Trial reportArchives of disease in childhood. Fetal and neonatal edition2007
Cardiorespiratory effects of changes in end expiratory pressure in ventilated newborns.
Trial report in Archives of disease in childhood. Fetal and neonatal edition, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04535375 (Sonographic Quantification of Venous Circulation in the Preterm Brain), which is not on this map. Cited by 16 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Sonographic Quantification of Venous Circulation in the Preterm Brain
Who cites it
16 citing papers in PubMed, 57 citations in OpenAlex.
- Trial
- Perfusion Pressure Deficits as Early Indicators of Abdominal Compartment Syndrome After Neonatal Congenital Diaphragmatic Hernia Repair: A Retrospective Cohort Study.Life (Basel, Switzerland) · 2026Article
- Pulmonary perfusion with dynamic PEEP recruitment or sustained inflation at birth in preterm lambs.Pediatric research · 2026Article
- Hemodynamics during noninvasive ventilation in neonates.Seminars in perinatology · 2025Review
- Targeted Cerebral Oxygenation Using Dedicated Treatment Versus Usual Care in Extremely Preterm Infants: Protocol for a Multicentre International Phase II Randomised Controlled Trial.Journal of paediatrics and child health · 2025Article
- Bioreactance-derived haemodynamic parameters in the transitional phase in preterm neonates: a longitudinal study.Journal of clinical monitoring and computing · 2022Observational
- Positive end expiratory pressure and respiratory system resistance between self-inflating bag and T-piece resuscitator in a cadaveric piglet lung model.Frontiers in pediatrics · 2022Article
- Respiratory distress syndrome: influence of management on the hemodynamic status of ≤ 32-week preterm infants in the first 24 hours of life.Revista Brasileira de terapia intensiva · 2019Article
- Neonatal Hemodynamics: From Developmental Physiology to Comprehensive Monitoring.Frontiers in pediatrics · 2018Review
- Monitoring Circulation During Transition in Extreme Low Gestational Age Newborns: What's on the Horizon?Frontiers in pediatrics · 2018Review
- The Pathophysiology of Low Systemic Blood Flow in the Preterm Infant.Frontiers in pediatrics · 2018Review
- Challenges in Treating Low Blood Pressure in Preterm Infants.Children (Basel, Switzerland) · 2015Review
- Bi-level CPAP does not change central blood flow in preterm infants with respiratory distress syndrome.Italian journal of pediatrics · 2014Article
- Resuscitation intensity at birth is associated with changes in brain metabolic development in preterm neonates.Neuroradiology · 2013Article
- Article
- Support of the preterm circulation: keynote address to the Fifth Evidence vs Experience Conference, Chicago, June 2008.Journal of perinatology : official journal of the California Perinatal Association · 2009Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPositive pressure ventilation in premature infants can improve oxygenation but may diminish cerebral blood flow and cardiac output. Low superior vena cava (SVC) flow increases risk of intraventricular haemorrhage, and higher mean airway pressure is associated with low SVC flow. Whether this is a direct effect of positive pressure ventilation or a reflection of severity of lung disease is not known. This study aimed to determine if positive end expiratory pressure (PEEP) in ventilated newborns could be increased without clinically relevant cardiorespiratory changes.
methodVentilated newborns were studied before and 10 min after increasing PEEP (5 cm H(2)O to 8 cmH(2)O) and again when PEEP returned to baseline. Echocardiographic and respiratory function measurements were collected during the intervention.
resultsIn 50 infants, increased PEEP was associated with a non-significant difference in mean SVC flow of -5 ml/kg/min (95% CI -12 to 3 ml/kg/min) but a significant reduction in right ventricular output of 17 ml/kg/min (95% CI 5 to 28 ml/kg/min). The increase in lung compliance was non-significant (median difference 0.02 ml/cmH(2)O/kg) and the decrease in lung resistance (18 cmH(2)O/l/s; 95% CI 10 to 26 cm H(2)O/l/s) was significant. Changes (%) in lung compliance and SVC flow, when corrected for Paco(2), were positively associated (regression coefficient 0.4%; 95% CI 0.2% to 0.6%).
conclusionA short-term increase in PEEP does not lead to significant changes in systemic blood flow, although 36% of infants in the present study had clinically important changes in flow (+/-25%). The intervention can improve dynamic lung function, especially airway resistance. Improvements in compliance tend to be associated with improvements in blood flow.
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