Grant: Banting Postdoctoral Fellowship Program

Establishing breathing immediately after birth is vital for the survival and long-term health of newborn babies. Most premature babies have difficulty in 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 which is used all round the world. During resuscitation the clinician predicts the volume she/he wants to apply for any inflation (tidal volume). She/he also has to recognize leaks around the facemask and adjust the mask position if a leak appears. A Respiratory Function Monitor can measure both the tidal volume and the amount of exhaled carbon dioxide (CO2). CO2 is produced in the body tissues, transported in blood to the lung and eliminated from the lung during exhalation. Thus, CO2 can be detected in exhaled gas. During breathing assistance a Respiratory Function Monitor can identify if there is a leak around the facemask, the volume delivered with each inflation and the amount of CO2 exhaled. A Respiratory Function Monitor is routinely used in the hospital intensive care nursery to guide ventilation. We believe that in the Delivery Room measuring the tidal volume and the exhaled CO2 in infants needing breathing assistance immediately after birth will provide clinicians with important information about the infant's breathing and how much the clinician needs to help the breathing of these infants. Aims: 1) describe how much CO2 babies exhale immediately after birth; 2) identify correlations between exhaled CO2 and tidal volume during breathing assistance; and 3) identify associations between exhaled CO2, tidal volume and cardiac output immediately after birth. Expected outcomes: Information about correlations between exhaled CO2, tidal volume and cardiac output, which may offer a potential non-invasive delivery room measurement of lung-heart function to improve breathing assistance in the immediate newborn period.