OBJECTIVES: To assess global and regional changes in lung volume and ventilation during lung recruitment in preterm infants with respiratory distress syndrome. STUDY DESIGN: Using electrical impedance tomography, changes in lung volume and ventilation were measured in 15 high-frequency oscillatory ventilated preterm infants during oxygenation-guided recruitment maneuvers. The inflation and deflation limbs were mapped, and the lower and upper inflection points were calculated using both oxygenation and impedance data. The impedance data were also used to determine recruitment-related changes in oscillation volume and distribution. RESULTS: During inflation, lower and upper inflection points were identified in the majority of infants. The deflation limb showed clear lung hysteresis in all infants. The upper inflection point was significantly lower when comparing the pressure/oxygenation and pressure/impedance curves. Lung volume changes differed between the ventral and dorsal regions, but did not show a consistent pattern. Optimal recruitment increased the oscillation volume, but the distribution of ventilation was relatively homogeneous along the ventral-dorsal axis. CONCLUSIONS: Lung hysteresis is present in preterm infants with respiratory distress syndrome. Regional differences in lung volume changes and ventilation during high-frequency oscillatory ventilation with lung recruitment are relatively modest and do not follow a gravity-dependent distribution.
OBJECTIVES: To assess global and regional changes in lung volume and ventilation during lung recruitment in preterm infants with respiratory distress syndrome. STUDY DESIGN: Using electrical impedance tomography, changes in lung volume and ventilation were measured in 15 high-frequency oscillatory ventilated preterm infants during oxygenation-guided recruitment maneuvers. The inflation and deflation limbs were mapped, and the lower and upper inflection points were calculated using both oxygenation and impedance data. The impedance data were also used to determine recruitment-related changes in oscillation volume and distribution. RESULTS: During inflation, lower and upper inflection points were identified in the majority of infants. The deflation limb showed clear lung hysteresis in all infants. The upper inflection point was significantly lower when comparing the pressure/oxygenation and pressure/impedance curves. Lung volume changes differed between the ventral and dorsal regions, but did not show a consistent pattern. Optimal recruitment increased the oscillation volume, but the distribution of ventilation was relatively homogeneous along the ventral-dorsal axis. CONCLUSIONS: Lung hysteresis is present in preterm infants with respiratory distress syndrome. Regional differences in lung volume changes and ventilation during high-frequency oscillatory ventilation with lung recruitment are relatively modest and do not follow a gravity-dependent distribution.
Authors: Arun Sett; Gillian W C Foo; Kelly R Kenna; Rebecca J Sutton; Elizabeth J Perkins; Magdy Sourial; Sheryle R Rogerson; Brett J Manley; Peter G Davis; Prue M Pereira-Fantini; David G Tingay Journal: Pediatr Res Date: 2022-09-27 Impact factor: 3.953
Authors: Stacey Peterson-Carmichael; Paul C Seddon; Ira M Cheifetz; Inéz Frerichs; Graham L Hall; Jürg Hammer; Zoltán Hantos; Anton H van Kaam; Cindy T McEvoy; Christopher J L Newth; J Jane Pillow; Gerrard F Rafferty; Margaret Rosenfeld; Janet Stocks; Sarath C Ranganathan Journal: Ann Am Thorac Soc Date: 2016-02
Authors: Anne P De Jaegere; Eline E Deurloo; Rick R van Rijn; Martin Offringa; Anton H van Kaam Journal: Eur J Pediatr Date: 2016-06-21 Impact factor: 3.183
Authors: Inéz Frerichs; Marcelo B P Amato; Anton H van Kaam; David G Tingay; Zhanqi Zhao; Bartłomiej Grychtol; Marc Bodenstein; Hervé Gagnon; Stephan H Böhm; Eckhard Teschner; Ola Stenqvist; Tommaso Mauri; Vinicius Torsani; Luigi Camporota; Andreas Schibler; Gerhard K Wolf; Diederik Gommers; Steffen Leonhardt; Andy Adler Journal: Thorax Date: 2016-09-05 Impact factor: 9.139
Authors: Martijn Miedema; Karen E McCall; Elizabeth J Perkins; Regina B Oakley; Prue M Pereira-Fantini; Anushi E Rajapaksa; Andreas D Waldmann; David G Tingay; Anton H van Kaam Journal: Front Pediatr Date: 2019-01-22 Impact factor: 3.418