Biomaterial Database

Intensive care monitoring of pulmonary mechanics for preterm infants undergoing mechanical ventilation. 1989

M D Cunningham

Department of Pediatrics, College of Medicine, University of Kentucky, Lexington.

Changing lung dynamics and ventilator settings were studied prospectively from onset of respiratory distress syndrome in 32 very low birthweight infants (790-1,460 g, mean 1,173 g). Infants were studied in the first and second week of life using pneumotachography for dynamic compliance and lung resistance calculated from spontaneous breaths. Infants were ventilated to maintain pH at or above 7.30, PCO2 40-50 torr, and PO2 50-70 torr. Eleven infants developed chronic lung disease (CLD). In the first week, CLD infants had lower compliance (0.87 vs. 1.01 mL/cm H2O) and higher resistance (94.23 vs. 76.29 cm H2O/L/sec) than non-CLD infants. CLD infants required greater mean airway pressure (9.56 vs. 7.02 cm H2O; P = .05) and higher peak inspiratory pressures (21.85 vs. 15.71 cm H2O; P = .01). Oxygen requirements were greater for CLD infants (FIO2 0.59 vs. 0.45, P = .05). During the second week compliance for CLD infants improved (1.00) and resistance decreased slightly (92.23), but peak inspiratory pressure settings remained higher for CLD infants (19.60 vs. 14.95 cm H2O; P = .02). Although pulmonary mechanics remained stable for both groups, infants exposed to continuously greater peak inspiratory pressure and oxygen concentration proved susceptible to CLD. Developing a match of ventilator settings to improve pulmonary mechanics may lessen CLD of infancy.

UI	MeSH Term	Description	Entries
D007231	Infant, Newborn	An infant during the first 28 days after birth.	Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007363	Intensive Care Units, Neonatal	Hospital units providing continuing surveillance and care to acutely ill newborn infants.	Neonatal Intensive Care Unit,Neonatal Intensive Care Units,Newborn Intensive Care Unit,Newborn Intensive Care Units,ICU, Neonatal,Neonatal ICU,Newborn ICU,Newborn Intensive Care Units (NICU),ICU, Newborn,ICUs, Neonatal,ICUs, Newborn,Neonatal ICUs,Newborn ICUs
D008170	Lung Compliance	The capability of the LUNGS to distend under pressure as measured by pulmonary volume change per unit pressure change. While not a complete description of the pressure-volume properties of the lung, it is nevertheless useful in practice as a measure of the comparative stiffness of the lung. (From Best & Taylor's Physiological Basis of Medical Practice, 12th ed, p562)	Compliance, Lung,Compliances, Lung,Lung Compliances
D008991	Monitoring, Physiologic	The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine.	Patient Monitoring,Monitoring, Physiological,Physiologic Monitoring,Monitoring, Patient,Physiological Monitoring
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D012121	Respiration, Artificial	Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2).	Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D012127	Respiratory Distress Syndrome, Newborn	A condition of the newborn marked by DYSPNEA with CYANOSIS, heralded by such prodromal signs as dilatation of the alae nasi, expiratory grunt, and retraction of the suprasternal notch or costal margins, mostly frequently occurring in premature infants, children of diabetic mothers, and infants delivered by cesarean section, and sometimes with no apparent predisposing cause.	Infantile Respiratory Distress Syndrome,Neonatal Respiratory Distress Syndrome,Respiratory Distress Syndrome, Infant
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014939	Work of Breathing	RESPIRATORY MUSCLE contraction during INHALATION. The work is accomplished in three phases: LUNG COMPLIANCE work, that required to expand the LUNGS against its elastic forces; tissue resistance work, that required to overcome the viscosity of the lung and chest wall structures; and AIRWAY RESISTANCE work, that required to overcome airway resistance during the movement of air into the lungs. Work of breathing does not refer to expiration, which is entirely a passive process caused by elastic recoil of the lung and chest cage. (Guyton, Textbook of Medical Physiology, 8th ed, p406)	Breathing Work,Breathing Works