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).
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
Abstract
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;G8VcYV'%hZXH>jc^[dgbanVZgViZYi]Zajc\WZ[dgZkZci^aVi^dchiVgiZY#
Introduction
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Methods
Animal experiments
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i]ZcgZbdkZY!i]ZjbW^a^XVaXdgYa^\ViZYVcYXjiVcYi]ZejelVheaVXZY^cVlViZg"ÄaaZY
eaZi]nhbd\gVe]hZZWZadl#I]ZejehlZgZi]ZckZci^aViZY[dg,b^cjiZhl]^aZi]ZnlZgZ
h^bjaiVcZdjhan^bV\ZY#6[iZgi]ZZmeZg^bZci!ejehlZgZ`^aaZYWnVcZhi]Zi^XdkZg"YdhZ#
Plethysmography
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gZXdgYZYZaZXigdc^XVaanjh^c\VXdbejiZg^hZYYViVVXfj^h^i^dchnhiZbEdlZgaVW!69>chigj"
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idgnVcYZme^gVidgni^bZh!V^glVnegZhhjgZ!kZci^aVidggViZVcY\VhÅdl#
Mechanical ventilation
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Protocol
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Phase contrast X-ray imaging
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XdbeaZiZajc\VZgVi^dc#
Analysis
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IdXdbeVgZi]ZÄghi^cÅVi^dckdajbZVcY;G8WZilZZc\gdjeh!VdcZ"lVn6CDK6[daadlZY
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Results
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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
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Time 2 mins A
B
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Lung gas volume (mL)Lung gas volume (mL)Lung gas volume (mL)Lung gas volume (mL)
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gZ\^dch^hZkZcijVaanhadl!Vaadl^c\i]Zdi]ZggZ\^dchid¹XViX]"jeºÄ\jgZ(#
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i]Vii]ZheVi^VaeViiZgcd[ajc\VZgVi^dc^hcdijc^[dgbVcYi]ViVÄc^iZeZg^dYs&*hZXh0
Ä\jgZ(^hgZfj^gZYWZ[dgZi]Zajc\^hjc^[dgbanVZgViZY#6hYZiZgb^cZY[gdbi]Z^bV\Z
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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>!
WnY^k^Y^c\i]Ze]VhZXdcigVhiM"gVn^bV\Zh^cidfjVYgVcih0#)adlZgaZ[iaZ[iXVjYVagZ\^dc0#) adlZgg^\]i
g^\]iXVjYVagZ\^dc0jeeZgaZ[iaZ[igdhigVagZ\^dcVcYjeeZgg^\]ig^\]igdhigVagZ\^dc#6^gkdajbZh
^cZVX]fjVYgVcilZgZbZVhjgZYjh^c\VegZk^djhanYZhXg^WZYVcYkVa^YViZYe]VhZgZig^ZkVaVcVanh^h#6hi]Z
Vbdjcid[ajc\i]jhediZci^VaV^gkdajbZkVg^ZhWZilZZcfjVYgVcih!i]ZV^gkdajbZd[ZVX]fjVYgVcilVh
ZmegZhhZYVhVeZgXZciV\Zd[i]ZbVm^bjbkdajbZVX]^ZkZY^ci]VifjVYgVciidXdbeVgZWZilZZcgZ\^dch#
I]ZgZaVi^kZV^gkdajbZlVhh^\c^ÄXVcian\gZViZg^cWdi]jeeZggdhigVa!!XdbeVgZYl^i]Wdi]adlZg
XVjYVa#, #)!gZ\^dchVh^cY^XViZYWni]ZVhiZg^h`h#KVajZhVgZbZVc£H:B#
i]Zajc\h^cdcan&d[+ejeh!l]ZgZVhcdejeh]VYXdbeaZiZanVZgViZYi]Z^gajc\h[daadl^c\
V*hZXH>Ä\jgZh&VcY*V"Y#
6hhjb^c\i]ZegZhhjgZ\gVY^Zci(*Xb='DgZbV^cZYXdchiVcii]gdj\]djii]ZH>!i]ZbZVc
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^cidi]ZY^hiVaV^glVnh!lVhXVaXjaViZY#9jg^c\i]Z'%hZXH>!i]ZbZVcajc\^cÅVi^dcgViZlVh
(#*(#*bA$`\$hZXgVc\Z&#+id.#+bA$`\$hZXl]ZgZVhV[iZgVZgVi^dclVhXdbeaZiZ!ajc\
^cÅVi^dcgViZhYjg^c\EEKlZgZbdgZi]Vc'%[daY]^\]Zg-&#,('#&bA$`\$hZX!YZhe^iZV
adlZgbZVcegZhhjgZ\gVY^Zci'+)#'Xb='D#I]ZgZh^hiVcXZidajc\^cÅVi^dclVh'*#(
'.#+Xb='D$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#
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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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
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&%#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#
Discussion
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