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Flow-resistive loading and diaphragmatic muscle function in term and preterm infants

Theodore Dassios1, Aggeliki Vervenioti1,2, Asimina Tsintoni1

  • 1Neonatal Intensive Care Unit, University Hospital of Patras, Rio, Greece.

Pediatric Pulmonology
|February 14, 2024
PubMed

Insights

Preterm infants, particularly those with bronchopulmonary dysplasia (BPD), show increased diaphragmatic pressure-time index (PTIdi) under inspiratory load. This suggests a higher risk of diaphragmatic muscle fatigue in these vulnerable infants.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Respiratory Physiology

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
  • Diaphragmatic function is crucial for respiratory support in infants.
  • Understanding diaphragmatic response to loading is vital for managing respiratory distress.

Purpose of the Study:

  • To evaluate diaphragmatic function in term and preterm infants.
  • To compare infants with and without a history of BPD.
  • To assess the impact of inspiratory flow resistive loading on diaphragmatic function.

Main Methods:

  • Studied 40 infants (gestational age 34 weeks median).
  • Categorized infants into term, preterm without BPD, and preterm with BPD.
  • Measured diaphragmatic pressure-time index (PTIdi) before and after applying inspiratory resistance.

Main Results:

  • Preterm infants, especially those with BPD history, exhibited higher PTIdi.
  • Application of inspiratory resistance significantly increased PTIdi in all groups.
  • The percentage change in PTIdi was notably higher in preterm infants without BPD compared to term infants.

Conclusions:

  • Preterm infants are at higher risk of diaphragmatic muscle fatigue.
  • Infants recovering from BPD are particularly susceptible to inspiratory loading.
  • Findings highlight the importance of monitoring diaphragmatic function in high-risk infant populations.
Abstract

Keywords:
diaphragmatic work of breathingneonatespressure time product of the diaphragmrespiratory muscles

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