Journal
PEDIATRIC RESEARCH
Volume 86, Issue 3, Pages 382-388Publisher
SPRINGERNATURE
DOI: 10.1038/s41390-019-0432-6
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Funding
- Swiss Kommission fur Technologie und Innovation (KTI) [25768.2 PFLS]
- European Respiratory Society Long-Term Fellowship [LTRF 2015-4459]
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BACKGROUND: We aimed at investigating whether early lung mechanics in non-intubated infants below 32 weeks of gestational age (GA) are associated with respiratory outcome. METHODS: Lung mechanics were assessed by the forced oscillation technique using a mechanical ventilator (Fabian HFOi, ACUTRONIC Medical Systems AG, Hirzel, Switzerland) that superimposed small-amplitude oscillations (10 Hz) on a continuous positive airway pressure. Measurements were performed during regular tidal breathing using a face mask on days 2, 4, and 7 of life. Respiratory system resistance (Rrs) and reactance (Xrs) were computed from flow and pressure. RESULTS: One hundred and seventy-seven measurements were successfully performed in 68 infants. Infants had a mean (range) GA of 29.3 (24.1-31.7) weeks and a birth weight of 1257 (670-2350)g. Xrs was associated with the duration of respiratory support (R-2 = 0.39, p < 0.001). A multilevel regression model, including Xrs and GA, explained the duration of respiratory support better than GA alone (R-2 = 0.51 vs. 0.45, p = 0.005, likelihood ratio test). CONCLUSION: Assessment of Xrs in the first week of life is feasible and improves prognostication of respiratory outcome in very preterm infants on noninvasive respiratory support.
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