High-frequency oscillatory ventilation in neonatal RDS: initial volume optimization and respiratory mechanics
1 Neonatal Intensive Care Unit, Clinique St. Vincent, 4000-Rocourt, Belgium; and 2 Utah Valley Regional Medical Center, Provo, Utah 84604 To determine whether initial lung volume optimization influences respiratory mechanics, which could indicate the achievement of optimal volume, we studied 17 pr...
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| Veröffentlicht in: | Journal of applied physiology (1985) 1998-04, Vol.84 (4), p.1174-1177 |
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| container_title | Journal of applied physiology (1985) |
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| creator | Kalenga, Masendu Battisti, Oreste Francois, Anne Langhendries, Jean-Paul Gerstmann, Dale R Bertrand, Jean-Marie |
| description | 1 Neonatal Intensive Care Unit, Clinique St.
Vincent, 4000-Rocourt, Belgium; and 2 Utah
Valley Regional Medical Center, Provo, Utah
84604
To determine whether
initial lung volume optimization influences respiratory mechanics,
which could indicate the achievement of optimal volume, we studied 17 premature infants with respiratory distress syndrome (RDS) assisted by
high-frequency oscillatory ventilation. The continuous distending
pressure (CDP) was increased stepwise from 6-8 cmH 2 O
up to optimal CDP (OCDP), i.e., that allowing good oxygenation with the
lowest inspired O 2 fraction. Respiratory system
compliance (Crs) and resistance were concomitantly
measured. Mean OCDP was 16.5 ± 1.2 cmH 2 O. Inspired
O 2 fraction could be reduced from an initial level of 0.73 ± 0.17 to 0.33 ± 0.07. However, Crs (0.45 ± 0.14
ml · cmH 2 O 1 · kg 1
at starting CDP point) remained unchanged through lung volume optimization but appeared inversely related to OCDP. Similarly, respiratory system resistance was not affected. We conclude that there
is a marked dissociation between oxygenation improvement and Crs
profile during the initial phase of lung recruitment by early
high-frequency oscillatory ventilation in infants with RDS. Thus
optimal lung volume cannot be defined by serial Crs measurement. At the
most, low initial Crs suggests that higher CDP will be needed.
newborn; optimal lung volume; static pulmonary compliance; respiratory distress syndrome |
| doi_str_mv | 10.1152/jappl.1998.84.4.1174 |
| format | Article |
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Vincent, 4000-Rocourt, Belgium; and 2 Utah
Valley Regional Medical Center, Provo, Utah
84604
To determine whether
initial lung volume optimization influences respiratory mechanics,
which could indicate the achievement of optimal volume, we studied 17 premature infants with respiratory distress syndrome (RDS) assisted by
high-frequency oscillatory ventilation. The continuous distending
pressure (CDP) was increased stepwise from 6-8 cmH 2 O
up to optimal CDP (OCDP), i.e., that allowing good oxygenation with the
lowest inspired O 2 fraction. Respiratory system
compliance (Crs) and resistance were concomitantly
measured. Mean OCDP was 16.5 ± 1.2 cmH 2 O. Inspired
O 2 fraction could be reduced from an initial level of 0.73 ± 0.17 to 0.33 ± 0.07. However, Crs (0.45 ± 0.14
ml · cmH 2 O 1 · kg 1
at starting CDP point) remained unchanged through lung volume optimization but appeared inversely related to OCDP. Similarly, respiratory system resistance was not affected. We conclude that there
is a marked dissociation between oxygenation improvement and Crs
profile during the initial phase of lung recruitment by early
high-frequency oscillatory ventilation in infants with RDS. Thus
optimal lung volume cannot be defined by serial Crs measurement. At the
most, low initial Crs suggests that higher CDP will be needed.
newborn; optimal lung volume; static pulmonary compliance; respiratory distress syndrome</description><identifier>ISSN: 8750-7587</identifier><identifier>ISSN: 0021-8987</identifier><identifier>EISSN: 1522-1601</identifier><identifier>DOI: 10.1152/jappl.1998.84.4.1174</identifier><identifier>PMID: 9516181</identifier><identifier>CODEN: JAPHEV</identifier><language>eng</language><publisher>Bethesda, MD: Am Physiological Soc</publisher><subject>Anesthesia & intensive care ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthésie & soins intensifs ; Biological and medical sciences ; Emergency and intensive care: neonates and children. Prematurity. Sudden death ; High-Frequency Ventilation ; Human health sciences ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive care medicine ; Lung Volume Measurements ; Medical sciences ; Pediatrics ; Pédiatrie ; Radiography, Thoracic ; Respiratory Distress Syndrome, Newborn - physiopathology ; Respiratory Distress Syndrome, Newborn - therapy ; Respiratory Mechanics - physiology ; Sciences de la santé humaine</subject><ispartof>Journal of applied physiology (1985), 1998-04, Vol.84 (4), p.1174-1177</ispartof><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c498t-22509360d5b4505a5085ff187caa30e0ad27df1b831c4bc34baa6928613d97bb3</citedby><cites>FETCH-LOGICAL-c498t-22509360d5b4505a5085ff187caa30e0ad27df1b831c4bc34baa6928613d97bb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,777,781,882,3026,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2228996$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9516181$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kalenga, Masendu</creatorcontrib><creatorcontrib>Battisti, Oreste</creatorcontrib><creatorcontrib>Francois, Anne</creatorcontrib><creatorcontrib>Langhendries, Jean-Paul</creatorcontrib><creatorcontrib>Gerstmann, Dale R</creatorcontrib><creatorcontrib>Bertrand, Jean-Marie</creatorcontrib><title>High-frequency oscillatory ventilation in neonatal RDS: initial volume optimization and respiratory mechanics</title><title>Journal of applied physiology (1985)</title><addtitle>J Appl Physiol (1985)</addtitle><description>1 Neonatal Intensive Care Unit, Clinique St.
