Regional ventilation distribution in the first 6 months of life

Abstract

Electrical impedance tomography (EIT) has been used to study regional ventilation distribution in neonatal and paediatric lung disease; however, little information has been obtained in healthy newborns and infants.Data on regional ventilation distribution and regional filling characteristics were obtained using EIT in the neonatal period, at 3 and 6 months of age, in spontaneously breathing infants during non-rapid eye movement sleep. Regional ventilation distribution was described using regional end-expiratory and end-inspiratory impedance amplitudes, and geometric centre of ventilation. Regional filling characteristics were described with the phase lag or lead of the regional impedance change in comparison to global impedance change.32 infants were measured in the supine position. Regional impedance amplitudes increased with age but regional ventilation distribution remained unchanged in all infants at any age, with the dependent (posterior) lung always better ventilated. Regional filling characteristics showed that the dependent lung filled during inspiration before the nondependent lung during all followup measurements.Regional ventilation distribution and regional filling characteristics remained unchanged over the first 6 months of life, and the results obtained on regional ventilation distribution are very similar to those in adult subjects.

Effect of Body Position on Ventilation Distribution in Ventilated Preterm Infants

“…In healthy preterm infants, the posterior (dependent) lung filled significantly earlier than the anterior lung in the supine position. Similar time-course characteristics were also found in supine in healthy newborns (5). This finding is consistent with the lung model proposed by Milic-Emili et al (31), which showed that the rate of volume change during the initial phase of tidal volume ventilation was greatest in the dependent lung.…”

“…Similar results were also found by our study group in healthy term newborns during non-rapid eye movement sleep (5).…”

“…EIT data were band-pass filtered to include the first and second harmonic of the respiratory rate (5,10,15), and a cutoff mask of 20% of the peak impedance signal was applied (16) to eliminate cardiac interference (10). As the preterm infant often displays a periodic respiratory pattern, noise-free, regular sections of data were selected for analysis.…”

Chest Physical Therapy in Acute Viral Bronchiolitis: An Updated Review

“…[24][25][26] However, it should be remembered that mucociliary clearance is predominant in the dependent lung areas of semi-sitting infants, as in adults, being stimulated by regional ventilation. [27][28][29] No wonder that conventional CPT gives poor results and is poorly tolerated, with side effects such as esophageal reflux, tachypnea, tachycardia, hypoxemia, rib fracture, and severe central nervous system complications, especially in newborns. [30][31][32][33][34] The 2012 Cochrane review showed no significant benefit from conventional CPT on clinical score or hospital stay, and conventional CPT in acute viral bronchiolitis is no longer recommended.…”

Paediatrics in Barcelona: highlights from the 2010 ERS Annual Congress

“…At the 2010 ERS Congress a number of research groups reported data from alternative techniques to quantify inhomogeneity. PHAM et al [107] reported EIT recordings in spontaneously breathing term infants measured soon after birth and again at 3 and 6 months SCIENTIFIC ASSEMBLY UPDATE: PAEDIATRICS E. EBER ET AL.…”