Static Volume-Pressure Relations of Excised Lungs of Infants With Hyaline Membrane Disease, Newborn and Stillborn Infants

Gribetz, Irwin; Frank, N. R.; Avery, Mary Ellen

doi:10.1172/jci103996

Cited by 93 publications

(29 citation statements)

References 14 publications

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“…In addition to marked differences in pressure requirements and oxygenation between ventilator groups over the study period, dramatic intergroup differences were present in the P-V curves at 24 h. The lungs of the IMV animals exhibited decreased compliance and minimal hysteresis, similar to the findings of Gribetz et al (20) in human premature infants with HMD and deLemos et al (21) in premature lambs. Although there was no difference in deflation stability between IMV and HFOV groups, the lungs of the HFOV animals showed significantly higher LV,,,, V,, and hysteresis.…”

Section: Age (Hours)supporting

confidence: 75%

High-Frequency Oscillatory Ventilation Versus Intermittent Mandatory Ventilation: Early Hemodynamic Effects in the Premature Baboon with Hyaline Membrane Disease

Clark

et al. 1991

Pediatr Res

101

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ABSTRACT. We studied the hemodynamic consequences during the first 24 h of life in premature baboons (140 d) with hyaline membrane disease that were treated with high-frequency oscillatory ventilation (HFOV) or conventional intermittent mandatory ventilation (IMV). Cardiac output and organ blood flow were measured at three timepoints using the radiolabeled microsphere technique. Seven of seven HFOV and six of eight IMV animals survived_the 24-h period. By design, initial mean airway pressus (P,,) was higher in the HFOV group (p < 0.01). HFOV Pa, was progressively reduced during the study period because of improving oxygenation as measured by the arterial to alveolar oxygen ratio. In contrast, it was necessary to increase Paw in the IMV animals to maintain the arterial to alveolar oxygen ratio. By 23 h, the IMV group required higher Pa, than the HFOV group (p < 0.05) and had a lower arterial to alveolar oxygen ratio (p < 0.05). We found no significant differences in left ventricular output, effective systemic flow, organ blood flow, or central venous pressure between the two groups at 3, 8, or 23 h. The HFOV strategy used in our study resulted in significant improvement in oxygenation during the initial 24 h of treatment without adverse effect on left ventricular output, cerebral blood flow, or central venousjressure. We conclude that when appropriate changes in Pa, are made during HFOV in response to improvement in arterial oxgenation and changes in lung inflation as assessed by chest radiographs HFOV can be achieved without depressing cardiovascular dynamics more than during conventional therapy with IMV. (Pediatr Res 29: 160-166,1991) Abbreviations CVP, central venous pressure Fi02, fraction of inspired oxygen HFOV, high-frequency oscillatory ventilation HMD, hyaline membrane disease IMV, intermittent mandatory ventilation LVO, left ventricular output -Paw, mean airway pressure PEEP, positive end expiratory pressure PIP, peak inspiratory pressure

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Section: Age (Hours)supporting

confidence: 75%

High-Frequency Oscillatory Ventilation Versus Intermittent Mandatory Ventilation: Early Hemodynamic Effects in the Premature Baboon with Hyaline Membrane Disease

Clark

et al. 1991

Pediatr Res

101

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“…Thoracic gas volumes of most sick infants are below 1.4 ml per g and rise with recovery; two of the sick infants had initial values within the range of the normal infants. Gribetz and co-workers (13), however, found a smaller gas-containing volume that was well below 1.0 ml per g in excised lungs of infants with hyaline membranes at all airway pressures used. This difference between lung volume/lung weight figures may be explained by inclusion of upper airway volume in the in vivo TGV measurements.…”

Section: Resultsmentioning

confidence: 83%

Measurement of Thoracic Gas Volume in the Newborn Infant*

Auld¹,

Nelson²,

Cherry³

et al. 1963

J. Clin. Invest.

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“…On expiration, the lung of the normal term infant retains residual air, up to 40% of total lung volume [21], so that, with subsequent breaths, inspiratory pressures are much lower than with the first. The retention of expiratory residual air is the functional measure of alveolar stability [2]Lungs excised from premature infants with and without RDS and from stillborn infants may have normal, less than normal, or inadequate alveolar stability [22,[24][25][26][27][28].…”

Section: Physiologic Aspects Of Alveolar Stabilitymentioning

confidence: 99%

Biochemical Development of Surface Activity in Mammalian Lung. IV. Pulmonary Lecithin Synthesis in the Human Fetus and Newborn and Etiology of the Respiratory Distress Syndrome

et al. 1972

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Static Volume-Pressure Relations of Excised Lungs of Infants With Hyaline Membrane Disease, Newborn and Stillborn Infants

Cited by 93 publications

References 14 publications

High-Frequency Oscillatory Ventilation Versus Intermittent Mandatory Ventilation: Early Hemodynamic Effects in the Premature Baboon with Hyaline Membrane Disease

High-Frequency Oscillatory Ventilation Versus Intermittent Mandatory Ventilation: Early Hemodynamic Effects in the Premature Baboon with Hyaline Membrane Disease

Measurement of Thoracic Gas Volume in the Newborn Infant*

Biochemical Development of Surface Activity in Mammalian Lung. IV. Pulmonary Lecithin Synthesis in the Human Fetus and Newborn and Etiology of the Respiratory Distress Syndrome

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