DEVELOPMENT OF PULMONARY FUNCTION IN LATE GESTATION: I. <i>The Functional Residual Capacity of the Lung in Premature Children</i>

G, Lacourt; Polgar, George

doi:10.1111/j.1651-2227.1974.tb04352.x

Cited by 18 publications

(7 citation statements)

References 18 publications

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“…The FRC values related to weight or length are lower than some of the previously published figures for neonates and infants (6)(7)(8)(9)(10)(12)(13)(14) but most of these data were TGV obtained by plethysmography (Table 1). Larger values for TGV than for FRC measured by He-dilution or N2 washout have been noted before and attributed to gas trapping (1 3-15).…”

Section: Discussioncontrasting

confidence: 62%

“…The regression line of FRC for weight intercepts the x axis at a body weight of 480 g corresponding to a gestational age of 20-22 wk. This is just prior to the time when air spaces begin to form and lung volume starts to increase rapidly (12).…”

Section: Discussionmentioning

confidence: 99%

“…The FRC values from the low birth weight infants shifted the initial part of the curve to the right because after birth their age increases without increases in weight or FRC until they receive sufficient calories. This weight shift is illustrated by the intercept of the regression line with the x axis at 27 wk instead of 23 to 26 wk (12) axis at zero but in the positive range or show an exponential increase.…”

Section: Discussionmentioning

confidence: 99%

“…FRC or TGV measurements have been reported most frequently in term neonates or infants with respiratory illness (6)(7)(8)(9)(10)(11)(12). Only a few of these studies include preterm infants (7, 1 1, 12), and none of them has been done with the N2 washout method.…”

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confidence: 99%

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Functional Residual Capacity in Normal Neonates and Children up to 5 Years of Age Determined by a N2 Washout Method

et al. 1986

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ABSTRACT. Functional residual capacity (FRC) was determined in 50 infantsMore recently the He-dilution method has been scaled down and perfected for the use in infants (2) and the classical N2 washout technique has been computerized to allow breath by breath analysis of NZ washed out (3, 4). We have developed a simpler, open circuit N2 washout technique suitable to measure FRC in small animals and neonates (5).FRC or TGV measurements have been reported most frequently in term neonates or infants with respiratory illness (6)(7)(8)(9)(10)(11)(12). Only a few of these studies include preterm infants (7, 1 1, 12), and none of them has been done with the N2 washout method.In the present study FRC measurements were performed in normal infants including preterm and term neonates and infants up to 5 yr of age using the open circuit N2 washout technique (5). MATERIALS AND METHODSin preterm and older infants using a NZ washout technique.Fifty healthy infants, free of any signs of pulmonary disease or (Pediatr Res 20: 668-671, 1986) upper respiratory infection were studied. Their weight ranged from 1.19 to 25.8 kg, and their age from 1 wk to 5 yr. Eighteen Abbreviations infants were studied during the newborn period (first 28 days FRC, functional residual capacity after birth). Their gestational age ranged from 32 wk to term, 14 TGV, thoracic gas volume infants were preterm. Gestational age was determined by Dubowitz examination, and added to postnatal age to obtain postconceptional age. None of the infants had a history of respiratory disease or a need for mechanical ventilation. All were breathing room air. The measurement of FRC is an important component when Newborn infants were studied without sedation while all older evaluating pulmonary function in neonates and infants. FRC infants were sedated with 50 mg/kg chloralhydrate PO. The study needs to be known as reference value when comparing compli-was done during sleep while infants rested in the supine position. ance and conductance of individuals with different size and its The procedure was well tolerated. There were no unsuccessful increase with age provides important information about lung attempts and arousal during the measurement occurred in only growth and development.one of 10 infants. Most of the lung volume determinations in neonates andThe details of the system used to measure FRC were described infants have been done by plethysmography measuring TGV previously (5). Briefly it consists of a blender connected to a rather than the FRC. This technique is difiicult to apply to sick source of oxygen and helium, providing a stable continuous flow or small preterm infants, requires complicated highly sensitive of any helium/oxygen mixture. The gas is warmed and humidiequipment, and bears a high risk of technical error. Airway fied and passed through a breathing circuit. The infants breathe closure at FRC as may occur in the newborn infant and uneven the gas from the circuit through a T tube. The gas leaving the distribution of pleural pressure may also lead to er...

