Document Detail


Respiratory mechanics in mechanically ventilated newborns: a comparison between passive inflation and occlusion methods.
MedLine Citation:
PMID:  1614746     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A passive inflation method was described for measuring total respiratory elastance and resistance during mechanical ventilation in adult patients (Rossi et al., J Appl Physiol 58:1849, 1985). We applied this method to preterm and full-term mechanically ventilated newborn infants and we compared the results with those obtained by the occlusion method. We performed 37 tests in 16 newborn infants (B.W. 880-4,500 g; G.A. 28-42 weeks), between 1 and 45 days of postnatal age, ventilated with a Servo Ventilator 900C, set in controlled-volume mode. Flow was measured through a pneumotachograph inserted between the endotracheal tube (ETT) and the breathing circuit, tidal volume by integration of flow and airway pressure directly at the airway opening. Flow, volume, and pressure were recorded on an X/Y plotter to obtain pressure-volume (P/V), flow-volume (V/V) loops, and pressure-time curves. Occlusion was performed by using the end-inspiratory and the end-expiratory pause buttons of the ventilator. Analysis of P/V and V/V loops provided respiratory system compliance (Crs, infl.), resistance (Rrs, infl.), and "intrinsic positive end-expiratory pressure" (PEEPi, infl.). These values were compared with Crs, occl., Rrs, occl., and PEEPi, occl. measured by the occlusion method. The measurements were well correlated (Crs, infl./Crs, occl.: r = 0.90; Rrs, infl./Rrs, occl.: r = 0.91; PEEPi, infl./PEEPi, occl.: r = 0.91). Rrs, infl./Rrs, occl. and PEEPi, infl./PEEPi, occl. did not differ significantly. However, Crs, occl. was 15% higher than Crs, infl. (P less than 0.01). The passive inflation method is simple to use and well tolerated in preterm and full-term ventilated newborn infants, it provides accurate results, and can be a good alternative to occlusion methods. It requires, however, a constant inflation flow and adaptation to the ventilator.
Authors:
L Storme; Y Riou; F Leclerc; N Kacet; J P Dubos; C Gremillet; S Rousseau; P Lequien
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pediatric pulmonology     Volume:  12     ISSN:  8755-6863     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  1992 Apr 
Date Detail:
Created Date:  1992-07-28     Completed Date:  1992-07-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  203-12     Citation Subset:  IM    
Affiliation:
Neonatal Medicine, Centre Hospitalier Universitaire, Lille, France.
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MeSH Terms
Descriptor/Qualifier:
Airway Resistance / physiology
Humans
Infant, Newborn
Intensive Care, Neonatal / methods*
Lung Compliance / physiology
Positive-Pressure Respiration / methods*
Respiratory Function Tests / methods
Respiratory Insufficiency / physiopathology,  therapy*
Respiratory Mechanics / physiology*

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


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