The Effect of Minimally Invasive Surfactant Therapy on Diaphragmatic Activity

Cornelia G. De Waal; Gerard J. Hutten; Frans H. De Jongh; Anton H. Van Kaam

doi:10.1159/000487916

The Effect of Minimally Invasive Surfactant Therapy on Diaphragmatic Activity

Cornelia G. De Waal^*, Gerard J. Hutten, Frans H. De Jongh, Anton H. Van Kaam

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

9 Citations (Scopus)

19 Downloads (Pure)

Abstract

Background: Minimally invasive surfactant therapy (MIST) is increasingly used to treat preterm infants with respiratory distress syndrome (RDS). However, the effect of MIST on breathing effort is poorly studied. Objectives: To describe the effect of MIST on neural breathing effort assessed with transcutaneous electromyography of the diaphragm (dEMG) in preterm infants with RDS. Methods: Preterm infants with a gestational age < 37 weeks treated with MIST for RDS were included. dEMG measurements were done from 15 min before to 1 h after MIST. The percentage change in dEMG activity after MIST and the clinical response were analyzed. Results: Twenty preterm infants (mean gestational age 29.3 [SD 2.1] weeks; mean birth weight 1,230 [SD 391] g) were included. Seventeen infants did complete the 1-h measurement. Eleven (65%) infants had a decrease in their peak_dEMG activity (median change -11.8% [IQR -26.8 to 5.8, p = 0.08]) 1 h after MIST. Tonic_dEMG activity decreased in 12 (71%) infants, with a median reduction of 6.3% (IQR -29.2 to 9.0, p = 0.07). FiO₂ showed a rapid decrease following MIST (before, 0.47 [IQR 0.38-0.84]; 1 h after, 0.25 [IQR 0.21-0.30], p < 0.001). Conclusion: In addition to improved oxygenation, MIST results in a decrease in neural breathing effort measured by dEMG activity in the majority of preterm infants with RDS.

Original language	English
Pages (from-to)	76-81
Number of pages	6
Journal	Neonatology
Volume	114
Issue number	1
DOIs	https://doi.org/10.1159/000487916
Publication status	Published - 1 Jun 2018
Externally published	Yes

Keywords

Electromyography of the diaphragm
Preterm infants
Respiratory distress syndrome
Surfactant

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1159/000487916Licence: CC BY-NC-ND

effectFinal published version, 656 KBLicence: CC BY-NC-ND

Cite this

@article{27321a6c3f974645a9422cb6c1ac9462,

title = "The Effect of Minimally Invasive Surfactant Therapy on Diaphragmatic Activity",

abstract = "Background: Minimally invasive surfactant therapy (MIST) is increasingly used to treat preterm infants with respiratory distress syndrome (RDS). However, the effect of MIST on breathing effort is poorly studied. Objectives: To describe the effect of MIST on neural breathing effort assessed with transcutaneous electromyography of the diaphragm (dEMG) in preterm infants with RDS. Methods: Preterm infants with a gestational age < 37 weeks treated with MIST for RDS were included. dEMG measurements were done from 15 min before to 1 h after MIST. The percentage change in dEMG activity after MIST and the clinical response were analyzed. Results: Twenty preterm infants (mean gestational age 29.3 [SD 2.1] weeks; mean birth weight 1,230 [SD 391] g) were included. Seventeen infants did complete the 1-h measurement. Eleven (65%) infants had a decrease in their peakdEMG activity (median change -11.8% [IQR -26.8 to 5.8, p = 0.08]) 1 h after MIST. TonicdEMG activity decreased in 12 (71%) infants, with a median reduction of 6.3% (IQR -29.2 to 9.0, p = 0.07). FiO2 showed a rapid decrease following MIST (before, 0.47 [IQR 0.38-0.84]; 1 h after, 0.25 [IQR 0.21-0.30], p < 0.001). Conclusion: In addition to improved oxygenation, MIST results in a decrease in neural breathing effort measured by dEMG activity in the majority of preterm infants with RDS.",

keywords = "Electromyography of the diaphragm, Preterm infants, Respiratory distress syndrome, Surfactant",

author = "{De Waal}, {Cornelia G.} and Hutten, {Gerard J.} and {De Jongh}, {Frans H.} and {Van Kaam}, {Anton H.}",

year = "2018",

month = jun,

day = "1",

doi = "10.1159/000487916",

language = "English",

volume = "114",

pages = "76--81",

journal = "Neonatology",

issn = "1661-7800",

publisher = "Karger",

number = "1",

}

TY - JOUR

T1 - The Effect of Minimally Invasive Surfactant Therapy on Diaphragmatic Activity

AU - De Waal, Cornelia G.

