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New aspects of airway mechanics in pre-term infants

¹ Dept of Paediatrics and Adolescent Medicine, University Hospital of Freiburg, Freiburg, Germany, ² Portex Respiratory Unit, Institute of Child Health, ³ Neonatal Unit, Homerton University Hospital, London, and ⁴ Dept of Child Health, University of Leicester, Leicester, UK, ⁵ Paediatric Respiratory Medicine, Dept of Paediatrics, University Hospital of Bern, Inselspital, Bern, Switzerland.

CORRESPONDENCE: M. Henschen, Schwarzwald-Baar Klinikum Villingen-Schwenningen GmbH, Vöhrenbacher Straße 23, D-78050 Villingen-Schwenningen, Germany. Fax: 49 7721933599. E-mail: matthias.henschen{at}sbk-vs.de

Keywords: Infant, interrupter technique, pre-term, respiratory function tests

Received: March 26, 2005
Accepted January 22, 2006

High-frequency respiratory impedance data measured noninvasively by the high-speed interrupter technique (HIT), particularly the first antiresonance frequency (f_ar,1), is related to airway wall mechanics.

The aim of this study was to evaluate the feasibility and repeatability of HIT in unsedated pre-term infants, and to compare values of f_ar,1 from 18 pre-term (post-conceptional age 32–37 weeks, weight 1,730–2,910 g) and 18 full-term infants (42–47 weeks, 3,920–5,340 g).

Among the pre-term infants, there was good short-term repeatability of f_ar,1 within a single sleep epoch (mean (SD) coefficient of variance: 8 (1.7)%), but 95% limits of agreement for repeated measures of f_ar,1 after 3–8 h were relatively wide (–41 Hz; 37 Hz). f_ar,1 was significantly lower in pre-term infants (199 versus 257 Hz), indicating that wave propagation characteristics in pre-term airways are different from those of full-term infants. The present authors suggest that this is consistent with developmental differences in airway wall structure and compliance, including the influence of the surrounding tissue.

Since flow limitation is determined by wave propagation velocity and airway cross-sectional area, it was hypothesised that the physical ability of the airways to carry large flows is fundamentally different in pre-term than in full-term infants.