Ratjen F A, Wiesemann H G
Department of Pediatrics, University of Essen, Germany.
Pediatr Pulmonol. 1992 Feb;12(2):73-80. doi: 10.1002/ppul.1950120203.
We studied reproducibility and variability of dynamic pulmonary compliance (Cdyn) by making measurements with the esophageal balloon at multiple locations within the esophagus, in both spontaneously breathing and mechanically ventilated newborn infants. Reliable measurements could be obtained over a range similar to that reported for measurements with a liquid-filled catheter. In spontaneously breathing infants Cdyn was found to be highly variable. This variability was unrelated to catheter position but was associated with concomitant changes in pulmonary resistance. Probably because of the high variability, the correlation of Cdyn with a measurement of respiratory system compliance (Crs) was rather poor (r = 0.63). Cdyn measured in mechanically ventilated infants was significantly less variable and compared favorably to Crs (r = 0.86), but its accuracy could not be adequately assessed since the comparison of esophageal and airway occlusion pressure was not feasible in all infants. In addition, significant differences in Cdyn were found between spontaneous and ventilated breaths during mechanical ventilation. Further studies in both ventilated and spontaneously breathing infants are needed to assess the variability of Cdyn over extended time periods.
我们通过在食管内多个位置使用食管球囊进行测量，研究了自主呼吸和机械通气新生儿动态肺顺应性（Cdyn）的可重复性和变异性。在与使用充液导管测量所报告的类似范围内，可以获得可靠的测量结果。在自主呼吸的婴儿中，发现Cdyn高度可变。这种变异性与导管位置无关，但与肺阻力的伴随变化有关。可能由于变异性高，Cdyn与呼吸系统顺应性（Crs）测量值的相关性相当差（r = 0.63）。在机械通气婴儿中测量的Cdyn变异性明显较小，与Crs相比良好（r = 0.86），但由于并非所有婴儿都能进行食管和气道闭塞压力的比较，其准确性无法得到充分评估。此外，在机械通气期间，自主呼吸和通气呼吸之间的Cdyn存在显著差异。需要对通气和自主呼吸的婴儿进行进一步研究，以评估Cdyn在较长时间段内的变异性。
