title: Evaluation of bedside pulmonary function in the neonate: From the past to the future.
abstract: Pulmonary function testing and monitoring plays an important role in the respiratory management of neonates. A noninvasive and complete bedside evaluation of the respiratory status is especially useful in critically ill neonates to assess disease severity and resolution and the response to pharmacological interventions as well as to guide mechanical respiratory support. Besides traditional tools to assess pulmonary gas exchage such as arterial or transcutaenous blood gas analysis, pulse oximetry, and capnography, additional valuable information about global lung function is provided through measurement of pulmonary mechanics and volumes. This has now been aided by commercially available computerized pulmonary function testing systems, respiratory monitors, and modern ventilators with integrated pulmonary function readouts. In an attempt to apply easy-to-use pulmonary function testing methods which do not interfere with the infant́s airflow, other tools have been developed such as respiratory inductance plethysmography, and more recently, electromagnetic and optoelectronic plethysmography, electrical impedance tomography, and electrical impedance segmentography. These alternative technologies allow not only global, but also regional and dynamic evaluations of lung ventilation. Although these methods have proven their usefulness for research applications, they are not yet broadly used in a routine clinical setting. This review will give a historical and clinical overview of different bedside methods to assess and monitor pulmonary function and evaluate the potential clinical usefulness of such methods with an outlook into future directions in neonatal respiratory diagnostics.
authors.affiliation: Division of Neonatology, Department of Pediatrics and Adolescence Medicine, Medical University Graz, Graz, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Reiterer
authors.affiliation: Section on Newborn Pediatrics, Pennsylvania Hospital, Philadelphia, Pennsylvania.|Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: E
authors.initials: E
authors.lastname: Sivieri
authors.affiliation: Section on Newborn Pediatrics, Pennsylvania Hospital, Philadelphia, Pennsylvania.|Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.|Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: S
authors.initials: S
authors.lastname: Abbasi
mesh_terms: D001785:Blood Gas Monitoring, Transcutaneous; D002245:Carbon Dioxide / Q000032:analysis; D003124:Colorimetry; D017097:Electric Impedance; D004562:Electrocardiography; D006801:Humans; D007231:Infant, Newborn; D010991:Plethysmography / Q000379:methods; D012129:Respiratory Function Tests / Q000379:methods*
chemical_list: D002245:Carbon Dioxide
keywords: electrical impedance tomography; neonates; pulmonary function testing; respiratory impedance pneumography; respiratory inductance plethysmography; review