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J Appl Physiol 73: 276-283, 1992;
8750-7587/92 $5.00
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Journal of Applied Physiology, Vol 73, Issue 1 276-283, Copyright © 1992 by American Physiological Society

ARTICLES

Functional residual capacity and ventilation homogeneity in mechanically ventilated small neonates

C. T. Vilstrup, L. J. Bjorklund, A. Larsson, B. Lachmann and O. Werner
Department of Anesthesia, University Hospital, Lund, Sweden.

A modification of a computerized tracer gas (SF6) washout method was designed for serial measurements of functional residual capacity (FRC) and ventilation homogeneity in mechanically ventilated very-low-birth-weight infants with tidal volumes down to 4 ml. The method, which can be used regardless of the inspired O2 concentration, gave accurate and reproducible results in a lung model and good agreement compared with He dilution in rabbits. FRC was measured during 2-4 cmH2O of positive end-expiratory pressure (PEEP) in 15 neonates (700-1,950 g), most of them with mild-to-moderate respiratory distress syndrome. FRC increased with body weight and decreased (P less than 0.05) with increasing O2 requirement. Change to zero end-expiratory pressure caused an immediate decrease in FRC by 29% (P less than 0.01) and gave FRC (ml) = -1.4 + 17 x weight (kg) (r = 0.83). Five minutes after PEEP was discontinued (n = 12), FRC had decreased by a further 16% (P less than 0.01). The washout curves indicated a near-normal ventilation homogeneity not related to changes in PEEP. This was interpreted as evidence against the presence of large volumes of trapped alveolar gas.


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