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Influence of preterm onset of inspiration on tidal breathing parameters in infants with and without CLD

Gerd Schmalisch1, Roland R Wauer, Bertram Foitzik

  • 1Clinic of Neonatology (Charité), Humboldt-University of Berlin, Schumannstrasse 20/21, D-10098, Berlin, Germany. gerd.schmalisch@charite.de

Respiratory Physiology & Neurobiology
|April 23, 2003
PubMed

Insights

Preterm onset of inspiration (POI) is a breathing strategy in newborns. This study found POI relates to breathing flow profiles, not just rate or depth, in healthy and chronic lung disease infants.

Area of Science:

  • Neonatal physiology
  • Respiratory medicine
  • Pediatric pulmonology

Background:

  • Preterm onset of inspiration (POI) is a recognized breathing strategy in neonates.
  • POI aims to increase end-expiratory lung volume in newborns.
  • Understanding POI's relationship with tidal breathing (TB) is crucial for assessing infant respiratory health.

Purpose of the Study:

  • To investigate the association between preterm onset of inspiration (POI) and tidal breathing (TB) parameters.
  • To compare POI and TB parameters in healthy neonates versus infants with chronic lung diseases (CLD).
  • To determine if TB parameters reflect breathing strategy or respiratory impairment.

Main Methods:

  • Utilized a deadspace-free flow-through technique to evaluate 10-60 breaths during quiet sleep.
  • Derived POI from averaged flow-volume loops, considering end-expiratory flow levels.
  • Compared healthy neonates (n=54) with infants with CLD (n=45) of similar postconceptional age.

Main Results:

  • Respiratory rate (RR), ventilation (VE), and peak flows were significantly higher in CLD infants.
  • The incidence of POI did not significantly differ between healthy and CLD infant groups.
  • POI showed a strong association with TB parameters describing flow profiles, but not with parameters solely dependent on breathing rate and depth (e.g., RR, VT, VE).

Conclusions:

  • Tidal breathing parameters characterizing flow profiles, rather than rate and depth, are associated with preterm onset of inspiration in infants.
  • These findings suggest that flow profile parameters may indicate differences in breathing strategies rather than solely reflecting impaired respiratory function.
  • The study highlights the importance of analyzing breathing mechanics beyond simple rate and volume measurements in neonates, particularly those with or at risk for chronic lung disease.

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