Affiliations: Pediatric Cardiology Unit, Department of Pediatrics,
Centre Hospitalier Universitaire Vaudois and University of Lausanne,
Switzerland | Division of Neonatology, Department of Pediatrics,
Centre Hospitalier Universitaire Vaudois and University of Lausanne,
Switzerland
Note: [] Corresponding author: Dr. S. Di Bernardo, Pediatric Cardiology
Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois and
University of Lausanne, Switzerland. Tel.: +41 21 314 36 89; Fax: +41 21 314 36
65; E-mail: Stefano.Di-Bernardo@chuv.ch
Abstract: Objective: Respiratory assistance with nasal continuous positive
airway pressure (n-CPAP) is an effective treatment in premature newborns
presenting respiratory distress. The aim of the study was to depict cardiac
function, systemic (Qs) and pulmonary output (Qp) by echocardiography in stable
premature infants requiring prolonged n-CPAP. Our hypothesis was that n-CPAP
could reduce pulmonary blood flow. Patients and methods: All premature
infants < 32 weeks gestation, > 7 days-old, requiring n-CPAP without
severe respiratory compromise nor need for additional oxygen were prospectively
included. Every patient had a first echocardiography while on n-CPAP. N-CPAP
was then discontinued for two hours and a second echocardiography was
performed. Results: 17 premature infants were included. Mean gestational
age was 28 ± 2 weeks and mean weight 1.1 ± 0.3 kg. Following
retrieval of n-CPAP we observed an increase in Qp of 53 ml/kg/min (95% CI
19–87 ml/kg/min), but no significant change in Qs. Consecutively a significant
increase in Qp/Qs ratio of 16% was found (95% CI 7–29%). Conclusions: Nasal continuous positive airway pressure has hemodynamic effects
in preterm infants in stable pulmonary and cardiac conditions. It reduces
pulmonary output without interference with systemic output.
