Effect of forced deflation maneuvers upon measurements of respiratory mechanics in ventilated infants.
OBJECTIVE
To determine the effect of forced deflation maneuvers on respiratory mechanics and to assess the reproducibility of such measurements in intubated infants with lung disease.


METHODS
Prospective study in the pediatric intensive care unit of a university children's hospital.


METHODS
Ten clinically stable infants requiring mechanically assisted ventilation for acute pulmonary disease, mean age 5.9 months (1-18), mean weight 5.8 kg (3.2-13).


METHODS
Two sets of measurements of compliance (Crs) and resistance (Rrs) were obtained at 20-min intervals both before and after +40/-40 cmH(2)O forced deflation maneuvers. Forced deflation measurements were repeated at the end of the study.


RESULTS
. Forced deflation caused a significant increase in Crs from 0.53+/-0.09 and 0.58+/-0.11 ml/cmH(2)O/kg to 0.71+/-0.11 and 0.68+/-0.11 ml/cmH(2)O/kg. Rrs measurements did not differ. The low coefficients of variation for repeated measures of the baseline measurements (Crs 4.2+/-0.5%, Rrs 7.1+/-0.8%, for forced vital capacity 8.6+/-2.5%, maximum expiratory flows at 25% vital capacity 16.0%+/-3.3%) confirmed the good reproducibility during stable conditions.


CONCLUSIONS
Inflation and deflation maneuvers affect subsequent measurements of respiratory system compliance but not measurements of maximum expiratory flow-volume relationships in intubated infants, probably through recruitment of lung volume. Careful interpretation and planning of the sequence of infant pulmonary function testing is necessary to reassure that changes are not related to short-term alterations in volume history.
Hammer
Jürg
J
Division of Pediatric Intensive Care and Pulmonology, University Children's Hospital, Römergasse 8, 4005, Basel, Switzerland. juerg.hammer@unibas.ch
Patel
Neal
N
Newth
Christopher J L
CJ
D000403:Airway Resistance; D000704:Analysis of Variance; D001988:Bronchiolitis / Q000503:physiopathology / Q000628:therapy; D001997:Bronchopulmonary Dysplasia / Q000503:physiopathology / Q000628:therapy; D005540:Forced Expiratory Flow Rates; D005541:Forced Expiratory Volume; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D016014:Linear Models; D015141:Los Angeles; D008170:Lung Compliance; D011014:Pneumonia / Q000503:physiopathology / Q000628:therapy; D011446:Prospective Studies; D011664:Pulmonary Valve / Q000002:abnormalities; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000503:physiopathology / Q000628:therapy; D015656:Respiratory Mechanics; D013997:Time Factors; D014797:Vital Capacity