TY - JOUR
T1 - Effect of Lung Recruitment on Pulmonary, Systemic, and Ductal Blood Flow in Preterm Infants
AU - de Waal, Koert
AU - Evans, Nick
AU - van der Lee, Johanna
AU - van Kaam, Anton
PY - 2009
Y1 - 2009
N2 - Objective To determine the effect of lung recruitment on pulmonary, systemic, and ductal blood flow in preterm infants treated with primary high-frequency ventilation (HFV). Study design Thirty-four infants (median gestational age, 28 weeks) were included in this prospective cohort study. Changes in oxygenation in response to stepwise changes in the continuous distending pressure (CDP) were used to monitor lung recruitment during HFV. For each individual patient, the opening pressure (CDPo), closing pressure (CDPc), and optimal pressure (CDPopt) were determined. Ultrasound measurements of right ventricular output (RVO), superior vena cava (SVC), and ductus arteriosus (DA) flow were performed at the start of recruitment (CDPs), CDPo, and CDPopt. Results increasing the CDP from 8 (CDPs) to 26 (CDPo) cmH(2)O resulted in a decreased RVO (mean difference, -17%; 95% CI, -24, -10%) and unchanged SVC flow and ductal shunting. Transient low RVO and SVC flow values at CDPo were seen in 3 and 2 infants, respectively. Conclusions Lung recruitment during HFV in preterm infants does not appear to result in clinically relevant changes in pulmonary, systemic, and ductal blood flow. (J Pediatr 2009;154:651-5)
AB - Objective To determine the effect of lung recruitment on pulmonary, systemic, and ductal blood flow in preterm infants treated with primary high-frequency ventilation (HFV). Study design Thirty-four infants (median gestational age, 28 weeks) were included in this prospective cohort study. Changes in oxygenation in response to stepwise changes in the continuous distending pressure (CDP) were used to monitor lung recruitment during HFV. For each individual patient, the opening pressure (CDPo), closing pressure (CDPc), and optimal pressure (CDPopt) were determined. Ultrasound measurements of right ventricular output (RVO), superior vena cava (SVC), and ductus arteriosus (DA) flow were performed at the start of recruitment (CDPs), CDPo, and CDPopt. Results increasing the CDP from 8 (CDPs) to 26 (CDPo) cmH(2)O resulted in a decreased RVO (mean difference, -17%; 95% CI, -24, -10%) and unchanged SVC flow and ductal shunting. Transient low RVO and SVC flow values at CDPo were seen in 3 and 2 infants, respectively. Conclusions Lung recruitment during HFV in preterm infants does not appear to result in clinically relevant changes in pulmonary, systemic, and ductal blood flow. (J Pediatr 2009;154:651-5)
U2 - https://doi.org/10.1016/j.jpeds.2009.01.012
DO - https://doi.org/10.1016/j.jpeds.2009.01.012
M3 - Article
C2 - 19364558
SN - 0022-3476
VL - 154
SP - 651
EP - 655
JO - Journal of pediatrics
JF - Journal of pediatrics
IS - 5
ER -