Royal Alexandra Children's Hospital, Brighton, UK.
Pediatr Pulmonol. 2009 Dec;44(12):1168-73. doi: 10.1002/ppul.21039.
Interrupter resistance (R(int)) is a useful measure of airway caliber in young children, but has not been well characterized in infants-in whom there are concerns about the accurate measurement of driving pressure. This study aimed to assess the feasibility and repeatability of measuring R(int) in unsedated newborn infants, and to explore alternative algorithms for calculating driving pressure. R(int) measurement was attempted in 28 healthy term newborn infants during natural sleep using the MicroRint device. Paired R(int) measurements were achieved in 24 infants, but after screening of waveforms only 15 infants had at least 5 technically acceptable waveforms on both measurements. R(int) values obtained were comparable with reported values for airflow resistance in newborns using other methods. However, the repeatability coefficient (CR) was much higher than reported values in preschool children using standard back-extrapolation algorithms, with CR 2.47 KPa L(-1) sec (unscreened) and 2.93 KPa L(-1) sec (screened). Other algorithms gave only marginally better repeatability, with all CR values over 50% of the mean R(int) value. Using current commercially available equipment, R(int) is too poorly repeatable to be a reliable measurement of airflow resistance in newborn infants. Lower deadspace equipment is needed, but anatomical and physiological factors in the infant are also important.
中断阻力（R(int)）是衡量小儿气道口径的有用指标，但在婴儿中尚未得到很好的描述-在婴儿中，人们担心准确测量驱动压力。本研究旨在评估在未镇静的新生儿中测量 R(int)的可行性和可重复性，并探索用于计算驱动压力的替代算法。使用 MicroRint 设备，在自然睡眠期间尝试对 28 名健康足月新生儿进行 R(int)测量。在 24 名婴儿中实现了配对的 R(int)测量，但在对波形进行筛选后，只有 15 名婴儿在两次测量中都至少有 5 个技术上可接受的波形。获得的 R(int)值与使用其他方法测量新生儿气流阻力的报告值相当。然而，重复性系数（CR）远高于使用标准后推算法在学龄前儿童中报告的值，未筛选时的 CR 为 2.47 KPa L(-1) sec，筛选时为 2.93 KPa L(-1) sec。其他算法的重复性仅略有改善，所有 CR 值均超过平均 R(int)值的 50%。使用当前市售的设备，R(int)的重复性太差，无法可靠测量新生儿的气流阻力。需要使用死腔更小的设备，但婴儿的解剖和生理因素也很重要。
