Am J Perinatol 2008; 25(2): 105-109
DOI: 10.1055/s-2008-1040341
© Thieme Medical Publishers

Nasal Continuous Positive Airway Pressure (n-CPAP) Does Not Change Cardiac Output in Preterm Infants

Barbara Moritz1 , Michael Fritz1 , Christian Mann1 , Burkhard Simma1
  • 1Department of Pediatrics, Feldkirch Academic Teaching Hospital, Feldkirch, Austria
Further Information

Publication History

Publication Date:
31 January 2008 (online)

ABSTRACT

Our objective was to study how invasive mechanical ventilation impairs cardiac output (CO) in children and adults. Although the application of continuous positive airway pressure (CPAP) is widely practiced in neonatal intensive care, its hemodynamic consequences have not yet been investigated. A prospective study to assess the hemodynamic effects was conducted in 21 preterm infants < 1500 g using two-dimensional M-mode and pulsed Doppler echocardiography during and 1 hour after discontinuation of nasal CPAP (n-CPAP). Gestational age was 28.0 ± 1.9 weeks (mean ± standard deviation); birthweight, 1000 ± 238 g; age at study entry, 200 ± 155 hours; total maintenance fluid, 154 ± 42 mL/kg/day; and n-CPAP level, 4.4 ± 0.9 cm H2O. None of the infants received inotropic support, and n-CPAP did not cause any significant difference in the parameters measured: stroke volume, 3.1 ± 1.0 mL (with n-CPAP) versus 3.1 ± 1.0 mL (without n-CPAP); cardiac output, 487 ± 156 mL/minute versus 500 ± 176 mL/minute; left ventricular diastolic diameter, 1.22 ± 0.15 cm versus 1.24 ± 0.14 cm; fractional shortening, 0.30 ± 0.05% versus 0.29 ± 0.04%; and aortic velocity-time integral, 8.64 ± 1.80 cm versus 8.70 ± 1.65 cm. The n-CPAP level did not influence CO; n-CPAP (up to 7 cm H2O) has no echocardiographically detectable hemodynamic effect in preterm infants. Our data imply there is no need to withhold n-CPAP support to prevent circulatory compromise in these infants.

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Barbara Moritz

Department of Pediatrics, Feldkirch Academic Teaching Hospital

Carinagasse 47, A-6800 Feldkirch, Austria