|
|
||||||||
1 Department of Pediatrics, The Children's Regional Hospital at Cooper Hospital and Robert Wood Johnson Medical School, Camden 08103; 2 Department of Pediatrics, Robert Wood Johnson Medical School, New Brunswick, New Jersey 08901; and 3 Department of Pediatrics, Mercy Children's Hospital at St. Vincent Mercy Medical Center, Medical College of Ohio, Toledo, Ohio 43608
Reported values of lung resistance
(RL) and elastance (EL) in spontaneously
breathing preterm neonates vary widely. We hypothesized that this
variability in lung properties can be largely explained by both inter-
and intrasubject variability in breathing pattern and demographics.
Thirty-three neonates receiving nasal continuous positive airway
pressure [weight 606-1,792 g, gestational age (GA) of
25-33 wk, 2-49 days old] were studied. Transpulmonary pressure was measured by esophageal manometry and airway flow by face
mask pneumotachography. Breath-to-breath changes in RL and
EL in each infant were estimated by Fourier analysis of
impedance (Z) and by multiple linear regression (MLR).
RLMLR (RLMLR = 0.85 × RLZ
0.43; r2 = 0.95) and ELMLR
(ELMLR = 0.97 × ELZ + 8.4; r2 = 0.98) were
highly correlated to RLZ and
ELZ, respectively. Both RL
(mean ± SD; RLZ = 70 ± 38, RLMLR = 59 ± 36 cmH2O · s · l
1)
and EL (ELZ = 434 ± 212, ELMLR = 436 ± 210 cmH2O/l)
exhibited wide intra- and intersubject variability.
Regardless of computation method, RL was found to decrease
as a function of weight, age, respiratory rate (RR), and tidal volume
(VT) whereas it increased as a function of
RR · VT and inspiratory-to-expiratory
time ratio (TI/TE). EL decreased
with increasing weight, age, VT and female gender and
increased as RR and TI/TE increased. We
conclude that accounting for the effects of breathing pattern
variability and demographic parameters on estimates of RL
and EL is essential if they are to be of clinical value.
Multivariate statistical models of RL and EL
may facilitate the interpretation of lung mechanics measurements in
spontaneously breathing infants.
impedance; multiple linear regression; frequency dependence; amplitude dependence
This article has been cited by other articles:
![]() |
R. H. Habib, K. H. Pyon, S. E. Courtney, and Z. H. Aghai Spectral characteristics of airway opening and chest wall tidal flows in spontaneously breathing preterm infants J Appl Physiol, May 1, 2003; 94(5): 1933 - 1940. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. B. Pandit, S. E. Courtney, K. H. Pyon, J. G. Saslow, and R. H. Habib Work of Breathing During Constant- and Variable-Flow Nasal Continuous Positive Airway Pressure in Preterm Neonates Pediatrics, September 1, 2001; 108(3): 682 - 685. [Abstract] [Full Text] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Visit Other APS Journals Online |