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Validity of forced expiratory flow volume loops in neonates
E W Hoskyns1, A D Milner, I E Hopkin
1Department of Neonatal Medicine and Surgery, City Hospital, Nottingham.
Archives of Disease in Childhood
|September 1, 1987
Summary
Chest squeezing in newborns to measure small airway function can yield inaccurate results. Neonates often make reflex inspiratory efforts in response to chest compression, interfering with measurements.
Area of Science:
- Neonatal physiology
- Respiratory mechanics
- Pulmonary function testing
Background:
- Assessing small airway function in neonates is crucial for early diagnosis of respiratory conditions.
- Current methods for measuring neonatal airway function may be influenced by infant's physiological responses.
Purpose of the Study:
- To investigate the physiological response of healthy term neonates to forced expiratory maneuvers using chest compression.
- To determine if reflex inspiratory efforts interfere with the accuracy of small airway function measurements in newborns.
Main Methods:
- Studied 10 healthy term neonates using an esophageal balloon and an inflatable jacket for chest compression.
- Recorded esophageal pressure, jacket pressure, and mouth flow/volume during forced expiration at various respiratory cycle points.
Main Results:
- An inspiratory effort was observed in 188 out of 221 squeezes before esophageal pressure plateaued.
- Inspiratory efforts were earlier and stronger when chest compression occurred at lower lung volumes.
- Upper airway narrowing or closure was noted in some cases during plateau pressure.
Conclusions:
- Newborns exhibit a reflex inspiratory response to chest compression.
- This reflex can significantly interfere with the accurate measurement of small airway function using this technique.
- The timing and intensity of the inspiratory response vary with lung volume during compression.