A very low dead space pneumotachograph for ventilatory measurements in newborns

In premature and full-term neonates, technical limitations hamper the measurements of pulmonary mechanics. Current commercially available pneumotachographs (PNT) either increase the dead space, causing hyperventilation, or increase resistance, thus altering the mechanics of breathing. We modified a previously described low dead space PNT for infants to increase the linear range and frequency response. The mean resistance of the new PNT was 2.44 cmH2O.1-1.s compared with 2.65 cmH2O.1-1.s for the Fleisch no. 0 PNT. The added dead space over the standard endotracheal connector was 0.6 ml compared with 4.7 ml for the Fleisch PNT. Like the Fleisch PNT, the flow resistance was linear from 0 to 15 l/min. In response to a sinusoidal waveform, the new PNT had a phase angle of 21 degrees at 5 Hz and 50 degrees at 16 Hz compared with 19 degrees and 43 degrees, respectively, for the Fleisch PNT. The change in attenuation for both systems was zero until 20 Hz. In summary, the new PNT is lightweight and provides accuracy and low resistance with a very small dead space.