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Section: Discussioncontrasting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Functional Residual Capacity in Normal Neonates and Children up to 5 Years of Age Determined by a N2 Washout Method

et al. 1986

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“…Heaf et al (25) Differences in mode of ventilation may have contributed to these discrepancies (23,26). We can consequently confirm the observations that infants with IRDS and a demand for respiratory support have lower FRC than comparable groups without lung disease (27)(28)(29)(30). As shown in Figure 2, there was no correlation between PEEP level and FRC.…”

Section: Discussionsupporting

confidence: 74%

Lung Volume, Gas Mixing, and Mechanics of Breathing in Mechanically Ventilated Very Low Birth Weight Infants with Idiopathic Respiratory Distress Syndrome

et al. 1991

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ABSTRACT. We assessed pulmonary function in 14 mechanically ventilated newborn very low birth weight infants with idiopathic respiratory distress syndrome by means of a face-out, volume displacement body plethysmograph and nitrogen washout analyses. Specially designed computer programs were used for calculations of lung volumes, ventilation, gas mixing efficiency, and mechanical parameters. In addition to very low compliance and moderately elevated resistance of the respiratory system, there were considerably impaired gas mixing efficiency and low functional residual capacity (FRC) For methodologic reasons, lung function studies in newborn infants with IRDS have largely been focused on lung mechanics. Using applied methods makes it possible to obtain a more comprehensive picture of ventilatory conditions, even in very premature, severely affected infants. To further clarify the pathophysiology of IRDS under conditions of mechanical ventilation in this group of infants, we assessed lung volume, alveolar ventilation, gas mixing efficiency, and lung mechanics in mechanically ventilated infants with birth weights below 1500 g. MATERIALS AND METHODSWe studied 14 very low birth weight infants with IRDS during intermittent positive pressure ventilation within 5 d (range 0-5 d) of birth. Six of the infants were boys and eight were girls. Median birth weight was 1.29 kg (range 1.00-1.50 kg) and median gestational age was 29 wk (range 26-33 wk). Informed consent was obtained from the parents of each infant before the procedure was camed out, and the study was approved by the ethics committee of Goteborg University.Maternal history included preeclampsia in six cases and abruption of the placenta in three cases. One infant was a twin. Twelve infants were delivered by cesarean section. Apgar scores were below 5 at 1 min in seven infants and below 7 at 5 min in seven infants. All infants were flushed with oxygen immediately after birth, and nine were also ventilated using a mask. Ten of the infants with adequate spontaneous respiration were treated with continuous positive airway pressure by nasal prongs within 4 h of birth, and the other four were intubated and ventilated within a few minutes of birth. Mechanical ventilation was started within 27 h in all infants. The pulmonary disease was classified as IRDS in all infants (1). All initial radiographs showed a reticulogranular pattern, and no infant had positive blood cultures or hematologic signs of infection.The following guidelines for mechanical ventilation of very low birth weight infants with IRDS were used in the intensive care unit: Nasal intubation with uncuffed endotracheal tubes 2.5-3.0 (Portex LTD, Hythe, Kent, UK) was performed. A Sechrist Infant Ventilator 400 B (Sechrist Industries Inc., Anaheim, CA) was connected to the endotracheal tube. The breathing gas was humidified and heated with a humidifier (Fisher and Paykel, Auckland, New Zealand). Initial ventilator settings were: respiratory rate 60 breathslmin, inspiratory/expiratory ratio 112, PIP 25-30 cm H20,...

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Growth and development of the term and premature pig‐tailed macaque (Macaca nemestrina): Cardiovascular and respiratory changes during the first 3 weeks of life

Standaert¹,

Truog²,

Guthrie³

et al. 1984

American J Primatol

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Growth and development of the infant pigtailed macaque (Macaca nernestrina) over the first 3 weeks of life have been characterized by the variables of body weight, blood pressure, heart rate, ventilation, blood gas tensions, and lung mechanics. The effects of prematurity on postnatal developmental trends were assessed at gestational ages of 135-145 days (0.80 of term) and 150-155 days (0.91 of term). There was no indication that cesarean section, restraint, or instrumentation had any significant influence on the measurements. Gestational age at delivery had no effect on the minute ventilation per kilogram body weight, the hematocrit, or the heart rate; however, body weight, tidal volume, respiratory frequency, arterial gas tensions, blood pressure, and lung compliance did vary with gestational age at delivery.Postnatal maturational changes in these variables were similar between term and premature animals. The data for infant macaques and newborn humans were compared. The newborn macaque appears to be an excellent model of human developmental trends (andor disease state) over the first 3 weeks of life, though some potentially important differences have been found.

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DEVELOPMENT OF PULMONARY FUNCTION IN LATE GESTATION: I. The Functional Residual Capacity of the Lung in Premature Children

Cited by 18 publications

References 18 publications

Functional Residual Capacity in Normal Neonates and Children up to 5 Years of Age Determined by a N2 Washout Method

Functional Residual Capacity in Normal Neonates and Children up to 5 Years of Age Determined by a N2 Washout Method

Lung Volume, Gas Mixing, and Mechanics of Breathing in Mechanically Ventilated Very Low Birth Weight Infants with Idiopathic Respiratory Distress Syndrome

Growth and development of the term and premature pig‐tailed macaque (Macaca nemestrina): Cardiovascular and respiratory changes during the first 3 weeks of life

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