Silva Neto G, Gerhardt T, Claure N, Duara S, Bancalari E
Department of Pediatrics, University of Miami School of Medicine, Florida 33101, USA.
Pediatr Pulmonol. 1995 Jul;20(1):34-9. doi: 10.1002/ppul.1950200107.
The purpose of this study was to determine the effect of chestwall distortion (CWD) on the measurement of pulmonary compliance (CL) and resistance (RL). Inductance plethysmography was used in 15 preterm infants to determine CWD as total compartmental displacement ratio (TCDR) and out of phase movement between ribcage and abdomen as phase shift (PS). Flow was measured by pneumotachography and esophageal pressure change (Pe) with a water-filled catheter. CL and RL were calculated by linear regression analysis. Seven infants (mean +/- SD: BW, 1,484 +/- 186 g, GA 32.4 +/- 2.2 weeks, age 8.7 +/- 4.7 days) had a breathing pattern characterized by episodes with a high degree of CWD, followed by periods with minimal CWD (distortion group). In this group lung function measurements were analyzed separately during periods with and without CWD. The remaining 8 infants (BW, 1,244 +/- 233 g, GA 30.4 +/- 2.4 weeks, age 7.4 +/- 3.1 days) always breathed with minimal CWD, and the measurements in this group (non-distortion group) were used as a reference for the values obtained in the distortion group. Measurements of TCDR, PS, CL, RL, and tidal volume (VT) obtained in the absence of CWD were not significantly different between distortion and non-distortion groups. The measurements obtained in the presence of CWD showed a significantly higher TCDR and PS, but CL and RL were not significantly different from the CL and RL measurements obtained in the distortion and non-distortion groups in the absence of CWD. The only significant effect of CWD was a reduction in VT.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是确定胸壁变形（CWD）对肺顺应性（CL）和阻力（RL）测量的影响。对15名早产儿使用电感体积描记法，将CWD确定为总隔室位移比（TCDR），并将胸廓与腹部之间的异相运动确定为相移（PS）。通过呼吸速度描记法测量流量，并使用充水导管测量食管压力变化（Pe）。通过线性回归分析计算CL和RL。7名婴儿（平均±标准差：体重1484±186g，胎龄32.4±2.2周，年龄8.7±4.7天）的呼吸模式特征为CWD程度高的发作期，随后是CWD最小的时期（变形组）。在该组中，分别分析了有和没有CWD时期的肺功能测量值。其余8名婴儿（体重1244±233g，胎龄30.4±2.4周，年龄7.4±3.1天）始终以最小的CWD呼吸，该组（非变形组）的测量值用作变形组获得值的参考。在无CWD情况下获得的TCDR、PS、CL、RL和潮气量（VT）测量值在变形组和非变形组之间无显著差异。在有CWD情况下获得的测量值显示TCDR和PS显著更高，但CL和RL与无CWD时变形组和非变形组获得的CL和RL测量值无显著差异。CWD的唯一显著影响是VT降低。（摘要截断于250字）
