Abstract 15

Aims: To assess the effects of diagnostic and therapeutic BAL on lung mechanics in ventilated infants. Subjects: 28 newborns, at 1 to 42 days of life. Diagnostic BAL: 16 subjects, birthweight (BW) 1380g (490-2750), gestational age (GA) 30.4w (25-36), with RDS. Therapeutic BAL: 12 subjects, BW 2160g (490-3780), GA 32.4w (24-40), with various lung diseases. Methods: Tidal volume (Vt, ml/kg), minute ventilation (VE, l/min/kg), dynamic compliance (Cdyn, ml/cmH2O/Kg) and airway resistance (Raw, cmH2O/l/sec) were measured 10 minutes before and after the BAL procedure with a Bicore CP100 (Sensor Medics). Heart rate (HR), respiratory rate (RR), transcutaneous O2 saturation (SaO2) and blood pressure (BP) were monitored continuously. The differences (▵) between values pre and post BAL were evaluated by the paired t test. Results: In all subjects HR, RR, SaO2 and BP did not change following BAL. Diagnostic BAL: Vt, VE, Raw and Cdyn did not change appreciably after the procedure. Therapeutic BAL: except for Vt, all variables improved significantly (p<0.05) after the procedure: ▵ VE 0.06, SD 0.09 l/min/kg; ▵Raw -41.50, SD 64.0 cmH2O/l/sec; ▵Cdyn 0.13, SD 0.17 ml/cmH2O/kg. Conclusions: BAL is a safe procedure in mechanically ventilated neonates even with very low birthweight. (Supported by a Grant of the Italian Ministry of Health)