Ventilatory response to increased dead spaces in the first week of life

We have developed a method for quantitatively assessing respiratory control in a group of 10 full-term healthy babies, mean age at test 5 days, by measuring their ventilatory response to added external dead spaces. The dead spaces were equal to 0.5, 1, 2, and 3 anatomic dead spaces (2.2 ml/kg body weight), respectively. Tidal volumes were measured by a nasal mask and a 200-I rigid container. End-tidal CO2 was monitored via a tube in the nostril by a mass spectrometer. Baseline measurements were made during a 10-minute period, after which similar recordings were obtained with each of the dead space tubes. The system was calibrated against a 20-ml syringe. The mean baseline ventilation was 602 ml/minute. On the addition of 0.5, 1, 2, and 3 dead spaces, minute ventilations were increased by 37.5, 74.7, 150.7, and 273.6%, respectively. These increases were due to rises in tidal volume rather than respiratory rate. End-tidal CO2 rose by 1.8 and 4 mmHg on the addition of 2 and 3 dead spaces. When the results were compared with expected minute ventilations--based on the baseline recordings and corrected for the added dead spaces and for changes in anatomic dead space ventilation due to alterations in respiratory rate--the results were within 10% of expected values.