RT Journal Article
SR Electronic
T1 The effect of airway pressure and oscillation amplitude on ventilation in pre-term infants
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 479
OP 484
DO 10.1183/09031936.00138311
VO 40
IS 2
A1 Martijn Miedema
A1 Frans H. de Jongh
A1 Inez Frerichs
A1 Mariette B. van Veenendaal
A1 Anton H. van Kaam
YR 2012
UL http://erj.ersjournals.com/content/40/2/479.abstract
AB We determined the effect of lung recruitment and oscillation amplitude on regional oscillation volume and functional residual capacity (FRC) in high-frequency oscillatory ventilation (HFOV) used in pre-term infants with respiratory distress syndrome (RDS). Changes in lung volume, oscillation volume and carbon dioxide levels were recorded in 10 infants during a stepwise recruitment procedure, and an increase in pressure amplitude of 5 cmH2O was measured using electrical impedance tomography and transcutaneous monitoring. The pressures at maximal respiratory system compliance, maximal oscillation volume and minimal carbon dioxide levels were determined. Impedance data were analysed for the chest cross-section and predefined regions of interest. Despite the fixed pressure amplitude, the oscillation volume changed during the incremental pressure steps following a parabolic pattern, with an inverse relationship to the carbon dioxide pressures. The pressures corresponding with maximal compliance, maximal oscillation volume and minimal carbon dioxide were similar and highly correlated. Regional analysis showed similar findings. The increase in pressure amplitude resulted in increased oscillation volumes and decreased carbon dioxide levels, while FRC remained unchanged. In HFV pre-term infants with RDS, oscillation volumes are closely related to the position of ventilation in the pressure–volume envelope and the applied pressure amplitude. Changes in pressure amplitude do not seem to affect FRC.