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Pas, A.B. de

Citation

Pas, A. B. de. (2009, March 5). Spontaneous breathing and respiratory support of preterm infants at birth. Retrieved from

https://hdl.handle.net/1887/13595

Version: Corrected Publisher’s Version

License: Licence agreement concerning inclusion of doctoral thesis in the Institutional Repository of the University of Leiden

Downloaded from: https://hdl.handle.net/1887/13595

Note: To cite this publication please use the final published version (if applicable).

(2)

Effect of sustained inflation length on establishing functional residual capacity at birth in

ventilated premature rabbits

Arjan B te Pas*1,2, Melissa Siew3, Megan J Wallace3, Marcus, J Kitchen4, Andreas Fouras6, Robert A Lewis5, Naoto Yagi7, Kentaro Uesugi7, Susan Donath8, Peter G Davis1,

Colin J Morley1, Stuart B Hooper3

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submitted

(3)

Abstract

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Wne]VhZXdcigVhiM"gVn^bV\^c\[dg,b^cjiZh#I]ZÄghi^che^gVidgnkdajbZh^\c^ÄXVciane

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;G8VcYV'%hZXH>jc^[dgbanVZgViZYi]Zajc\WZ[dgZkZci^aVi^dchiVgiZY#

(4)

Introduction

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>ci]^hhijYn!lZ]VkZ^ckZhi^\ViZYi]ZZ[[ZXid[H>hd[Y^[[ZgZciYjgVi^dchdci]ZgZXgj^ibZci

d[;G8VcYi^YVakdajbZh[gdbW^gi]#LZ]nedi]Zh^oZYi]Vi^cXgZVh^c\i]ZYjgVi^dcd[i]Z

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Methods

Animal experiments

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(5)

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Plethysmography

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Mechanical ventilation

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Protocol

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Phase contrast X-ray imaging

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]VkZWZZcgZedgiZYegZk^djhan&%!&(!&)#I]ZM"gVnZcZg\njhZYlVh')`ZK!i]ZYZiZXidg

(6)

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i^bZ*%bhZXVcYVgZaVi^kZanadc\^che^gVi^dci^bZ&hZXlZgZjhZYidb^c^b^hZbdi^dc

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XdbeaZiZajc\VZgVi^dc#

Analysis

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;G8lVhXVaXjaViZYVi'%hZX!&!(VcY,b^cWnYZiZgb^c^c\i]ZVkZgV\Z;G8[daadl^c\[djg

XdchZXji^kZ^cÅVi^dchVii]ZhZi^bZh#;G8lVhVhhjbZYidWZoZgdVii]ZhiVgid[kZci^aVi^dc#

IdXdbeVgZi]ZÄghi^cÅVi^dckdajbZVcY;G8WZilZZc\gdjeh!VdcZ"lVn6CDK6[daadlZY

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VcVanhZYjh^c\HEHHhd[ilVgZHEHH[dgl^cYdlh!kZgh^dc&*#%!'%%+!8]^XV\d!>A#

Results

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Zfj^ebZcibVa[jcXi^dc#CdcZd[i]ZejehYZkZadeZYVecZjbdi]dgVm!l]^X]lVhkZg^ÄZY

jh^c\^bV\^c\#I]ZVkZgV\ZejelZ^\]iH9^cZVX]\gdjelVh/\gdje&cdH>()#)'#)\!

\gdje'*H>)%#&*#)\!\gdje(&%H>(+#''#&\!<gdje)'%H>(,#.'#(\#:VX]\gdje

XdciV^cZY+ejeh#

First inflation volume

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VhjhiV^cZY^cÅVi^dcd[&%VcY'%hZXdcYh!Wjicdi*hZXdcYh!h^\c^ÄXVcian^cXgZVhZYi]Z

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(7)

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Ä\jgZ&!l]Zci]Zejeh]VYgZXgj^iZYV;G8d[s&(ba$`\VcYlZgZkZci^aViZYidgZVX]V

Table 1. BZY^Vc>FG;G8ViZVX]i^bZ[dgZVX]\gdje#

;G82;jcXi^dcVagZh^YjVaXVeVX^in0H>2HjhiV^cZY^cÅVi^dc#

Group First inspiratory volume (ml/kg)

FRC 20 s (ml/kg)

FRC 1 min (ml/kg)

FRC 3 min (ml/kg)

FRC 7 min (ml/kg) CdH>

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0 0.5 1.0 0 0.5 1.0

0 0.5 1.0

0 0.5 1.0

Time 2 mins A

B

C

D

Lung gas volume (mL)Lung gas volume (mL)Lung gas volume (mL)Lung gas volume (mL)

Figure 1. EaZi]nhbd\gVe] gZXdgY^c\h

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(8)

a b A B

C D

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hjhiV^cZY[dg*B!&%Cdg'%DhZXdcYh#

(9)

Kid[s&%ba$`\Ä\jgZ&#;jgi]ZgbdgZ!Yjg^c\i]Z'%hZXH>!Vai]dj\]i]ZjeeZggdhigVa

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0 5 10 15 20 25

0 20 40 60 80 100 120

LLHS LRHS ULHS URHS

*

* * * *

Gas Volume (% of total)

Time (secs)

Figure 3#I]Z^cXgZVhZ^cV^gkdajbZl^i]^cY^[[ZgZcigZ\^dchd[i]Zajc\lVhbZVhjgZYYjg^c\i]Z'%hZXH>!

