Measurements of pulmonary mechanics prior to the elective extubation of neonates

• Published in: Pediatric pulmonology Vol. 9; no. 4; p. 238
• Main Authors: Balsan, M J, Jones, J G, Watchko, J F, Guthrie, R D
• Format: Journal Article
• Language: English
• Published: United States 1990
• Subjects: Airway Resistance; Body Weight; Humans; Infant, Newborn; Lung Compliance; Respiratory Distress Syndrome, Newborn - physiopathology; Respiratory Distress Syndrome, Newborn - therapy; Respiratory Mechanics; Ventilator Weaning
• ISSN: 8755-6863
• DOI: 10.1002/ppul.1950090409

We measured total respiratory system compliance (CRS) and resistance (RRS) by the passive expiratory flow technique prior to the elective extubation of 61 neonates with a history of respiratory distress syndrome. Successful trials of extubation were characterized by a higher mean value of CRS when compared to trials that led to reintubation (1.52 vs. 1.10 mL/cm H2O, P = 0.004). Low values of CRS (0.9 mL/cm H2O or less) were invariably associated with extubation failure, whereas high values of CRS (1.3 mL/cm H2O or greater) were associated with extubation success in 94% of patients. A higher mean value of RRS was recorded in the group of infants who failed extubation when compared to those who were successful (0.22 vs. 0.17 cm H2O/mL/s, P = 0.042). We propose that measurements of pulmonary mechanics, particularly CRS, may be useful in identifying infants who will be at risk for extubation failure.