Ratjen F, Trost A, Welker J, Spangenberg P, Wiesemann H G
Department of Pediatrics, University of Essen, Germany.
Pediatr Res. 1995 Nov;38(5):664-7. doi: 10.1203/00006450-199511000-00006.
Measurements of forced expiratory flow in infants can be obtained with the rapid thoracoabdominal compression (RTC) technique. To assess the transmission of the chest wall compression pressure into the cerebrum, we have performed intracranial pressure (ICP) measurements during RTCs in newborn lambs. Thirteen lambs were studied during the first 8 d of life. An epidural pressure transducer was implanted under general anesthesia. Respiratory measurements were performed under sedation with ketamine. RTCs were induced through an inflatable jacket wrapped around the lamb's trunk. RTCs were started with a pressure of 30 cm H2O. The compression pressure was increased in steps of 20 cm H2O up to 250 cm H2O. Flow and volume were determined with a pneumotachograph attached to a face mask. Transpulmonary pressure (Ptp) was measured with an esophageal balloon placed in the lower esophagus. RTCs resulted in proportional increases of Ptp and ICP. ICP was lower or equal to Ptp in all measurements. No changes in baseline ICP occurred throughout the study period. The maximal ICP observed during RTCs was within the range of pressures observed during crying in newborn infants. These data suggest that the RTC technique can be considered safe even at high compression pressures.
婴儿用力呼气流量的测量可通过快速胸腹按压（RTC）技术获得。为了评估胸壁按压压力向大脑的传导，我们在新生羔羊进行RTC期间进行了颅内压（ICP）测量。在出生后的前8天对13只羔羊进行了研究。在全身麻醉下植入硬膜外压力传感器。在氯胺酮镇静下进行呼吸测量。通过包裹在羔羊躯干周围的充气夹克诱导RTC。RTC从30 cm H2O的压力开始。按压压力以20 cm H2O的步长增加，直至250 cm H2O。使用连接到面罩的呼吸流速仪测定流量和容积。通过放置在食管下部的食管气囊测量跨肺压（Ptp）。RTC导致Ptp和ICP成比例增加。在所有测量中，ICP均低于或等于Ptp。在整个研究期间，基线ICP没有变化。RTC期间观察到的最大ICP在新生儿哭泣期间观察到的压力范围内。这些数据表明，即使在高按压压力下，RTC技术也可被认为是安全的。
