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Intra-breath respiratory oscillometry in the first days of life in preterm infants: a prospective observational study

Emanuela Zannin1, Camilla Rigotti2, Maria Luisa Ventura1

  • 1Neonatal Intensive Care Unit, Fondazione IRCCS San Gerardo Dei Tintori, Via Pergolesi 33, 20900, Monza, Italy.

European Journal of Pediatrics
|August 19, 2026
PubMed

Insights

Preterm infants show significant intra-breath changes in respiratory mechanics during non-invasive support. Reduced expiratory reactance (Xrs) is linked to poor lung compliance, suggesting dynamic lung volume adjustments.

Area of Science:

  • Neonatal physiology
  • Respiratory mechanics
  • Infant respiratory support

Background:

  • Intra-breath changes in oscillatory mechanics reveal disease-specific behaviors in other populations.
  • Understanding these dynamics in preterm infants is crucial for optimizing respiratory support.

Purpose of the Study:

  • To describe intra-breath changes in respiratory system resistance (Rrs) and reactance (Xrs) in preterm infants receiving non-invasive respiratory support.
  • To investigate the relationship between these changes and lung compliance.

Main Methods:

  • Prospective observational study of 69 infants born <32 weeks' gestation.
  • Respiratory oscillometry performed at 24-48 hours of life using superimposed oscillations.
  • Calculated average and end-inspiratory/expiratory Rrs and Xrs.

Main Results:

  • Significant differences observed between inspiratory and expiratory Rrs and Xrs.
  • Gestational age explained intra-breath fluctuations.
  • Reduced expiratory reactance (Xexp) correlated with poor lung compliance, independent of gestational age.

Conclusions:

  • Preterm infants exhibit distinct intra-breath oscillatory mechanics, particularly at lower gestational ages.
  • Reduced expiratory Xrs may indicate compensatory mechanisms for elevating end-expiratory lung volume in infants with poor lung compliance.
  • Findings inform the standardization of respiratory oscillometry in preterm infants.

Keywords:
Continuous positive airway pressurePreterm infantsRespiratory oscillometry

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