Grant: CIHR Fellowship

Most premature babies have difficulty breathing at birth and need help (resuscitation). The treatment for this is to gently inflate their lungs with a resuscitation device and a facemask. The device commonly used is the T-piece Resuscitator and is used all round the world. During resuscitation the clinician predicts the volume she/he wants to apply with any inflation (which we call tidal volume) and has to recognize leaks around the facemask and adjust the mask position if a leak appears. A Respiratory Function Monitor can measure tidal volume and exhaled carbon dioxide (what we call CO2). CO2 is produced in the tissue, transported in blood to the lung and eliminated from the lung during expiration. This makes it possible to be detected in expired gas. During breathing assistance a Respiratory Function Monitor can identify if there is a leak around a facemask, the volume delivered with each inflation and the amount of CO2 exhaled. A Respiratory Function Monitor is routinely used in the intensive care nursery to improve ventilation. We believe that measuring the tidal volume and the exhaled CO2 will provide clinicians with important information about an infants breathing and how much clinicians need to help the breathing of those infants. The aim of this project is to obtain i) data to describe how much CO2 infants exhale; ii) identify a correlation between exhaled CO2 and expired tidal volume during breathing assistance in newborn infants; and iii) identify an association between exhaled CO2 and cardiac output during neonatal transition. Expected outcomes: More information about the correlation between exhaled CO2 in relation to expired tidal volume and cardiac output might offer a potential non-invasive measurement of lung aeration which might help to improve respiratory management in the immediate newborn period.