Expired CO2 Levels Indicate Degree of Lung Aeration at Birth
Permanent link
https://hdl.handle.net/10037/6007Date
2013Type
Journal articleTidsskriftartikkel
Peer reviewed
Author
Hooper, Stuart B.; Fouras, Andreas; Siew, Melissa; Wallace, Megan; Kitchen, Marcus; te Pas, Arjan B; Klingenberg, Claus; Lewis, Robert; Davis, Peter; Morley, Colin J.; Schmölzer, Georg M.Abstract
As neonatal resuscitation critically depends upon lung aeration at birth, knowledge of the progression of this process is
required to guide ongoing care. We investigated whether expired CO2 (ECO2) levels indicate the degree of lung aeration
immediately after birth in two animal models and in preterm infants. Lambs were delivered by caesarean section and
ventilated from birth. In lambs, ECO2 levels were significantly (p,0.0001) related to tidal volumes and CO2 clearance/breath
increased exponentially when tidal volumes were greater than 6 mL/kg. Preterm (28 days of gestation; term = 32 days)
rabbits were also delivered by caesarean section and lung aeration was measured using phase contrast X-ray imaging. In
rabbit kittens, ECO2 levels were closely related (p,0.001) to lung volumes at end-inflation and were first detected when
,7% of the distal lung regions were aerated. ECO2 levels in preterm infants at birth also correlated with tidal volumes. In
each infant, ECO2 levels increased to .10 mmHg 28 (median) (21–36) seconds before the heart rate increased above 100
beats per minute. These data demonstrate that ECO2 levels can indicate the relative degree of lung aeration after birth and
can be used to clinically assess ventilation in the immediate newborn period.
Publisher
Public Library of Science (PLoS)Citation
PLoS ONE 8(2013) nr. 8 s. e70895-Metadata
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