Diaphragm dimensions of the healthy term infant

V K Rehan1, F D McCool

  • 1Department of Pediatrics, Memorial Hospital of Rhode Island, Pawtucket, RI, USA. vrehan@gcrc.rei.edu

Insights

In healthy infants, diaphragm thickness scales with body size, but maximal transdiaphragmatic pressure remains constant and is higher than in adults. This suggests perinatal diaphragm strengthening may aid infant breathing.

Area of Science:

  • Neonatal physiology
  • Respiratory mechanics
  • Developmental biology

Background:

  • Human neonatal diaphragm development is understudied.
  • Previous research in older subjects indicates diaphragm thickness (t(di)) scales with body size, maintaining constant maximal transdiaphragmatic pressure (P(dimax)).
  • This relationship has not been established in healthy term infants.

Purpose of the Study:

  • To investigate the relationship between diaphragm thickness (t(di)), body dimensions, and calculated maximal transdiaphragmatic pressure (P(dimax)) in healthy term infants.
  • To test the hypothesis that t(di) correlates with body size and P(dimax) is independent of body weight and length in this population.

Main Methods:

  • Ultrasound measurement of t(di) at the zone of apposition in 15 healthy term infants.
  • Measurement of anthropometric dimensions including rib cage dimensions.
  • Calculation of P(dimax) using the piston-in-cylinder model.

Main Results:

  • Significant positive correlations were observed between t(di) and body weight (BW), body length (BL), and head circumference (HC).
  • Diaphragm thickness increased with larger body size and larger lower rib cage cross-sectional areas (A(ZAP)).
  • Calculated P(dimax) was independent of BW and BL, and was higher than adult values.

Conclusions:

  • Neonatal diaphragm mass is proportional to body size in healthy term infants.
  • Calculated P(dimax) is independent of body size and exceeds adult levels.
  • Potential perinatal diaphragm strengthening may help infants manage the high respiratory loads during pulmonary transition.
Abstract

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