Dynamic maintenance of end-expiratory lung volume in full-term infants. 1984

P C Kosch, and A R Stark

We recorded airflow, tidal volume, respiratory muscle electromyogram (EMG), and chest wall configuration in eight normal newborn infants to investigate the determination of end-expiratory lung volume (EEV). The expiratory flow-volume representation was nearly linear and EMG evidence of respiratory muscle activity was absent during the latter part of expiration in both supine and upright postures, consistent with passive expiration. Occasional breaths were associated with marked retardation of expiratory airflow (braking). During unobstructed apnea, expiration proceeded to the relaxation volume (Vr) with no change in slope of the flow-volume curve. During breathing, EEV was greater than Vr observed during apnea. We calculated the difference between EEV and Vr estimated by extrapolation of the linear portion of the expiratory flow-volume curve as 14.4 +/- 5.4 ml (supine) and 11.8 +/- 2.4 ml (upright). When infants were tilted from supine to upright, expiratory duration (TE) and the expiratory time constant (tau) increased significantly. Since the increases in tau and TE offset each other, the EEV-Vr difference was similar in both postures. We propose that while braking plays a major role in the early part of expiration, as long as the final portion of expiration is passive, the dynamic maintenance of EEV above Vr depends on the relative values of tau and TE. Expiratory braking mechanisms interact with the passive mechanical properties of the respiratory system to modulate the balance between tau and TE. These mechanisms provide a neonatal breathing strategy to maintain EEV above a low Vr until the chest wall stiffens with maturity.

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
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
D008176 Lung Volume Measurements Measurement of the amount of air that the lungs may contain at various points in the respiratory cycle. Lung Capacities,Lung Volumes,Capacity, Lung,Lung Capacity,Lung Volume,Lung Volume Measurement,Measurement, Lung Volume,Volume, Lung
D011187 Posture The position or physical attitude of the body. Postures
D012119 Respiration The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration ( Breathing
D012123 Pulmonary Ventilation The total volume of gas inspired or expired per unit of time, usually measured in liters per minute. Respiratory Airflow,Ventilation Tests,Ventilation, Pulmonary,Expiratory Airflow,Airflow, Expiratory,Airflow, Respiratory,Test, Ventilation,Tests, Ventilation,Ventilation Test
D005652 Functional Residual Capacity The volume of air remaining in the LUNGS at the end of a normal, quiet expiration. It is the sum of the RESIDUAL VOLUME and the EXPIRATORY RESERVE VOLUME. Common abbreviation is FRC. Capacities, Functional Residual,Capacity, Functional Residual,Functional Residual Capacities,Residual Capacities, Functional,Residual Capacity, Functional
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013990 Tidal Volume The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T. Tidal Volumes,Volume, Tidal,Volumes, Tidal

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