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Clinical application of lung function testing in ventilated infants
1Dept of Child Health, King's College Hospital, London, UK.
Insights
Clinicians can now measure lung function and ventilator-patient interaction in neonates, aiding therapy assessment and respiratory support development. Careful consideration of limitations and benefits is crucial before adopting new computerized systems.
Area of Science:
- Neonatal respiratory physiology
- Mechanical ventilation
- Pulmonary function testing
Background:
- Lung function, respiratory timing, and ventilator-patient interaction can be assessed in ventilator-dependent neonates.
- These measurements are typically conducted within research settings.
- They are crucial for evaluating disease severity, predicting prognosis, and assessing therapeutic efficacy, especially for surfactant therapy.
Purpose of the Study:
- To review the applications and implications of lung function measurements in neonatal respiratory care.
- To highlight the utility of assessing ventilator-patient interaction for refining ventilation strategies and developing new support systems.
- To emphasize the need for careful consideration of potential problems, limitations, and benefits before clinical adoption of computerized lung function systems.
Main Methods:
- Review of existing research and clinical practices in neonatal respiratory monitoring.
- Analysis of the role of lung function measurements in evaluating disease and therapy.
- Discussion of the impact of ventilator-patient interaction on conventional and novel respiratory support.
Main Results:
- Lung function measurements provide valuable insights into neonatal respiratory status.
- Ventilator-patient interaction assessment aids in optimizing ventilation and developing patient-triggered ventilation.
- Commercial computerized systems offer potential for broader clinical application.
Conclusions:
- Lung function assessment is a valuable tool in neonatal intensive care.
- Careful evaluation of new technologies is necessary before widespread clinical implementation.
- Understanding limitations and benefits ensures safe and effective use of respiratory monitoring tools.
Abstract:
Lung function (compliance, resistance and functional residual capacity), respiratory timing and ventilator-patient interaction can now be assessed in ventilator-dependent neonates. Such measurements have usually been made as part of research studies. Disease severity has been evaluated and prognosis predicted, the efficacy of many therapies, particularly surfactant, has been assessed by determining their ability to improve lung function. Measurement of ventilator-patient interaction has been particularly useful to refine conventional ventilation and in the development of newer forms of respiratory support such as patient triggered ventilation. The recent arrival of commercially available computerized lung function systems may tempt clinicians to introduce respiratory measurements into their practice. Before such an approach is adopted, however, it is vital the potential problems, limitations and likely benefits are carefully thought through.