Document Detail


Effects of mean airway pressure on lung volume during high-frequency oscillatory ventilation of preterm infants.
MedLine Citation:
PMID:  9563741     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Measurement of mean lung volume (MLV) in high-frequency oscillatory ventilation (HFO) may be useful for optimizing the high lung volume strategy, but has not been available until now. We have measured MLV by means of the sulfur hexafluoride (SF6) washout method in 13 premature infants ventilated with HFO because of respiratory distress syndrome (gestational age, 23 to 31 wk [median, 25 + 6/7 wk]; birthweight, 630 to 1,140 g [790 g]; age at measurement, 2 to 10 d [4 d]; weight, 675 to 1,250 g [850 g]). To evaluate the relationship between MLV and mean airway pressure (MAP), the latter was systematically varied between the measurements. With clinically selected MAP, MLV was between 23.3 and 41.9 ml/kg (median, 33.5 ml/kg) and was strongly dependent on MAP in each patient; linear regression analyses resulted in slope factors between 1.0 and 6.9 ml/cm H2O/kg (median, 2.83 ml/cm H2O/kg), with correlation coefficients between 0.77 and 0.99 (median, 0.94). Stabilization of MLV after modification of MAP took 2 to 25 min (median, 9 min). We conclude that the selection of MAP on a clinical basis leads to a wide range of different MLVs. Despite the strong dependence of MLV on MAP, the prediction of MLV solely based on MAP was impossible because of large patient to patient variability of linear regressions. Alveolar recruitment and derecruitment may take up to 25 min after MAP changes.
Authors:
U Thome; A Töpfer; P Schaller; F Pohlandt
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  157     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1998 Apr 
Date Detail:
Created Date:  1998-05-07     Completed Date:  1998-05-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1213-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, University of Ulm, Germany.
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MeSH Terms
Descriptor/Qualifier:
Airway Resistance*
Functional Residual Capacity
High-Frequency Ventilation*
Humans
Infant, Newborn
Infant, Premature, Diseases / physiopathology,  therapy*
Lung Volume Measurements*
Respiratory Distress Syndrome, Newborn / physiopathology,  therapy*
Sulfur Hexafluoride / diagnostic use
Chemical
Reg. No./Substance:
2551-62-4/Sulfur Hexafluoride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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