The effect of a face mask for respiratory support on breathing in preterm infants at birth

• Published in: Resuscitation 2019-11, Vol.144, p.178-184
• Main Authors: Kuypers, Kristel L.A.M., Lamberska, Tereza, Martherus, Tessa, Dekker, Janneke, Böhringer, Stefan, Hooper, Stuart B., Plavka, Richard, te Pas, Arjan B.
• Format: Article
• Language: English
• Subjects: Breathing; Face mask; Preterm infants; Respiratory support; Trigeminocardiac reflex
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/j.resuscitation.2019.08.043

Applying a mask on the face for respiratory support could induce a trigeminocardiac reflex leading to apnoea and bradycardia. We have examined the effect of applying a face mask on breathing and heart rate in preterm infants at birth. Resuscitation videos of infants ≤ 32 weeks gestation recorded from 2010 until 2018 at the Leiden University Medical Centre and the General University Hospital in Prague were reviewed. All infants received respiratory support via face mask. Breathing and heart rate were noted before and after application of the face mask and over the first 5 min. Recordings of 429 infants were included (median (IQR) gestational age of 28+6 (27+1-30+4) weeks). In 368/429 (86%) infants breathing was observed before application of the face mask and 197/368 (54%) of these infants stopped breathing following application of the face mask. Apnoea occurred at a median of 5 (3–17) seconds after application of the face mask with a duration of 28 (22–34) seconds of the first minute. In a logistic regression model, the occurrence of apnoea after face mask application was inversely associated with gestational age (OR = 1.424 (1.281–1.583), p