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J Appl Physiol 18: 534-538, 1963;
8750-7587/63 $5.00
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Pulmonary function in the newborn infant: the alveolar-arterial oxygen gradient

Nicholas M. Nelson 1, L. Samuel Prod'hom 1, Ruth B. Cherry 1, Philip J. Lipsitz 1, and Clement A. Smith 1

1 Department of Pediatrics, Harvard Medical School and Boston Lying-in Hospital, Boston, Massachusetts

The venous admixture component of the total alveolar-arterial gradient for oxygen (AaD-O2) has been measured in 26 normal infants less than 4 days of age and in 12 others with the respiratory distress syndrome (hyaline membrane disease). The AaD-O2 in normal air-breathing infants (average 28 mm Hg) is nearly three times that seen in adults. Analysis of mixing data from N2-washout curves in these infants suggests such excellent distribution of ventilation that the distribution component of the AaD-O2 must be quite small. By contrast, estimates of the shunt component during oxygen breathing reveal a shunt flow in normal infants of nearly one-fourth cardiac output (AaD-O2 = 311) which is further increased in distressed babies (up to two-thirds cardiac output) and which can completely account for the large AaD-O2's found in both groups of infants.

Submitted on July 9, 1962




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