• Pediatric research · Sep 2019

    Observational Study

    Forced oscillation measurements in the first week of life and pulmonary outcome in very preterm infants on noninvasive respiratory support.

    • Emanuela Zannin, Roland P Neumann, Raffaele Dellacà, and Sven M Schulzke.
    • Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano University, Milan, Italy. emanuela.zannin@polimi.it.
    • Pediatr. Res. 2019 Sep 1; 86 (3): 382-388.

    BackgroundWe aimed at investigating whether early lung mechanics in non-intubated infants below 32 weeks of gestational age (GA) are associated with respiratory outcome.MethodsLung mechanics were assessed by the forced oscillation technique using a mechanical ventilator (Fabian HFOi, ACUTRONIC Medical Systems AG, Hirzel, Switzerland) that superimposed small-amplitude oscillations (10 Hz) on a continuous positive airway pressure. Measurements were performed during regular tidal breathing using a face mask on days 2, 4, and 7 of life. Respiratory system resistance (Rrs) and reactance (Xrs) were computed from flow and pressure.ResultsOne hundred and seventy-seven measurements were successfully performed in 68 infants. Infants had a mean (range) GA of 29.3 (24.1-31.7) weeks and a birth weight of 1257 (670-2350)g. Xrs was associated with the duration of respiratory support (R2 = 0.39, p < 0.001). A multilevel regression model, including Xrs and GA, explained the duration of respiratory support better than GA alone (R2 = 0.51 vs. 0.45, p = 0.005, likelihood ratio test).ConclusionAssessment of Xrs in the first week of life is feasible and improves prognostication of respiratory outcome in very preterm infants on noninvasive respiratory support.

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