Vol. 94, Issue 5, 1933-1940, May 2003
Spectral characteristics of airway opening and chest wall
tidal flows in spontaneously breathing preterm infants
Robert H.
Habib1,2,
Kee H.
Pyon3,
Sherry E.
Courtney3, and
Zubair H.
Aghai3
1 Mercy Children's Hospital at St. Vincent Mercy
Medical Center, and 2 Department of Pediatrics,
Medical College of Ohio, Toledo, Ohio 43608; and
3 Department of Pediatrics, Cooper Hospital and
Robert Wood Johnson Medical School, Camden, New Jersey 08103
We compared the
harmonic content of tidal flows measured simultaneously at the mouth
and chest wall in spontaneously breathing very low birth weight infants
(n = 16, 1,114 ± 230 g, gestation age:
28 ± 2 wk). Airway opening flows were measured via face
mask-pneumotachograph (P-tach), whereas chest wall flows were derived
from respiratory inductance plethysmography (RIP) excursions. Next, for
each, we computed two spectral shape indexes: 1) harmonic
distortion (kd; kd,P-tach
and kd,RIP, respectively) defines the extent to
which flows deviated from a single sine wave, and 2) the
exponent of the power law (s; sP-tach
and sRIP, respectively), describing the
spectral energy vs. frequency. P-tach and RIP flow spectra exhibited
similar power law functional forms consistently in all infants. Also,
mouth [sP-tach = 3.73 ± 0.23% (95%
confidence interval), kd,P-tach = 38.8 ± 4.6%] and chest wall (sRIP = 3.51 ± 0.30%, kd,RIP = 42.8 ± 4.8%)
indexes were similar and highly correlated (sRIP = 1.17 × sP-tach + 0.85;
r2 = 0.81;
kd,RIP = 0.90 × kd,P-tach + 8.0;
r2 = 0.76). The corresponding time to peak
tidal expiratory flow-to-expiratory time ratio (0.62 ± 0.08) was
higher than reported in older infants. The obtained s and
kd values are similar to those reported in older
and/or larger chronic lung disease infants, yet appreciably lower than
for 1-mo-old healthy infants of closer age and/or size; this indicated
increased complexity of tidal flows in very low birth weight
babies. Importantly, we found equivalent flow spectral data
from mouth and chest wall tidal flows. The latter are desirable because
they avoid face mask artificial effects, including leaks around it,
they do not interfere with ventilatory support delivery, and they may
facilitate longer measurements that are useful in control of breathing assessment.
harmonic distortion; control of breathing; power law; respiratory
mechanics; respiratory inductance plethysmography