The researchers aimed to measure tidal volumes in (near) term newborns while they were being stabilized in the delivery room. A secondary analysis of a randomized controlled trial evaluating 2 types of face masks for use with positive pressure ventilation (PPV) in infants delivered at or more than or equal to 34 weeks of gestation. For PPV, a T-piece was used to provide 30 cmH2O of Personal Injury Protection (PIP) and 5 cmH2O of positive end-expiratory airway pressure (PEEP) to the airway at the end of the expiratory phase. A respiratory function monitor was used to calculate expired tidal volumes (Vt). About 4 to 8 milliliters per kilogram (ml/kg) was set as the goal Vt range. The median and interquartile range (IQR) Vt for the 23 newborns was 4.6 (3.3-6.2) ml/kg, and their median (IQR) gestational ages were 38.1 (36.4-39.0) weeks. Only 12 of the infants (52%) had a median Vt within the desirable range, while 9 (39%) fell short and 2 (9%) were excessive. Over the course of PPV, 36 (25-27%) of inflations fell within the intended range, while 42 (25-65%) and 10 (3-33%), respectively, did not. There was a large range in the expiratory tidal volume administered to full-term and late preterm infants. Normal pressures and clinical indications alone may not be enough to ensure proper breathing during childbirth.

Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03600-y