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Assessment of passive respiratory compliance in healthy preterm infants: A critical evaluation
Author(s) -
Gappa M.,
Rabbette P. S.,
Costeloe K. L.,
Stocks J.
Publication year - 1993
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950150508
Subject(s) - medicine , gestational age , neonatal intensive care unit , bronchopulmonary dysplasia , respiratory system , anesthesia , lung function , pulmonary compliance , birth weight , pediatrics , functional residual capacity , airway , lung volumes , lung , pregnancy , genetics , biology
Abstract The airway occlusion techniques for assessing passive respiratory mechanics have become well established methods in fullterm neonates and older infants. The single breath technique (SBT) is frequently used for assessing lung function in intubated infants on neonatal intensive care units. However, less is known about the reliability of these quick and noninvasive techniques in healthy preterm infants. The aim of this study was to evaluate these methods in healthy unintubated preterm infants to facilitate both establishment of reference values and more meaningful interpretation of lung function assessments in the neonatal unit. Forty‐seven studies were attempted in 31 healthy preterm infants (gestational age 29–36 weeks; body weight 1.88 ± 0.28 kg; mean ± SD) during the first 2 weeks of life, using both the multiple occlusion technique (MOT) and the SBT. Whereas technically acceptable respiratory system compliance (Crs) data from either the MOT or the SBT were obtained on 37 occasions in 25 infants, satisfactory results from both techniques were achieved only on 22 occasions. In these infants mean ± SD Crs was 28.1± 5.2 mL kPa −1 when assessed by MOT and 29.1± 5 6.0 mL kPa −1 when using the SBT. The mean difference between technically satisfactory paired Crs values obtained with MOT and SBT was less than 5% (range, +28 to −18%). By contrast, in infants in whom data were invalidated as a result of expiratory airflow braking, failure to relax or instability of the end‐expiratory level, gross discrepancies occurred between the techniques. In conclusion, assessment of passive respiratory compliance is feasible in healthy, unintubated preterm infants, but strict criteria for quality control should be applied to avoid gross errors in the results. Ideally, passive respiratory mechanics should be assessed using both MOT and SBT in order to increase confidence in the reported results. © 1993 Wiley‐Liss, Inc.