Abstract
The response of aortic blood pressure (BP) to the initiation of CPAP was studied in 8 prematures with birth weights 0.8-1.95 kg and gestational ages 28-33 weeks. CPAP (2.5-6.5 cm water) was started within the first 4 hours of life for the treatment of severe HMD. Instantaneous heart rate, aortic BP, respirations and rectal and toe temperatures were recorded continuously. Readings were obtained prior to and at 2 min. intervals for 20 min. during CPAP. Arterial blood gases were obtained before and while on CPAP. Using paired t test each variable was compared before CPAP and at 10 and 20 min. intervals after the onset of CPAP. The only significant change was a sustained elevation of systolic and diastolic BP after 10 and 20 min. (p<0.05) without a significant change in baseline heart rate. Five of 7 infants showed no change or an increase in toe temperature during this period suggesting that peripheral vasoconstriction was not responsible for the rise in BP. The increase in BP therefore should be the result of an increase in stroke volume, and with no change in heart rate should result in an increased cardiac, output. The absence of change in heart rate in response to the increase in BP differs from the baroreceptor reflex described in normal preterm infants. This sustained increase in BP with initiation of CPAP appears to be a reflex not previously identified in the distressed preterm infant.
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Waffarn, F., Cabal, L. & Hodgman, J. SYSTEMIC BLOOD PRESSURE RESPONSE TO CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) IN INFANTS WITH HYALINE MEMBRANE DISEASE (HMD). Pediatr Res 11, 581 (1977). https://doi.org/10.1203/00006450-197704000-01265
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DOI: https://doi.org/10.1203/00006450-197704000-01265