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Forced oscillation measurements in the first week of life and pulmonary outcome in very preterm infants on noninvasive respiratory support



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.

Author information

All authors substantially contributed to the conception and design of the study and to the interpretation of data. R.P.N. and E.Z. acquired the data, E.Z. performed data analysis, E.Z. wrote the first draft of the paper, all authors revised it critically, and approved the final version of the paper to be published.

Competing interests

The authors declare no competing interests.

Correspondence to Emanuela Zannin.

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