Document Detail


Changes in Lung Volume and Ventilation During Surfactant Treatment in Ventilated Preterm Infants.
MedLine Citation:
PMID:  21493733     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
RATIONALE: The immediate and regional effects of exogenous surfactant in open lung high-frequency oscillatory ventilated (HFOV) preterm infants are unknown. OBJECTIVES: To assess regional changes in lung volume, mechanics and ventilation during and after surfactant administration in HFOV preterm infants with respiratory distress syndrome (RDS). METHODS: Using electrical impedance tomography, changes in lung volume were continuously recorded during a stepwise recruitment procedure before, during and after surfactant administration in 15 preterm infants (gestational age: 28.3 weeks; birth weight: 1000 grams). Deflation limbs of the pressure-impedance curve before and after surfactant were mapped and the effect of surfactant on oscillation volumes and ventilation was determined. Data were analyzed for the whole cross-section and the left, right, ventral and dorsal lung regions. MEASUREMENTS AND MAIN RESULTS: Surfactant increased lung volume by 61±39 % within a median time of 241 s. The ventral to dorsal ratio in lung volume changed significantly from 1.16 before to 0.81 after surfactant administration. The upper inflection point of the deflation limb after surfactant (10.4±2.4 cmH2O) was significantly lower compared to before surfactant (16.4±3.1 cmH2O). Surfactant increased maximal compliance of the respiratory system and this effect was reached at lower airway pressures. Surfactant caused a transient decrease in oscillatory volume, but did not alter its regional distribution. CONCLUSIONS: Surfactant treatment in HFOV preterm infants with RDS causes a rapid increase and subsequent stabilization of lung volume, which is most prominent in dependent lung regions. It increased maximal compliance but this effect is only reached at lower airway pressures.
Authors:
Martijn Miedema; Frans H de Jongh; Inez Frerichs; Mariëtte B van Veenendaal; Anton H van Kaam
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-14
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  -     ISSN:  1535-4970     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Neonatology, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands.
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