AU - Hutten, Gerard J.

AU - De Jongh, Frans H.

AU - Van Kaam, Anton H.

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Background: Minimally invasive surfactant therapy (MIST) is increasingly used to treat preterm infants with respiratory distress syndrome (RDS). However, the effect of MIST on breathing effort is poorly studied. Objectives: To describe the effect of MIST on neural breathing effort assessed with transcutaneous electromyography of the diaphragm (dEMG) in preterm infants with RDS. Methods: Preterm infants with a gestational age < 37 weeks treated with MIST for RDS were included. dEMG measurements were done from 15 min before to 1 h after MIST. The percentage change in dEMG activity after MIST and the clinical response were analyzed. Results: Twenty preterm infants (mean gestational age 29.3 [SD 2.1] weeks; mean birth weight 1,230 [SD 391] g) were included. Seventeen infants did complete the 1-h measurement. Eleven (65%) infants had a decrease in their peakdEMG activity (median change -11.8% [IQR -26.8 to 5.8, p = 0.08]) 1 h after MIST. TonicdEMG activity decreased in 12 (71%) infants, with a median reduction of 6.3% (IQR -29.2 to 9.0, p = 0.07). FiO2 showed a rapid decrease following MIST (before, 0.47 [IQR 0.38-0.84]; 1 h after, 0.25 [IQR 0.21-0.30], p < 0.001). Conclusion: In addition to improved oxygenation, MIST results in a decrease in neural breathing effort measured by dEMG activity in the majority of preterm infants with RDS.

AB - Background: Minimally invasive surfactant therapy (MIST) is increasingly used to treat preterm infants with respiratory distress syndrome (RDS). However, the effect of MIST on breathing effort is poorly studied. Objectives: To describe the effect of MIST on neural breathing effort assessed with transcutaneous electromyography of the diaphragm (dEMG) in preterm infants with RDS. Methods: Preterm infants with a gestational age < 37 weeks treated with MIST for RDS were included. dEMG measurements were done from 15 min before to 1 h after MIST. The percentage change in dEMG activity after MIST and the clinical response were analyzed. Results: Twenty preterm infants (mean gestational age 29.3 [SD 2.1] weeks; mean birth weight 1,230 [SD 391] g) were included. Seventeen infants did complete the 1-h measurement. Eleven (65%) infants had a decrease in their peakdEMG activity (median change -11.8% [IQR -26.8 to 5.8, p = 0.08]) 1 h after MIST. TonicdEMG activity decreased in 12 (71%) infants, with a median reduction of 6.3% (IQR -29.2 to 9.0, p = 0.07). FiO2 showed a rapid decrease following MIST (before, 0.47 [IQR 0.38-0.84]; 1 h after, 0.25 [IQR 0.21-0.30], p < 0.001). Conclusion: In addition to improved oxygenation, MIST results in a decrease in neural breathing effort measured by dEMG activity in the majority of preterm infants with RDS.

KW - Electromyography of the diaphragm

KW - Preterm infants

KW - Respiratory distress syndrome

KW - Surfactant

UR - http://www.scopus.com/inward/record.url?scp=85046455830&partnerID=8YFLogxK

U2 - 10.1159/000487916

DO - 10.1159/000487916

M3 - Article

C2 - 29719289

AN - SCOPUS:85046455830

SN - 1661-7800

VL - 114

SP - 76

EP - 81

JO - Neonatology

JF - Neonatology

IS - 1

ER -

The Effect of Minimally Invasive Surfactant Therapy on Diaphragmatic Activity

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this