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dc.contributor.authorCrawshaw, JR
dc.contributor.authorKitchen, MJ
dc.contributor.authorBinder-Heschl, C
dc.contributor.authorThio, M
dc.contributor.authorWallace, MJ
dc.contributor.authorKerr, LT
dc.contributor.authorRoehr, CC
dc.contributor.authorLee, KL
dc.contributor.authorBuckley, GA
dc.contributor.authorDavis, PG
dc.contributor.authorFlemmer, A
dc.contributor.authorte Pas, AB
dc.contributor.authorHooper, SB
dc.date.accessioned2020-12-21T03:31:57Z
dc.date.available2020-12-21T03:31:57Z
dc.date.issued2018-03-01
dc.identifierpii: archdischild-2017-312681
dc.identifier.citationCrawshaw, J. R., Kitchen, M. J., Binder-Heschl, C., Thio, M., Wallace, M. J., Kerr, L. T., Roehr, C. C., Lee, K. L., Buckley, G. A., Davis, P. G., Flemmer, A., te Pas, A. B. & Hooper, S. B. (2018). Laryngeal closure impedes non-invasive ventilation at birth. ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION, 103 (2), pp.F112-F119. https://doi.org/10.1136/archdischild-2017-312681.
dc.identifier.issn1359-2998
dc.identifier.urihttp://hdl.handle.net/11343/257245
dc.description.abstractBACKGROUND: Non-invasive ventilation is sometimes unable to provide the respiratory needs of very premature infants in the delivery room. While airway obstruction is thought to be the main problem, the site of obstruction is unknown. We investigated whether closure of the larynx and epiglottis is a major site of airway obstruction. METHODS: We used phase contrast X-ray imaging to visualise laryngeal function in spontaneously breathing premature rabbits immediately after birth and at approximately 1 hour after birth. Non-invasive respiratory support was applied via a facemask and images were analysed to determine the percentage of the time the glottis and the epiglottis were open. HYPOTHESIS: Immediately after birth, the larynx is predominantly closed, only opening briefly during a breath, making non-invasive intermittent positive pressure ventilation (iPPV) ineffective, whereas after lung aeration, the larynx is predominantly open allowing non-invasive iPPV to ventilate the lung. RESULTS: The larynx and epiglottis were predominantly closed (open 25.5%±1.1% and 17.1%±1.6% of the time, respectively) in pups with unaerated lungs and unstable breathing patterns immediately after birth. In contrast, the larynx and the epiglottis were mostly open (90.5%±1.9% and 72.3%±2.3% of the time, respectively) in pups with aerated lungs and stable breathing patterns irrespective of time after birth. CONCLUSION: Laryngeal closure impedes non-invasive iPPV at birth and may reduce the effectiveness of non-invasive respiratory support in premature infants immediately after birth.
dc.languageEnglish
dc.publisherBMJ PUBLISHING GROUP
dc.titleLaryngeal closure impedes non-invasive ventilation at birth
dc.typeJournal Article
dc.identifier.doi10.1136/archdischild-2017-312681
melbourne.affiliation.departmentObstetrics and Gynaecology
melbourne.source.titleArchives of Disease in Childhood: Fetal and Neonatal Edition
melbourne.source.volume103
melbourne.source.issue2
melbourne.source.pagesF112-F119
dc.rights.licenseCC BY-NC
melbourne.elementsid1269467
melbourne.contributor.authorDavis, Peter
melbourne.contributor.authorThio, Marta
dc.identifier.eissn1468-2052
melbourne.accessrightsOpen Access


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