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Vbdjcid[ajc\i]jhediZci^VaV^gkdajbZkVg^ZhWZilZZcfjVYgVcih!i]ZV^gkdajbZd[ZVX]fjVYgVcilVh

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I]ZgZaVi^kZV^gkdajbZlVhh^\c^ÄXVcian\gZViZg^cWdi]jeeZggdhigVa!!XdbeVgZYl^i]Wdi]adlZg

XVjYVa#, #)!gZ\^dchVh^cY^XViZYWni]ZVhiZg^h`h#KVajZhVgZbZVc£H:B#

(10)

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'.#+Xb='D$bA$`\$hZXYjg^c\i]Z'%hZXH>l]ZgZVhYjg^c\EEK^ci]ZhVbZejeh!i]Z

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kVg^ZYXdch^YZgVWanWZilZZcejeh-#+hZXhid3'%hZXh#

a b c d

e f g h

t = 1 sec t = 5 sec t = 10 sec t = 20 sec

**

**

Figure 4#E]VhZXdcigVhiM"gVn^bV\ZhVXfj^gZYVi&VZ!*W[!&%X\VcY'%Y]hZXdcYhV[iZg

W^gi]^cegZbVijgZanYZa^kZgncZlWdgcgVWW^iejehkZci^aViZY[gdbW^gi]#I]ZÄghi^cÅVi^dclVhZ^i]Zgcdi

hjhiV^cZY&hZX^cYjgVi^dc0ideeVcZa0^bV\ZhV!W!XYdghjhiV^cZY[dg'%hZXdcYhWdiidbeVcZa0^bV\Zh

Z![!\]#I]ZYdjWaZVhiZg^h`h^cY^XViZ^bV\ZhVXfj^gZYVii]ZZcYd[i]ZÄghi^cÅVi^dc#>bV\ZhVXfj^gZY

V[iZgi]ZÄghi^cÅVi^dclZgZVXfj^gZYViZcY"^che^gVi^dc#

(11)

a b c d

a b c d

t = 1 sec t = 5 sec t = 10 sec t = 20 sec

**

**

e f g h

Figure 5#E]VhZXdcigVhiM"gVn^bV\ZhVXfj^gZYVi&VZ!*W[!&%X\VcY'%Y]hZXdcYhV[iZg

W^gi]^cegZbVijgZanYZa^kZgncZlWdgcgVWW^iejehkZci^aViZY[gdbW^gi]#I]ZÄghi^cÅVi^dclVhhjhiV^cZY[dg

Z^i]Zg*hZXdcYhideeVcZa0^bV\ZhV!W!XYdg&%hZXdcYhWdiidbeVcZa0^bV\ZhZ![!\]#I]ZYdjWaZ

VhiZg^h`h^cY^XViZ^bV\ZhVXfj^gZYVii]ZZcYd[i]ZÄghi^cÅVi^dc#>bV\ZhVXfj^gZYV[iZgi]ZÄghi^cÅVi^dc

lZgZVXfj^gZYViZcY"^che^gVi^dc#

FRC

I]ZbZY^Vc>FG;G8d[ZVX]\gdjeViZVX]i^bZed^ci^hh]dlc^ciVWaZ&VcYÄ\jgZ+#

8dbeVgZYidV&hZX^cÅVi^dcCdH>!V*hZXH>Y^YcdigZhjai^cVh^\c^ÄXVcian]^\]Zg;G8Vi

Vcnd[i]Zi^bZed^cihbZVhjgZY#=dlZkZg!V&%hZXH>gZhjaiZY^cVh^\c^ÄXVcian]^\]Zg;G8

Vi,b^cjiZhV[iZgW^gi]VcYV'%hZXH>gZhjaiZY^cVh^\c^ÄXVcian]^\]Zg;G8Vi'%hZXVcY,

b^cjiZhV[iZgW^gi]#

Tidal volume

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,^cÅVi^dch^cVaadi]Zg\gdjehCdH>!'#%&#-ba$`\!E1%#%*0*H>!)#.(#-ba$`\!E1%#%%&0

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(12)

0 100 200 300 400 0

2 4 6 8 10 12 14 16

FRC (mL/kg)

Time (secs)

Figure 6#BZVc;G8^cXgZVhZl^i]i^bZ#KVajZhlZgZYZg^kZY[gdbegZbVijgZanYZa^kZgnegZiZgbgVWW^iejeh

kZci^aViZY[gdbW^gi]#I]ZÄghi^cÅVi^dclVhZ^i]ZgcdihjhiV^cZY&hZX^cYjgVi^dc0dghjhiV^cZY[dg*!

&%#dg'%#hZXdcYh#!!#!#2ed^cihd[bZVhjgZbZciViI2'%hZXdcYh!&!(!,b^cjiZh#KVajZhVgZ

bZVc£H:B#

0 2 4 6 8 10

p(g)

0 4 8 12 16

No SI 5 sec SI 10 sec SI 20 sec SI

Expired tidal volume (mL/kg)

Breath Number

Figure 7#I^YVakdajbZ gZXgj^ibZci^cegZbVijgZanYZa^kZgZYcZlWdgcgVWW^iejehkZci^aViZY[gdbW^gi]#I]Z

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hZXdcYh#KVajZhVgZbZVc£H:B#

(13)

Discussion

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ZcYd['%hZX!i]Zajc\]VYXdbeaZiZanVcYjc^[dgbanVZgViZYWZ[dgZi]ZdchZid[EEK#Djg

YViVVahdYZbdchigViZYi]Viajc\VZgVi^dcgZfj^gZhVÄc^iZi^bZ!dXXjgg^c\ViVbVm^bjb

gViZd[(#*(#*bA$`\$hZXVcYgZhjaih^c.%ajc\VZgVi^dcl^i]^c&)#%)#&hZXdcYhjh^c\

Vc^cÅVi^c\egZhhjgZd[(*Xb='D#;jgi]ZgbdgZ!^cXgZVh^c\i]ZYjgVi^dcd[i]ZH>[gdb*id

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(14)

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(15)

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Reference List

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(17)

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