Assessment of respiratory mechanics with forced oscillations in healthy newborns

Hantos, Zoltán; Czövek, Dorottya; Gyurkovits, Zita; Szabó, Hajnalka; Maár, Balázs; Radics, Bence; Virág, Katalin; Makan, Gergely; Orvos, Hajnalka; Gingl, Zoltán; Sly, Peter D.

doi:10.1002/ppul.23103

Cited by 32 publications

(39 citation statements)

References 40 publications

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“…Some newborns in the current study showed marked variability of respiratory impedance on day 1. The elevated compliance of the chest—relative to that of the lung—implies active mechanisms to compensate for the floppy rib cage so as to defend the functional residual capacity beyond the very first breath.…”

mentioning

confidence: 51%

“…In dynamic conditions, it is likely to be determined to a major extent by the parallel impedance of the airway wall and the distribution of mechanical time constants within the lung that is very likely to fluctuate with ventilation inhomogeneity and trapping of alveolar gas. 15,16 Some newborns in the current study 10 showed marked variability of respiratory impedance on day 1. The elevated compliance of the chest-relative to that of the lung-implies active mechanisms to compensate for the floppy rib cage so as to defend the functional residual capacity beyond the very first breath.…”

mentioning

confidence: 57%

“…In contrast, the forced oscillation technique has the significant advantage that it provides valid measurement during active breathing. Nevertheless, the respiratory muscle contraction per se is capable of altering the impedance of the chest, therefore impacting on respiratory system resistance and compliance, thus a potential contributor to the large variability observed in some newborns of Hantos' paper …”

mentioning

confidence: 99%

“…In the current article, Hantos et al 10 have undertaken the original task of a systematic investigation of respiratory mechanical impedance at days 1, 2, and 3 of life in healthy unsedated term newborns. The forced oscillation technique estimated respiratory resistancemostly determined by frictional losses in the airwaysand respiratory compliance, which is related to the apparent elastic respiratory properties.…”

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confidence: 99%

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From respiratory adaptation at birth to early markers of childhood respiratory health

Marchal

2015

Pediatr Pulmonol.

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Assessing lung function in the newborn relates to the need for early markers of chronic respiratory diseases such as cystic fibrosis or asthma. Non-invasive respiratory measurements of forced oscillations mechanics are recently shown to be possible in unsedated babies. The bronchodilator effect of catecholamine release at birth, and the respiratory muscle contribution to respiratory mechanical impedance resulting in sometimes excessive variability suggest that measurements should be performed beyond the first 24 hr of life.

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confidence: 51%

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confidence: 57%

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confidence: 99%

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confidence: 99%

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From respiratory adaptation at birth to early markers of childhood respiratory health

Marchal

2015

Pediatr Pulmonol.

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“…Recent developments have seen new methods for measuring the mechanical properties of the airway and lungs in unsedated infants during natural sleep. 43 This technique can be used to study the effects of prenatal exposures suspected of restricting lung growth in utero, thus demonstrating a direct link between environmental exposures and long-term risk of lung disease.…”

Section: F U T U R E D I R E C T I O N Smentioning

confidence: 99%

Health Consequences of Environmental Exposures: Causal Thinking in Global Environmental Epidemiology

Sly

Carpenter

Berg

et al. 2016

Annals of Global Health

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The 2010 Global Burden of Disease estimates indicate a trend toward increasing years lived with disability from chronic noncommunicable diseases (NCDs). Risk factors examined included smoking, diet, alcohol, drug abuse, and physical inactivity. By contrast, little consideration was given to accumulating evidence that exposures to environmental chemicals, psychosocial stress, and malnutrition during fetal development and across the life span also increase risk of NCDs. To address this gap, we undertook a narrative review of early-life environmental contributions to disease. We documented numerous etiologic associations. We propose that future GBD estimates use an expanded approach for assessing etiologic contributions of environmental exposures to recognized disease risk factors. We argue that broadening the definition of environmental disease, together with improved methods of assessing early life exposures and their health outcomes across the life span, will allow better understanding of causal associations and provide the incentives required to support strategies to control avoidable exposures and reduce disease risk.

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Evaluation of bedside pulmonary function in the neonate: From the past to the future

Reiterer

Sivieri

Abbasi

2015

Pediatric Pulmonology

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Pulmonary function testing and monitoring plays an important role in the respiratory management of neonates. A noninvasive and complete bedside evaluation of the respiratory status is especially useful in critically ill neonates to assess disease severity and resolution and the response to pharmacological interventions as well as to guide mechanical respiratory support. Besides traditional tools to assess pulmonary gas exchage such as arterial or transcutaenous blood gas analysis, pulse oximetry, and capnography, additional valuable information about global lung function is provided through measurement of pulmonary mechanics and volumes. This has now been aided by commercially available computerized pulmonary function testing systems, respiratory monitors, and modern ventilators with integrated pulmonary function readouts. In an attempt to apply easy-to-use pulmonary function testing methods which do not interfere with the infant́s airflow, other tools have been developed such as respiratory inductance plethysmography, and more recently, electromagnetic and optoelectronic plethysmography, electrical impedance tomography, and electrical impedance segmentography. These alternative technologies allow not only global, but also regional and dynamic evaluations of lung ventilation. Although these methods have proven their usefulness for research applications, they are not yet broadly used in a routine clinical setting. This review will give a historical and clinical overview of different bedside methods to assess and monitor pulmonary function and evaluate the potential clinical usefulness of such methods with an outlook into future directions in neonatal respiratory diagnostics.

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Assessment of respiratory mechanics with forced oscillations in healthy newborns

Abstract: Noninvasive measurement of Zrs can be made in neonates during natural sleep with a high success rate, even in the first hours of life.

Cited by 32 publications

References 40 publications

From respiratory adaptation at birth to early markers of childhood respiratory health

From respiratory adaptation at birth to early markers of childhood respiratory health

Health Consequences of Environmental Exposures: Causal Thinking in Global Environmental Epidemiology

Evaluation of bedside pulmonary function in the neonate: From the past to the future

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