wp\/v2\/comments?post=6493"}],"version-history":[{"count":2,"href":"https:\/\/allthingsneonatal.com\/wp-json\/wp\/v2\/posts\/6493\/revisions"}],"predecessor-version":[{"id":6527,"href":"https:\/\/allthingsneonatal.com\/wp-json\/wp\/v2\/posts\/6493\/revisions\/6527"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/allthingsneonatal.com\/wp-json\/wp\/v2\/media\/6498"}],"wp:attachment":[{"href":"https:\/\/allthingsneonatal.com\/wp-json\/wp\/v2\/media?parent=6493"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/allthingsneonatal.com\/wp-json\/wp\/v2\/categories?post=6493"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/allthingsneonatal.com\/wp-json\/wp\/v2\/tags?post=6493"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}