Optimizing lung aeration at birth using a sustained inflation and positive pressure ventilation in preterm rabbits

Arjan B. Te Pas, Marcus J. Kitchen, Katie Lee, Megan J. Wallace, Andreas Fouras, Robert A. Lewis, Naoto Yagi, Kentaro Uesugi, Stuart B. Hooper

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background:A sustained inflation (SI) facilitates lung aeration, but the most effective pressure and duration are unknown. We investigated the effect of gestational age (GA) and airway liquid volume on the required inflation pressure and SI duration.Methods:Rabbit kittens were delivered at 27, 29, and 30 d gestation, intubated and airway liquid was aspirated. Either no liquid (control) or 30 ml/kg of liquid was returned to the airways. Lung gas volumes were measured by plethysmography and phase-contrast X-ray-imaging. Starting at 22 cmH 2 O, airway pressure was increased until airflow commenced and pressure was then held constant. The SI was truncated when 20 ml/kg air had entered the lung and ventilation continued with intermittent positive pressure ventilation (iPPV).Results:Higher SI pressures and longer durations were required in 27-d kittens compared to 30-d kittens. During iPPV, 27-d kittens needed higher pressures and had lower functional residual capacity (FRC) compared to 30-d kittens. Adding lung liquid increased SI duration, reduced FRC, and increased resistance and pressures during iPPV in 29- and 30-d kittens.Conclusion:Immature kittens required higher starting pressures and longer SI durations to achieve a set inflation volume. Larger airway liquid volumes adversely affected lung function during iPPV in older but not young kittens.
Original languageEnglish
Pages (from-to)85-91
Number of pages7
JournalPediatric Research
Volume80
Issue number1
DOIs
Publication statusPublished - 1 Jul 2016

Cite this

@article{5f7a66e4f412462a8e2a3db1fdd46902,
title = "Optimizing lung aeration at birth using a sustained inflation and positive pressure ventilation in preterm rabbits",
abstract = "Background:A sustained inflation (SI) facilitates lung aeration, but the most effective pressure and duration are unknown. We investigated the effect of gestational age (GA) and airway liquid volume on the required inflation pressure and SI duration.Methods:Rabbit kittens were delivered at 27, 29, and 30 d gestation, intubated and airway liquid was aspirated. Either no liquid (control) or 30 ml/kg of liquid was returned to the airways. Lung gas volumes were measured by plethysmography and phase-contrast X-ray-imaging. Starting at 22 cmH 2 O, airway pressure was increased until airflow commenced and pressure was then held constant. The SI was truncated when 20 ml/kg air had entered the lung and ventilation continued with intermittent positive pressure ventilation (iPPV).Results:Higher SI pressures and longer durations were required in 27-d kittens compared to 30-d kittens. During iPPV, 27-d kittens needed higher pressures and had lower functional residual capacity (FRC) compared to 30-d kittens. Adding lung liquid increased SI duration, reduced FRC, and increased resistance and pressures during iPPV in 29- and 30-d kittens.Conclusion:Immature kittens required higher starting pressures and longer SI durations to achieve a set inflation volume. Larger airway liquid volumes adversely affected lung function during iPPV in older but not young kittens.",
author = "{Te Pas}, {Arjan B.} and Kitchen, {Marcus J.} and Katie Lee and Wallace, {Megan J.} and Andreas Fouras and Lewis, {Robert A.} and Naoto Yagi and Kentaro Uesugi and Hooper, {Stuart B.}",
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Optimizing lung aeration at birth using a sustained inflation and positive pressure ventilation in preterm rabbits. / Te Pas, Arjan B.; Kitchen, Marcus J.; Lee, Katie; Wallace, Megan J.; Fouras, Andreas; Lewis, Robert A.; Yagi, Naoto; Uesugi, Kentaro; Hooper, Stuart B.

In: Pediatric Research, Vol. 80, No. 1, 01.07.2016, p. 85-91.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Optimizing lung aeration at birth using a sustained inflation and positive pressure ventilation in preterm rabbits

AU - Te Pas, Arjan B.

AU - Kitchen, Marcus J.

AU - Lee, Katie

AU - Wallace, Megan J.

AU - Fouras, Andreas

AU - Lewis, Robert A.

AU - Yagi, Naoto

AU - Uesugi, Kentaro

AU - Hooper, Stuart B.

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background:A sustained inflation (SI) facilitates lung aeration, but the most effective pressure and duration are unknown. We investigated the effect of gestational age (GA) and airway liquid volume on the required inflation pressure and SI duration.Methods:Rabbit kittens were delivered at 27, 29, and 30 d gestation, intubated and airway liquid was aspirated. Either no liquid (control) or 30 ml/kg of liquid was returned to the airways. Lung gas volumes were measured by plethysmography and phase-contrast X-ray-imaging. Starting at 22 cmH 2 O, airway pressure was increased until airflow commenced and pressure was then held constant. The SI was truncated when 20 ml/kg air had entered the lung and ventilation continued with intermittent positive pressure ventilation (iPPV).Results:Higher SI pressures and longer durations were required in 27-d kittens compared to 30-d kittens. During iPPV, 27-d kittens needed higher pressures and had lower functional residual capacity (FRC) compared to 30-d kittens. Adding lung liquid increased SI duration, reduced FRC, and increased resistance and pressures during iPPV in 29- and 30-d kittens.Conclusion:Immature kittens required higher starting pressures and longer SI durations to achieve a set inflation volume. Larger airway liquid volumes adversely affected lung function during iPPV in older but not young kittens.

AB - Background:A sustained inflation (SI) facilitates lung aeration, but the most effective pressure and duration are unknown. We investigated the effect of gestational age (GA) and airway liquid volume on the required inflation pressure and SI duration.Methods:Rabbit kittens were delivered at 27, 29, and 30 d gestation, intubated and airway liquid was aspirated. Either no liquid (control) or 30 ml/kg of liquid was returned to the airways. Lung gas volumes were measured by plethysmography and phase-contrast X-ray-imaging. Starting at 22 cmH 2 O, airway pressure was increased until airflow commenced and pressure was then held constant. The SI was truncated when 20 ml/kg air had entered the lung and ventilation continued with intermittent positive pressure ventilation (iPPV).Results:Higher SI pressures and longer durations were required in 27-d kittens compared to 30-d kittens. During iPPV, 27-d kittens needed higher pressures and had lower functional residual capacity (FRC) compared to 30-d kittens. Adding lung liquid increased SI duration, reduced FRC, and increased resistance and pressures during iPPV in 29- and 30-d kittens.Conclusion:Immature kittens required higher starting pressures and longer SI durations to achieve a set inflation volume. Larger airway liquid volumes adversely affected lung function during iPPV in older but not young kittens.

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