Mechanics of the respiratory system during passive exhalation in preterm lambs

Previous studies have shown large inhomogeneities in the distributions of ventilation and perfusion of newborn infants with hyaline membrane disease. The purpose of this study was to show that measurements of lung mechanics also show evidence of lung inhomogeneities and that a multiple compartment analysis of mechanics gives a more accurate representation of passive exhalation flow and volume than single valued mechanics. We studied 10 sedated preterm lambs (130 d gestation) weighing 2.2 +/- 0.3 kg at 4 h postnatal age. Passive exhalation lung mechanics of the respiratory system were measured by obstructing gas flow near end inhalation then, after pressures within the lung reached equilibrium, allowing the animals to exhale to the atmosphere. Airway pressure and flow signals were monitored by a computer then analyzed using single and multiple compartment analyses. Single compartment analysis of time constant (tau) in s, respiratory system resistance (R) in cm H2O/L/s and quasistatic compliance (C) in mL/cm H2O yielded tau = 0.16 +/- 0.07, R = 92 +/- 17, and C = 1.8 +/- 1.1 (mean +/- SD). Multiple compartment analysis yielded "fast compartment" tau 1 = 0.10 +/- 0.04, R1 = 90 +/- 28, and C1 = 1.1 +/- 0.5 and "slow compartment" tau 2 = 0.25 +/- 0.12, R2 = 503 +/- 288, and C2 = 0.7 +/- 0.6. All of the animals studied exhibited nonlinearity in their flow-volume plots. Calculated flow-volume plots were much more accurately portrayed by the two-compartment analysis than by single valued mechanics. Multiple compartment analysis of lung mechanics may provide useful insight into the pathophysiology of the preterm lab with hyaline membrane disease.