title: Case-control study of respiratory dynamic compliance in mechanically ventilated near-term newborns in a pre-hospital setting.
abstract: OBJECTIVE
  To determine the threshold value between normal or decreased dynamic compliance (Cdyn) in ventilated near-term newborns.
  
  
  METHODS
  A case control study was performed during pediatric transport. Controls were newborns without pulmonary disease (group 1; n = 30) and cases were newborns with respiratory distress syndrome, the paradigm of decreased Cdyn (group 2; n = 30). All consecutive newborns of more than 34 weeks' gestation and less than 5 days of life, intubated and ventilated with Babylog 8,000 plus (Dräger, Lübeck, Germany) were included from February 2008 to June 2010. Newborns were assigned to groups 1, 2, or 3 (other patients with disease where the compliance is not easily predictable) by two physicians, using predefined criteria. Cdyn was as measured by the ventilator in spontaneous mandatory ventilation mode with less than 15% leaks.
  
  
  RESULTS
  One hundred and twelve newborns were included in the study. In the multivariate analysis, the groups of diseases and height were statistically associated with Cdyn (p < 0.001). The receiver operating characteristic curve of Cdyn corrected for height constructed with group 1 and 2 newborns yielded a cutoff value of 2.02 mL/mbar/m with a sensitivity of 100% (95% confidence interval [100-100%]) and a specificity of 96% (95% confidence interval [90-100%]) to differentiate between group 1 and 2 newborns.
  
  
  CONCLUSIONS
  Ventilator-measured dynamic compliance can differentiate normal and decreased compliance in near-term newborns of more than 34 weeks' gestation in the clinical setting.
authors: Pediatric Transportation Unit, SAMU 93, Assistance Publique Hôpitaux de Paris, Avicenne University Hospital, Bobigny, France. mtsapis@gmail.com
authors: Michael
authors: M
authors: Tsapis
authors: Cécile
authors: C
authors: Mignot
authors: Sandrine
authors: S
authors: Katsahian
authors: Hocine
authors: H
authors: Arbaoui
authors: Azzedine
authors: A
authors: Ayachi
mesh_terms: D016022:Case-Control Studies; D004632:Emergency Medical Services; D006801:Humans; D007231:Infant, Newborn; D008170:Lung Compliance / Q000502:physiology*; D015999:Multivariate Analysis; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000503:physiopathology / Q000628:therapy