Neuro-adjusted ventilatory assist is emerging in the field of respiratory support, which uses an infant’s electrical diaphragmatic activity (Edi) to give synchronized inspiratory pressure support. However, there is a lack of information about typical neonatal Edi values. The purpose of this research was to determine appropriate Edi levels as a baseline for premature and full-term infants who are not in need of respiratory support. A group of newborn babies was observed as they breathed naturally in room air, and the results were recorded prospectively. A specialized naso/orogastric feeding tube with implanted electrodes at the level of the diaphragm was used to track the Edi waveform. Without deviating from standard clinical practice, researchers monitored Edi minimums and maximums constantly for 4 hours without deviating from standard clinical practice. The participants included 24 infants, 16 of whom were born prematurely (< 37 weeks of pregnancy) and 8 of whom were delivered full-term. During the research period, all newborns were using only room air for breathing during the research period. All infants had their edi data successfully recorded. The median Edi peak was 10.13 (±3.50) μV, whereas the median Edi minimum was 3.02 (±0.94)  μV. Edi lowest in preterm infants was 3.05 (±0.91)  μV, and Edi maximum was 9.36 (±2.13)  μV on average (±SD). The mean (±SD) Edi minimum in full-term newborns was 2.97 (±1.05)  μV, and the mean (±SD) Edi maximum was 11.66 (±5.14)  μV. Preterm and full-term neonates have respective reference Edi value sets. These values can serve as guidance when monitoring breathing assistance and applying diaphragm-triggered modalities of respiratory support to newborn infants.

Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03619-1