title: Chest wall motion in preterm infants using respiratory inductive plethysmography.
abstract: Preterm infant tidal breathing may be different from that of healthy full-term infants because of various features of the premature thorax. The purpose of this project was to describe chest wall motion in the preterm infant (gestational age <37 weeks) and compare it with chest wall motion data in a group of healthy, full-term infants. We wanted to use an objective bedside method for assessment with minimal disruption to the infant. The study population consisted of 61 preterm human infants whose mean(+/-sD) postconceptional age at time of study was 35.3+/-2.1 weeks. During the study, the infants were quietly awake in a prone position. Preterm infants had initially been admitted to a level III neonatal intensive care unit for acute management and had been transferred to a step-down area, where they were in stable condition for study. Data were collected with a semiquantitatively calibrated, noninvasive respiratory inductive plethysmograph. Mean(+/-SD) phase angle was significantly greater in preterm infants than in full-term infants (60.6+/-39.8 degrees versus 12.5+/-5.0 degrees, respectively, p < or = 0.0001). The laboured breathing index was significantly greater in preterm infants than in full-term infants (1.35+/-0.35 versus 1.01+/-0.01, respectively, p = 0.001). The ribcage contribution to breathing did not differ significantly between preterm and full-term infants (25.5+/-17.7% versus 36.3+/-14.4%, respectively, p = 0.11). These results indicate a significant increase in the degree of ribcage and abdomen asynchrony in the preterm subjects compared to the full-term infants. Plethysmography provided a time-efficient and objective method of assessing chest wall motion in this fragile population.
authors.affiliation: Dept of Pediatrics, University of Arkansas for Medical Sciences, and Arkansas Children's Hospital, Little Rock, USA.
authors.forename: R H
authors.initials: RH
authors.lastname: Warren
authors.forename: S M
authors.initials: SM
authors.lastname: Horan
authors.forename: P K
authors.initials: PK
authors.lastname: Robertson
mesh_terms: D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D008297:Male; D009068:Movement / Q000502:physiology; D010991:Plethysmography / Q000295:instrumentation* / Q000379:methods; D012016:Reference Values; D012119:Respiration / Q000502:physiology; D015656:Respiratory Mechanics / Q000502:physiology*; D012272:Ribs / Q000033:anatomy & histology / Q000502:physiology; D012680:Sensitivity and Specificity; D013909:Thorax / Q000033:anatomy & histology / Q000502:physiology*