Vincent, 4000-Rocourt, Belgium; and 2 Utah
Valley Regional Medical Center, Provo, Utah
84604
To determine whether
initial lung volume optimization influences respiratory mechanics,
which could indicate the achievement of optimal volume, we studied 17 premature infants with respiratory distress syndrome (RDS) assisted by
high-frequency oscillatory ventilation. The continuous distending
pressure (CDP) was increased stepwise from 6-8 cmH 2 O
up to optimal CDP (OCDP), i.e., that allowing good oxygenation with the
lowest inspired O 2 fraction. Respiratory system
compliance (Crs) and resistance were concomitantly
measured. Mean OCDP was 16.5 ± 1.2 cmH 2 O. Inspired
O 2 fraction could be reduced from an initial level of 0.73 ± 0.17 to 0.33 ± 0.07. However, Crs (0.45 ± 0.14
ml · cmH 2 O 1 · kg 1
at starting CDP point) remained unchanged through lung volume optimization but appeared inversely related to OCDP. Similarly, respiratory system resistance was not affected. We conclude that there
is a marked dissociation between oxygenation improvement and Crs
profile during the initial phase of lung recruitment by early
high-frequency oscillatory ventilation in infants with RDS. Thus
optimal lung volume cannot be defined by serial Crs measurement. At the
most, low initial Crs suggests that higher CDP will be needed.
newborn; optimal lung volume; static pulmonary compliance; respiratory distress syndrome</description><subject>Anesthesia & intensive care</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anesthésie & soins intensifs</subject><subject>Biological and medical sciences</subject><subject>Emergency and intensive care: neonates and children. Prematurity. Sudden death</subject><subject>High-Frequency Ventilation</subject><subject>Human health sciences</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Intensive care medicine</subject><subject>Lung Volume Measurements</subject><subject>Medical sciences</subject><subject>Pediatrics</subject><subject>Pédiatrie</subject><subject>Radiography, Thoracic</subject><subject>Respiratory Distress Syndrome, Newborn - physiopathology</subject><subject>Respiratory Distress Syndrome, Newborn - therapy</subject><subject>Respiratory Mechanics - physiology</subject><subject>Sciences de la santé humaine</subject><issn>8750-7587</issn><issn>0021-8987</issn><issn>1522-1601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1v1DAQhi0EKkvhH4CUA0JcsvgzsblVhVKkSkhQziPHcXZdOXGwk4Xw6_GS1UocOHk887wzmnkReknwlhBB3z3ocfRbopTcSr7lOVnzR2iTS7QkFSaP0UbWApe1kPVT9CylB4wJ54JcoAslSEUk2aD-1u32ZRftj9kOZilCMs57PYW4FAc7TC7HLgyFG4rBhkFP2hdfP3x7nxNucvlzCH7ubRHGyfXu9wrroS2iTaOLa6Pemr0enEnP0ZNO-2RfnN5L9P3m4_31bXn35dPn66u70nAlp5JSgRWrcCsaLrDQAkvRdUTWRmuGLdYtrduONJIRwxvDeKN1paisCGtV3TTsEtG1r3d2ZyHExsGBQtBujWe_A22gsUBpJYEIxlkWvVlFYwz5GmmC3iVj8zXy5nOCWtWCMEEzyFfQxJBStB2M0fU6LkAwHK2Bv9bA0RqQHDgcrcmyV6f-c9Pb9iw6eZHrr091nYz2XdSDcemMUUqlUlXG3q7YPjv300UL435JLviwW46D_5nI_4_ezN7f21_TUXOWwNh27A_GH7tZ</recordid><startdate>19980401</startdate><enddate>19980401</enddate><creator>Kalenga, Masendu</creator><creator>Battisti, Oreste</creator><creator>Francois, Anne</creator><creator>Langhendries, Jean-Paul</creator><creator>Gerstmann, Dale R</creator><creator>Bertrand, Jean-Marie</creator><general>Am Physiological Soc</general><general>American Physiological Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>Q33</scope></search><sort><creationdate>19980401</creationdate><title>High-frequency oscillatory ventilation in neonatal RDS: initial volume optimization and respiratory mechanics</title><author>Kalenga, Masendu ; Battisti, Oreste ; Francois, Anne ; Langhendries, Jean-Paul ; Gerstmann, Dale R ; Bertrand, Jean-Marie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c498t-22509360d5b4505a5085ff187caa30e0ad27df1b831c4bc34baa6928613d97bb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Anesthesia & intensive care</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anesthésie & soins intensifs</topic><topic>Biological and medical sciences</topic><topic>Emergency and intensive care: neonates and children. Prematurity. Sudden death</topic><topic>High-Frequency Ventilation</topic><topic>Human health sciences</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Intensive care medicine</topic><topic>Lung Volume