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Measurement and repeatability of interrupter resistance in unsedated newborn infants
Author(s) -
Adams A.M.,
Olden C.,
Wertheim D.,
Ives A.,
Bridge P.D.,
Lenton J.,
Seddon P.
Publication year - 2009
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.21039
Subject(s) - repeatability , medicine , limits of agreement , airway resistance , anesthesia , airway , statistics , nuclear medicine , mathematics
Abstract Interrupter resistance (R int ) is a useful measure of airway caliber in young children, but has not been well characterized in infants—in whom there are concerns about the accurate measurement of driving pressure. This study aimed to assess the feasibility and repeatability of measuring R int in unsedated newborn infants, and to explore alternative algorithms for calculating driving pressure. R int measurement was attempted in 28 healthy term newborn infants during natural sleep using the MicroRint device. Paired R int measurements were achieved in 24 infants, but after screening of waveforms only 15 infants had at least 5 technically acceptable waveforms on both measurements. R int values obtained were comparable with reported values for airflow resistance in newborns using other methods. However, the repeatability coefficient (CR) was much higher than reported values in preschool children using standard back‐extrapolation algorithms, with CR 2.47 KPa L −1 sec (unscreened) and 2.93 KPa L −1 sec (screened). Other algorithms gave only marginally better repeatability, with all CR values over 50% of the mean R int value. Using current commercially available equipment, R int is too poorly repeatable to be a reliable measurement of airflow resistance in newborn infants. Lower deadspace equipment is needed, but anatomical and physiological factors in the infant are also important. Pediatr Pulmonol. 2009; 44:1168–1173. © 2009 Wiley‐Liss, Inc.