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Functional residual capacity measurements in healthy infants: ultrasonic flow meter versus a mass spectrometer

¹ Portex Unit: Respiratory Physiology, Institute of Child Health. ² Dept of Neonatology, University College London Hospital NHS Trust, and ³ Neonatal Unit, Homerton Hospital NHS Trust, London, UK. ⁴ Centre for Child Health Research, Perth, Australia. ⁵ Dept of Paediatric Clinical Physiology, Queen Silvia Children's Hospital, Göteborg, Sweden, ⁶ Universitäts-Kinderklinik, Münster, Germany

CORRESPONDENCE: J.J. Pillow, Neonatal Clinical Care Unit, King Edward Memorial Hospital, P.O. Box 134, Subiaco Perth, Western Australia, 6904. Fax: 61 893817559. E-mail: janep@ichr.uwa.edu.au

Keywords: Equipment, infant, lung volume measurements, multiple-breath washout, respiratory function tests, validation

Received: August 7, 2003
Accepted November 26, 2003

This research was supported by a Neil Hamilton Fairley NHMRC Postdoctoral Fellowship (J.J. Pillow), a European Respiratory Society Long Term Research Fellowship (H. Ljungberg), the Innovative Medizinische Forschung, University of Münster, Germany, and the Gesellschaft für Pädiatrische Pneumologie (G. Hülskamp) and Portex Ltd (J. Stocks). Research at the Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust benefits from R&D funding received from the NHS Executive.

Accurate, reproducible and portable bedside monitoring of lung volume could potentially facilitate the early recognition of both under and overinflation of the lungs in ventilated and nonventilated subjects. This study asked whether a prototype portable ultrasonic flow meter provided valid and reliable measurements of functional residual capacity (FRC_US) when compared to those obtained using a mass spectrometer (FRC_MS) in nonventilated healthy infants.

Paired, randomised measurements of FRC_MS and FRC_US were obtained using the sulphur hexafluoride (SF₆) multiple-breath washout technique in 23 healthy infants with a median (range) postnatal age of 34.6 (1.3–92.6) weeks and weight of 8.3 (3.9–11.7) kg.

FRC_US was on average 5.7% (95% CI: 1.0–10.4%) less than FRC_MS equating to a difference of approximately 1 mL·kg^–1. The 95% limits of agreement (LA) between the two techniques were relatively wide (95% LA: –17.5% to 29%), although in keeping with previously reported within-patient variability for lung volume measurements. There was no significant difference between the within subject coefficient of variation for FRC_MS (3.7%) and FRC_US (5.2%).

The ultrasonic flow meter used in this study provides repeatable measurements of functional residual capacity in spontaneously breathing healthy infants that approximate those obtained during mass spectrometry.

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