Measurements</topic><topic>Medical sciences</topic><topic>Pediatrics</topic><topic>Pédiatrie</topic><topic>Radiography, Thoracic</topic><topic>Respiratory Distress Syndrome, Newborn - physiopathology</topic><topic>Respiratory Distress Syndrome, Newborn - therapy</topic><topic>Respiratory Mechanics - physiology</topic><topic>Sciences de la santé humaine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kalenga, Masendu</creatorcontrib><creatorcontrib>Battisti, Oreste</creatorcontrib><creatorcontrib>Francois, Anne</creatorcontrib><creatorcontrib>Langhendries, Jean-Paul</creatorcontrib><creatorcontrib>Gerstmann, Dale R</creatorcontrib><creatorcontrib>Bertrand, Jean-Marie</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Université de Liège - Open Repository and Bibliography (ORBI)</collection><jtitle>Journal of applied physiology (1985)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kalenga, Masendu</au><au>Battisti, Oreste</au><au>Francois, Anne</au><au>Langhendries, Jean-Paul</au><au>Gerstmann, Dale R</au><au>Bertrand, Jean-Marie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High-frequency oscillatory ventilation in neonatal RDS: initial volume optimization and respiratory mechanics</atitle><jtitle>Journal of applied physiology (1985)</jtitle><addtitle>J Appl Physiol (1985)</addtitle><date>1998-04-01</date><risdate>1998</risdate><volume>84</volume><issue>4</issue><spage>1174</spage><epage>1177</epage><pages>1174-1177</pages><issn>8750-7587</issn><issn>0021-8987</issn><eissn>1522-1601</eissn><coden>JAPHEV</coden><abstract>1 Neonatal Intensive Care Unit, Clinique St.
Vincent, 4000-Rocourt, Belgium; and 2 Utah
Valley Regional Medical Center, Provo, Utah
84604
To determine whether
initial lung volume optimization influences respiratory mechanics,
which could indicate the achievement of optimal volume, we studied 17 premature infants with respiratory distress syndrome (RDS) assisted by
high-frequency oscillatory ventilation. The continuous distending
pressure (CDP) was increased stepwise from 6-8 cmH 2 O
up to optimal CDP (OCDP), i.e., that allowing good oxygenation with the
lowest inspired O 2 fraction. Respiratory system
compliance (Crs) and resistance were concomitantly
measured. Mean OCDP was 16.5 ± 1.2 cmH 2 O. Inspired
O 2 fraction could be reduced from an initial level of 0.73 ± 0.17 to 0.33 ± 0.07. However, Crs (0.45 ± 0.14
ml · cmH 2 O 1 · kg 1
at starting CDP point) remained unchanged through lung volume optimization but appeared inversely related to OCDP. Similarly, respiratory system resistance was not affected. We conclude that there
is a marked dissociation between oxygenation improvement and Crs
profile during the initial phase of lung recruitment by early
high-frequency oscillatory ventilation in infants with RDS. Thus
optimal lung volume cannot be defined by serial Crs measurement. At the
most, low initial Crs suggests that higher CDP will be needed.
newborn; optimal lung volume; static pulmonary compliance; respiratory distress syndrome</abstract><cop>Bethesda, MD</cop><pub>Am Physiological Soc</pub><pmid>9516181</pmid><doi>10.1152/jappl.1998.84.4.1174</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 8750-7587 |
| ispartof | Journal of applied physiology (1985), 1998-04, Vol.84 (4), p.1174-1177 |
| issn | 8750-7587 0021-8987 1522-1601 |
| language | eng |
| recordid | cdi_highwire_physiology_jap_84_4_1174 |
| source | MEDLINE; American Physiological Society; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Anesthesia & intensive care Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anesthésie & soins intensifs Biological and medical sciences Emergency and intensive care: neonates and children. Prematurity. Sudden death High-Frequency Ventilation Human health sciences Humans Infant, Newborn Infant, Premature Intensive care medicine Lung Volume Measurements Medical sciences Pediatrics Pédiatrie Radiography, Thoracic Respiratory Distress Syndrome, Newborn - physiopathology Respiratory Distress Syndrome, Newborn - therapy Respiratory Mechanics - physiology Sciences de la santé humaine |
| title | High-frequency oscillatory ventilation in neonatal RDS: initial volume optimization and respiratory mechanics |
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