We aimed at investigating whether early lung mechanics in non-intubated infants below 32 weeks of gestational age (GA) are associated with respiratory outcome.
Lung mechanics were assessed by the forced oscillation technique using a mechanical ventilator (Fabian HFOi, ACUTRONIC Medical Systems AG, Hirzel, Switzerland) that superimposed small-amplitude oscillations (10 Hz) on a continuous positive airway pressure. Measurements were performed during regular tidal breathing using a face mask on days 2, 4, and 7 of life. Respiratory system resistance (Rrs) and reactance (Xrs) were computed from flow and pressure.
One hundred and seventy-seven measurements were successfully performed in 68 infants. Infants had a mean (range) GA of 29.3 (24.1–31.7) weeks and a birth weight of 1257 (670–2350)g. Xrs was associated with the duration of respiratory support (R2 = 0.39, p < 0.001). A multilevel regression model, including Xrs and GA, explained the duration of respiratory support better than GA alone (R2 = 0.51 vs. 0.45, p = 0.005, likelihood ratio test).
Assessment of Xrs in the first week of life is feasible and improves prognostication of respiratory outcome in very preterm infants on noninvasive respiratory support.
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This work was supported by the Swiss Kommission für Technologie und Innovation (KTI, Grant-Nr. 25768.2 PFLS). ACUTRONIC Medical Systems AG provided the device and disposables to perform the measurements. Dr. Zannin was supported in this work by a European Respiratory Society Long-Term Fellowship (LTRF 2015-4459). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the paper.