Hantos Zoltán, Czövek Dorottya, Gyurkovits Zita, Szabó Hajnalka, Maár Balázs A, Radics Bence, Virág Katalin, Makan Gergely, Orvos Hajnalka, Gingl Zoltán, Sly Peter D
Department of Medical Physics and Informatics, University of Szeged, Szeged, 6720, Hungary; Queensland Children's Medical Research Institute, University of Queensland, Queensland, Australia.
Pediatr Pulmonol. 2015 Apr;50(4):344-52. doi: 10.1002/ppul.23103. Epub 2014 Aug 25.
Lung function data in healthy newborn infants are scarce largely due to lack of suitable techniques, although data for developmental and prenatal exposure studies are much needed. We have modified the forced oscillation technique (FOT) for the measurement of respiratory mechanical impedance (Zrs) in unsedated sleeping infants in the first 3 days of life.
Zrs was measured during 30-s epochs of quiet sleep in term neonates born via spontaneous vaginal delivery with a non-invasive FOT between 8 and 48 Hz. Total respiratory resistance (R), compliance (C) and inertance (I) were obtained by fitting Zrs spectra. Cluster analysis was used to determine a set of minimal Zrs spectra representing optimal respiratory mechanics for each infant.
Successful measurements were obtained in each of the first 3 days in 30/38 (78.9%) neonates. Group mean (± SD) values of R, C, I, and resonant frequency pooled for the 3 days were 45.9 ± 16.6 hPa s L(-1), 0.97 ± 0.21 ml hPa(-1), 0.082 ± 0.031 hPa s(2) L(-1) and 19.2 ± 3.2 Hz, respectively. Within-session variability represented by coefficient of variation was 5.34 ± 3.18% for R and 13.80 ± 8.57% for C. Greater between-session variability was observed for the individual infants; however, the only statistically significant change over time was a 13% increase in R from day 1 to day 2. Parameter interdependence was significant (r(2) = 0.63) between R and I reflecting the large contribution of the upper airways to the total Zrs.
Noninvasive measurement of Zrs can be made in neonates during natural sleep with a high success rate, even in the first hours of life.
尽管发育和产前暴露研究非常需要相关数据，但由于缺乏合适的技术，健康新生儿的肺功能数据非常稀少。我们对强迫振荡技术（FOT）进行了改进，用于测量出生后前3天未使用镇静剂的睡眠婴儿的呼吸机械阻抗（Zrs）。
通过非侵入性FOT在8至48Hz之间测量经阴道自然分娩的足月儿安静睡眠30秒期间的Zrs。通过拟合Zrs频谱获得总呼吸阻力（R）、顺应性（C）和惯性（I）。聚类分析用于确定一组代表每个婴儿最佳呼吸力学的最小Zrs频谱。
38名新生儿中的30名（78.9%）在出生后的前3天每天均成功完成测量。3天的R、C、I和共振频率的组均值（±标准差）分别为45.9±16.6hPa·s·L⁻¹、0.97±0.21ml·hPa⁻¹、0.082±0.031hPa·s²·L⁻¹和19.2±3.2Hz。以变异系数表示的测量期间内变异性，R为5.34±3.18%，C为13.80±8.57%。各婴儿之间的测量期间变异性更大；然而，唯一具有统计学意义的随时间变化是R从第1天到第2天增加了13%。R和I之间的参数相互依赖性显著（r² = 0.63），反映了上呼吸道对总Zrs的巨大贡献。
即使在出生后的最初几个小时内，也可以在新生儿自然睡眠期间以高成功率进行Zrs的无创测量。
