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Chest wall motion in preterm infants using respiratory inductive plethysmography

R H Warren1, S M Horan, P K Robertson

  • 1Dept of Pediatrics, University of Arkansas for Medical Sciences, and Arkansas Children's Hospital, Little Rock, USA.

The European Respiratory Journal
|December 5, 1997
PubMed
Summary

Preterm infants exhibit significantly greater chest wall and abdomen asynchrony during breathing compared to full-term infants. This study used respiratory inductive plethysmography to objectively assess preterm infant chest wall motion.

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Area of Science:

  • Neonatal physiology
  • Respiratory mechanics
  • Infant development

Background:

  • Preterm infant thoracic structures differ from those of healthy full-term infants, potentially altering tidal breathing patterns.
  • Objective bedside assessment of chest wall motion in preterm infants is needed for better understanding and management.

Purpose of the Study:

  • To describe chest wall motion in preterm infants (gestational age <37 weeks).
  • To compare chest wall motion in preterm infants with that of healthy, full-term infants.
  • To evaluate the utility of respiratory inductive plethysmography for bedside assessment.

Main Methods:

  • Sixty-one preterm infants (mean postconceptional age 35.3 weeks) and a group of healthy, full-term infants were studied.
  • Chest wall motion was assessed using a noninvasive, semiquantitatively calibrated respiratory inductive plethysmograph.

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  • Infants were studied in a quiet, awake, prone position to minimize disruption.

    • Main Results:

    • Preterm infants showed a significantly greater mean phase angle (60.6 vs. 12.5 degrees) and laboured breathing index (1.35 vs. 1.01) compared to full-term infants (p < 0.0001 and p = 0.001, respectively).
    • Ribcage contribution to breathing did not significantly differ between groups (25.5% vs. 36.3%, p = 0.11).
    • A significant increase in ribcage and abdomen asynchrony was observed in preterm infants.

    Conclusions:

    • Preterm infants demonstrate increased chest wall and abdominal asynchrony during tidal breathing.
    • Respiratory inductive plethysmography is an effective, objective, and time-efficient method for assessing chest wall motion in preterm infants.