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The effect of changing respiratory rate settings on CO2 levels during nasal intermittent positive pressure ventilation (NIPPV) in premature infants

Journal of Perinatology volume 43, pages 305–310 (2023)Cite this article

Subjects

Abstract

Objective

To examine the change in CO2, when applying NIPPV with either a low or a high rate in stable premature infants.

Study design

Prospective, controlled, crossover study. Preterm infants on NIPPV were monitored by tcCO2 during two rate changes switching every hour between high (30 bpm) and low (10 bpm) set rates.

Results

Fifty premature infants (mean ± SD: 28.3 ± 2.4 weeks’ gestation) were enrolled. Each infant had two rate changes; therefore, a hundred rate changes were studied. The mean change in tcCO2, i.e., ΔtcCO2 (95% confidence-interval), was −1.1 (−2.3 to 0.1) mmHg for increasing rate from low to high, and 0.46 (−0.49 to 1.41) mmHg for decreasing rate from high to low.

Conclusion

Multiplying or dividing the rate settings by three did not significantly change the tcCO2 readings an hour after the change. These findings could affect the management of ventilation settings of NIPPV in premature infants.

Clinical trial registry

ClinicalTrials.gov ID: NCT04836689, The name of the trial registry: “Influence of Respiratory Rate Settings on CO2 Levels During Nasal Intermittent Positive Pressure Ventilation (NIPPV).”

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Fig. 1: The study Flow Diagram*.
Fig. 2: Equivalence trial results - Possible scenarios and results of this study.

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Rambam Health Care Campus, Neonatal Intensive Care Unit, Haifa, Israel

    Ori Hochwald, Liron Borenstein-Levin, Gil Dinur, Huda Jubran, Yoav Littner, Michal Breuer & Amir Kugelman

  2. The Technion Israel Institute of Technology, The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel

    Ori Hochwald, Liron Borenstein-Levin & Amir Kugelman

Authors
  1. Ori Hochwald
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  2. Liron Borenstein-Levin
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  7. Amir Kugelman
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Contributions

HO conceptualized and designed the study, designed the data collection instruments, collected data, carried out the initial analyses, drafted the initial manuscript, and revised the manuscript. B-LL and KA conceptualized and designed the study, and critically reviewed and revised the manuscript. DG, JH, LY, and BM collected data, carried out the initial analyses, and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Ori Hochwald.

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Hochwald, O., Borenstein-Levin, L., Dinur, G. et al. The effect of changing respiratory rate settings on CO2 levels during nasal intermittent positive pressure ventilation (NIPPV) in premature infants. J Perinatol 43, 305–310 (2023). https://doi.org/10.1038/s41372-023-01614-7

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