To obtain valid information on the natural and dynamic pattern of breathing and overcome factors potentially causing the above mentioned inconsistencies, it is necessary to measure tidal breathing parameters in addition to lung volume and ventilation inhomogeneity in a large sample of unsedated infants, matching preterm infants with contemporarily recruited healthy controls, and using the same appropriate methods for all infants adhering to recently published ATS/ERS standards for infant lung function testing. Differences in measurement techniques or inappropriate matching for age, weight and length of the control groups, also limit physiological implications of these studies. Furthermore, the use of 100% oxygen in the nitrogen washout test used in many studies to determine lung volume may induce atelectasis, and the effect may be more pronounced in young and preterm infants. due to sedation, test gas used, or sighs. It is difficult to draw clear conclusions from these studies, partly because of disregard of possible changes in breathing pattern, e.g. On the other hand, there are also reports of comparable lung volumes in infants with BPD, preterm and term-born controls. Furthermore, these infants have increased ventilation inhomogeneity, as well as reduced forced expiratory flows, without catching up from this diminished airway growth within the first two years of life –. End-expiratory lung volume (functional residual capacity, FRC) has been shown to be diminished in healthy preterm and BPD infants. These morphological changes in BPD lungs have functional consequences on lung volume, ventilation homogeneity and mechanics of the respiratory system, as reviewed recently –. The immaturity of the lungs together with other factors such as inflammation, disturbed vascularisation, hyperoxia and volu- or barotrauma during treatment may lead to the clinical picture of bronchopulmonary dysplasia (BPD). This leads to disturbed alveolar septation with fewer but larger alveoli and impaired vascular growth in these infants. Lung development in preterm infants is interrupted during the saccular phase of the normal maturational process usually taking place in utero.
The funding sources had no role in study design, data collection and analysis, preparation of the manuscript or decision to publish.Ĭompeting interests: The authors have declared that no competing interests exist.Ĭhronic lung disease of infancy remains one of the major complications in premature infants, with possible impact upon short- and long-term respiratory morbidity –. and Swiss National Foundation PROSPER grnt 3200-069349 to C.K. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.įunding: Swiss National Foundation grant 3200-B0-112099 to U.F. Received: OctoAccepted: JanuPublished: February 27, 2009Ĭopyright: © 2009 Latzin et al. PLoS ONE 4(2):Įditor: Oliver Eickelberg, Helmholtz Zentrum München/Ludwig-Maximilians-University Munich, Germany (2009) Lung Volume, Breathing Pattern and Ventilation Inhomogeneity in Preterm and Term Infants. Citation: Latzin P, Roth S, Thamrin C, Hutten GJ, Pramana I, Kuehni CE, et al.
0 kommentar(er)
