The impact of gasping versus apnea on initial heart rate and response to positive pressure ventilation in the delivery room following interruption of placental blood flow
Main finding · DeathResult — go to the resultFold more likely to die 7.2Authors' conclusion
Infants who present with gasping versus apnea are less likely to die; apneic infants are more likely to die within the initial 24 h. Gasping versus apneic infants had a higher initial HR, were less likely to have a HR < 100 bmp and initiated spontaneous respiratory effort sooner after PPV.
Study context
- Population
- Late preterm and term newborns who gasped or were apneic at birth and received PPV in the delivery room
- Participants
- 126 vs 105
- Exposure
- Gasping vs apnea at birth
- Gaspingn = 126
- Apneicn = 105reference
- Outcome
- Initial HR, responses to PPV, time to onset of spontaneous respirations, and their relationship to 24-hour outcome (death/survival)
- Follow-up
- 24 hours
Methodological detailsrural setting, video recorded, continuous HR and respiratory monitoring
- Rural setting
- Video recorded
- Continuous HR and respiratory monitoring
Main finding
Death · first 24 h
Fold more likely to die
7.2
P = 0.01
By group
As reported in the abstract
Observational data: associations, not effects.
Further findings
Initial HR · higher in gasping
P = 0.01
| Outcome | Fold more likely to die | P value |
|---|---|---|
| Death · 7 days | 2.8 | P = 0.047 |
Time to initiate breathing after starting PPV
- Significantly shorter in gasping vs apneic infants
Peak inflation pressure, tidal volume, end tidal CO2, resuscitation duration
- No differences
HR < 100 bpm, died vs survivors
- HR < 100 bpm observed more often in infants who died, in both gasping and apneic infants
- P = 0.01
Original publication
The impact of gasping versus apnea on initial heart rate and response to positive pressure ventilation in the delivery room following interruption of placental blood flow. Resuscitation. Published 12 December 2024. doi:10.
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