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Ventilatory response to nitrogen multiple‐breath washout in infants
Author(s) -
Singer Florian,
Yammine Sophie,
Schmidt Anne,
Proietti Elena,
Kieninger Elisabeth,
Barben Juerg,
Casaulta Carmen,
Regamey Nicolas,
Gustafsson Per,
Frey Urs,
Latzin Philipp
Publication year - 2014
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.22841
Subject(s) - nitrogen washout , medicine , washout , intensive care medicine , functional residual capacity , lung volumes , lung
Summary Background Nitrogen multiple‐breath washout (N 2 MBW) using 100% oxygen (O 2 ) has regained interest to assess efficiency of tracer gas clearance in, for example, children with Cystic Fibrosis (CF). However, the influence of hyperoxia on the infants' respiratory control is unclear. We assessed safety and impact on breathing pattern from hyperoxia, and if exposure to 40% O 2 first induces tolerance to subsequent 100% O 2 for N 2 MBW. Methods We prospectively enrolled 39 infants aged 3–57 weeks: 15 infants with CF (8 sedated for testing) and 24 healthy controls. Infants were consecutively allocated to the protocols comprising of 100% O 2 or 40/100% O 2 administered for 30 breaths. Lung function was measured using an ultrasonic flowmeter setup. Primary outcome was tidal volume (V T ). Results None of the infants experienced apnea, desaturation, or bradycardia. Both protocols initially induced hypoventilation. V T temporarily declined in 33/39 infants across 10–25 breaths. Hypoventilation occurred independent of age, disease, and sedation. In the new 40/100% O 2 protocol, V T returned to baseline during 40% O 2 and remained stable during 100% O 2 exposure. End‐tidal carbon dioxide monitored online did not change. Conclusion The classical N 2 MBW protocol with 100% O 2 may change breathing patterns of the infants. The new protocol with 40% O 2 induces hyperoxia‐tolerance and does not lead to changes in breathing patterns during later N 2 washout using 100% O 2 . Both protocols are safe, the new protocol seems an attractive option for N 2 MBW in infants. Pediatr Pulmonol. 2014; 49:342–347. © 2013 Wiley Periodicals, Inc.