Computer simulation of the measured respiratory impedance in newborn infants and the effect of the measurement equipment.

The forced oscillation technique (FOT) is a non-invasive method to investigate lung mechanics. FOT does not require active cooperation and therefore it seems to be useful for lung function measurements in newborn infants. The aims of this simulation study were to investigate the effects of development and growth of the lung, pulmonary inhomogeneities and the measurement equipment on the respiratory impedance (Zrs). The respiratory impedance was simulated by using four lung models with lumped parameters in the frequency range of 3-50 Hz considering resistive and elastic resistances of the respiratory system and the inertance of breathing air and tissue. The simulation has shown that the maturation of lungs produces only a parallel shifting of the real and imaginary part of the impedance curves whereas respiratory diseases change the course of the curves. Furthermore, a high influence of the measurement equipment (e.g. compliance of the face mask, endotracheal tube leaks) on Zrs was found. In conclusion, the simulation has shown that FOT offers a deeper insight in the structure of the respiratory system. However, the technical requirements for accurate measurements in newborns are very high.