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  • Clinical Research Article
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Oscillatory mechanics trajectory in very preterm infants: a cohort study

Pediatric Research volume 94, pages 1998–2004 (2023)Cite this article

Abstract

Background

The aim of this study was to describe the trajectory of oscillatory mechanics from the first week of life to term equivalent and evaluate whether oscillatory mechanics are associated with simultaneous lung disease in infants ≤32 weeks gestation.

Methods

In this observational, longitudinal study, we enrolled 66 infants. Forced oscillations were applied using a neonatal mechanical ventilator (Fabian HFOi) that superimposed oscillations (10 Hz, amplitude 2.5 cmH2O) on a positive end-expiratory pressure (PEEP). Measurements were performed at 5-7-9 cmH2O of PEEP or the clinical pressure ±2 cmH2O; they were repeated at 7, 14, 28 post-natal days, and 36 and 40 weeks post-menstrual age (PMA).

Results

The mean (range) gestational age of study participants was 29.2 (22.9–31.9) weeks. Nineteen infants (29%) developed bronchopulmonary dysplasia (BPD). Respiratory system reactance was significantly lower (lower compliance), and respiratory system resistance was significantly higher in infants with developing BPD from 7 post-natal days to 36 weeks PMA. All oscillatory mechanics parameters were significantly associated with the simultaneous respiratory severity score (p < 0.001 for all).

Conclusions

Serial measurements of oscillatory mechanics allow differentiating lung function trajectory in infants with and without evolving BPD. Oscillatory mechanics significantly correlate with the severity of simultaneous lung disease.

Impact

  • The results of the present study suggest that respiratory system reactance, as assessed by respiratory oscillometry, allows the longitudinal monitoring of the progression of lung disease in very premature infants.

  • This paper describes for the first time the trajectory of oscillatory mechanics in very preterm infants with and without evolving bronchopulmonary dysplasia from the first week of life to term equivalent.

  • Serial respiratory oscillometry measurements allow the identification of early markers of evolving bronchopulmonary dysplasia and may help personalizing the respiratory management strategy.

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Fig. 1: Trajectory of oscillatory mechanics parameters from the first week of life to term equivalent in infants with and without BPD.
Fig. 2: Relationship between respiratory system resistance and reactance vs continuous positive airway pressure in BPD and non-BPD patients.
Fig. 3: Oscillatory mechanics parameters during different respiratory support modes.

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Data availability

All data generated or analysed during this study are included in this article. Further enquiries can be directed to the corresponding author.

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Acknowledgements

We acknowledge Abedulrhman S Abdelfattah for their support in performing the measurements.

Author information

Author notes

  1. These authors contributed equally: Camilla Rigotti, Emanuela Zannin.

Authors and Affiliations

  1. Tin-neonatologia, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy

    Camilla Rigotti, Emanuela Zannin, Giulia Dognini & Maria Luisa Ventura

  2. TechRes Lab, Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano University, Milan, Italy

    Raffaele Dellacà

Authors
  1. Camilla Rigotti
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  2. Emanuela Zannin
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  3. Giulia Dognini
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  4. Raffaele Dellacà
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  5. Maria Luisa Ventura
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Contributions

E.Z. has contributed to the study design, data acquisition and data analysis and drafted the first version of the manuscript. C.R. contributed to the study design, data acquisition and clinical interpretation of results and approved the final manuscript as submitted. G.D. contributed to the data collection and critically revised the manuscript. R.D. supervised data acquisition and analysis and critically revised the manuscript. M.L.V. contributed to the study design and the clinical interpretation of the results and approved the final version of the manuscript.

Corresponding author

Correspondence to Emanuela Zannin.

Ethics declarations

Competing interests

R.D. reports that Politecnico di Milano received research grants from Vyaire and licensed a patent for using FOT to assess lung volume recruitment to Vyaire. C.R. has received honoraria for lectures from Vyaire. The other authors have nothing to disclose. None of the authors received any form of payment to produce the manuscript.

Ethics approval and consent to participate

The local ethics committee (nr. 3804/21) approved the study and written informed consent was obtained from parents before enrollment.

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Rigotti, C., Zannin, E., Dognini, G. et al. Oscillatory mechanics trajectory in very preterm infants: a cohort study. Pediatr Res 94, 1998–2004 (2023). https://doi.org/10.1038/s41390-023-02724-w

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