Partitioning of Airway and Parenchymal Mechanics in Unsedated Newborn Infants

Pillow, J. Jane; Stocks, Janet; Sly, Peter D.; Hantos, Zoltán

doi:10.1203/01.pdr.0000185273.86320.13

Cited by 27 publications

(26 citation statements)

References 33 publications

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“…The relationship between Xrs and PEEP was quite flat, suggesting that, for the range of PEEPs applied in this study, the lungs did not either collapse or reach the upper flat part of the pressure-volume relationship. In this group Xrs was higher compared with the other groups, likely because these infants have more mature lungs with larger aerated volumes, and Xrs is positively related to body size and lung maturation [21,22].…”

Section: Effects Of Peep On Respiratory Input Impedancementioning

confidence: 68%

Relationship between respiratory impedance and positive end-expiratory pressure in mechanically ventilated neonates

et al. 2013

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Section: Effects Of Peep On Respiratory Input Impedancementioning

confidence: 68%

Relationship between respiratory impedance and positive end-expiratory pressure in mechanically ventilated neonates

et al. 2013

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“…The neonatal subgroup has been the focus of recent work, and published data supports the investigation of the oscillometry assessment in the youngest patients, with some technical modifications, which included the stimulation of a minimum of 2-second breathing pause at the end of inspiration using the Hering-Breuer inflation reflex (reflex triggered to prevent overinflation of the lungs by creating an apneic pause) in unsedated neonates by means of a shutter valve and a face mask [28, 29]. The IOS approach in neonates has not been validated against an accepted “gold standard” technique of respiratory function measurement (i.e., the use of an esophageal balloon to determine transpulmonary pressures to separate the chest wall and lung components of the resistance spectrum).…”

Section: Introductionmentioning

confidence: 99%

Comparison Study of Airway Reactivity Outcomes due to a Pharmacologic Challenge Test: Impulse Oscillometry versus Least Mean Squared Analysis Techniques

et al. 2013

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The technique of measuring transpulmonary pressure and respiratory airflow with manometry and pneumotachography using the least mean squared analysis (LMS) has been used broadly in both preclinical and clinical settings for the evaluation of neonatal respiratory function during tidal volume breathing for lung tissue and airway frictional mechanical properties measurements. Whereas the technique of measuring respiratory function using the impulse oscillation technique (IOS) involves the assessment of the relationship between pressure and flow using an impulse signal with a range of frequencies, requires less cooperation and provides more information on total respiratory system resistance (chest wall, lung tissue, and airways). The present study represents a preclinical animal study to determine whether these respiratory function techniques (LMS and IOS) are comparable in detecting changes in respiratory resistance derived from a direct pharmacological challenge.

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“…The forced oscillation technique (FOT) has been widely used to measure the impedance of the respiratory system in dogs (3)(4)(5)(6), rats (7), monkeys (8)(9)(10)(11) and human infants (12). By measuring lung impedance over a wide range of frequencies, it is possible to separate the components of the system impedance into airway and tissue components.…”

Section: Introductionmentioning

confidence: 99%

Differential Effects of Dexamethasone on the Proximal and Distal Lung Response to Antigen Challenge in Allergic Cynomolgus Monkeys

Curran¹,

Skeans²,

Landers³

et al. 2008

Journal of Asthma

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The proximal and distal portions of the lungs may respond differently to antigen challenge and bronchodilator treatment. This difference may contribute to differences in actual and perceived efficacy of therapies. In this study we used the forced oscillation technique (FOT) to measure impedance in the pulmonary system and discern the effects of antigen challenge on proximal (large airway) and distal (small airway and lung parenchyma) portions of the lung. In addition we treated the animals with two i.m. injections of either a saline control or dexamethasone (0.5 mg/kg) 18 and 1 hour(s) before the antigen challenge. The FOT technique was used to measure indices of proximal airway status, Newtonian airway resistance (R(N)), and distal airway status, including tissue damping (G) and tissue elastance (H). Challenging the animals with Ascaris Suum antigen caused a significant increase in both the proximal and distal lung measures. Pretreatment with dexamethasone significantly reduced the peak increase in R(N) but not G or H. In addition, the area under the curve (AUC) of the FOT response over 60 minutes was significantly reduced for the R(N) but again, G and H were not significantly reduced. These data indicate that, using the FOT, we can dissociate the response of proximal and distal airways to an antigen challenge. Moreover, steroid pre-treatment can reduce the bronchoconstrictor response to inhaled antigen but this effect is primarily via effects on the proximal airways with little effect on the distal airways and parenchymal component of pulmonary impedance. These data may help to provide a mechanism for evaluation of novel therapies for small airway dysfunction.

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Partitioning of Airway and Parenchymal Mechanics in Unsedated Newborn Infants

Cited by 27 publications

References 33 publications

Relationship between respiratory impedance and positive end-expiratory pressure in mechanically ventilated neonates

Relationship between respiratory impedance and positive end-expiratory pressure in mechanically ventilated neonates

Comparison Study of Airway Reactivity Outcomes due to a Pharmacologic Challenge Test: Impulse Oscillometry versus Least Mean Squared Analysis Techniques

Differential Effects of Dexamethasone on the Proximal and Distal Lung Response to Antigen Challenge in Allergic Cynomolgus Monkeys

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