Validation of a nitrogen washout system to measure functional residual capacity in premature infants with hyaline membrane disease

1995 ◽  
Vol 20 (6) ◽  
pp. 403-409 ◽  
Author(s):  
Jason Miller ◽  
Amy B. Law ◽  
Robert A. Parker ◽  
Håkan W. Sundell ◽  
Daniel P. Lindstrom ◽  
...  
Keyword(s):  
Premature Infants ◽  
Functional Residual Capacity ◽  
Hyaline Membrane Disease ◽  
Nitrogen Washout ◽  
Hyaline Membrane ◽  
Residual Capacity

scholarly journals 1737 FUNCTIONAL RESIDUAL CAPACITY (FRC) CHANGES IN PRETERM BABOONS WITH HYALINE MEMBRANE DISEASE (HMD)

1985 ◽  
Vol 19 (4) ◽  
pp. 400A-400A
Author(s):  
Ramiro Caballero ◽  
Marilyn B Escobedo ◽  
Manisol Montes ◽  
R Lee Boyd ◽  
Cheryl Cipriani ◽  
...  
Keyword(s):  
Functional Residual Capacity ◽  
Hyaline Membrane Disease ◽  
Hyaline Membrane ◽  
Residual Capacity

Surfactant for Hyaline Membrane Disease

PEDIATRICS ◽  
1980 ◽  
Vol 66 (5) ◽  
pp. 795-798 ◽  
Author(s):  
Tetsuro Fujiwara ◽  
Forrest H. Adams
Keyword(s):  
Premature Infants ◽  
Lung Surfactant ◽  
Hyaline Membrane Disease ◽  
The Other ◽  
Synthetic Surfactant ◽  
Natural Surfactant ◽  
Hyaline Membrane ◽  
Dipalmitoyl Lecithin ◽  
Air Intake ◽  
Relative Deficiency

Since it has been demonstrated that hyaline membrane disease (HMD) is due to a relative deficiency of lung surfactant,1,2 one possible approach to the treatment or prevention of HMD in premature infants might be the introduction of surfactant into the lungs. Thus far, attempts at aerosolization of either synthetic surfactant (dipalmitoyl lecithin [DPL]) or natural surfactant into the lungs of patients or animals have failed to produce convincing benefits.3-5 On the other hand, direct instillation of a solution of natural surfactant into the trachea seems to produce striking results. Enhörning et al6 were the first to show that tracheal deposition of natural surfactant into premature rabbit fetuses before the first breath enhanced air intake and improved the pressure-volume relationships of the lungs; it also increased their survival time.7

STUDIES ON HYALINE MEMBRANE DISEASE

PEDIATRICS ◽  
1963 ◽  
Vol 32 (1) ◽  
pp. 10-24
Author(s):  
Clara M. Ambrus ◽  
David H. Weintraub ◽  
Donal Dunphy ◽  
John E. Dowd ◽  
John W. Pickren ◽  
...  
Keyword(s):  
Placebo Group ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Plasminogen Activator ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Hyaline Membrane Disease ◽  
Blood Coagulation Factors ◽  
Plasminogen Activator Activity ◽  
Hyaline Membrane

In the serum of normal prematures and premature infants with respiratory distress syndrome, plasminogen was absent. In mature newborns plasminogen levels were low, as compared to adults. In the euglobulin fraction of plasma, plasminogen level was highest in mature newborns, lower in healthy prematures, and lowest in prematures with respiratory distress syndrome. Antiplasmin level was exceptionally high in about a fourth of the premature infants with or without respiratory distress syndrome. Plasminogen activator activity was found more often in the blood of infants with respiratory distress syndrome than in normal infants. This may be due to the liberation of tissue activators as a consequence of hypoxia. Because of the absence of the substrate (plasminogen), this activator level may have no significance. Tissue activator activity was found in the lungs of premature infants whether they died of hyaline membrane disease or from other causes. Forty-five infants with respiratory distress were treated in a therapeutic study. Twelve were treated in a preliminary series and 33 in a randomizd, double-blind investigation. Of the latter, 11 were treated with placebo, and 5 (45%) survived; 8 were treated with streptokinase activated human plasmin and 2 (25%) survived; 14 were treated with urokinase activated human plasmin and 12 (86%) survived. Among the infants who died, no definite hyaline membrane disease was found by histopathologic examination in two of the placebo group, one in the streptokinase-plasmin treated group, and the two who died in the urokinase-plasmin group. No significant side-effects of plasmin therapy were seen. Although considerable fibrinolytic and plasminogen-activator activity was generated in many treated patients, there was no significant fall in blood coagulation factors. Intracerebral hemorrhage, which appears to occur often in patients who die with hyaline membrane disease, was not more frequent in the plasmintreated group than in the placebo group.

Chronic Pulmonary Insufficiency of Prematurity (CPIP)

PEDIATRICS ◽  
1975 ◽  
Vol 55 (1) ◽  
pp. 55-58
Author(s):  
Alfred N. Krauss ◽  
David B. Klain ◽  
Peter A. M. Auld
Keyword(s):  
Mortality Rate ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Hyaline Membrane Disease ◽  
Supplemental Oxygen ◽  
Pulmonary Insufficiency ◽  
Radiologic Findings ◽  
Sense Of Security ◽  
Hyaline Membrane ◽  
False Sense

This report describes a syndrome of delayed respiratory distress occurring in premature infants usually under 1,250 gm at birth. Unlike hyaline membrane disease, this syndrome occurs after four to seven days in a previously healthy infant; also unlike hyaline membrane disease, it persists for two to four weeks. Chronic pulmonary insufficiency of prematurity (CPIP) carries a 10% to 20% mortality rate. The infants are frequently apneic, require supplemental oxygen, but lack the radiologic findings of hyaline membrane disease or bronchopulmonary dysplasia. When compared with nondistressed infants of similar birthweight, infants with CPIP demonstrate slowly progressive atelectasis, hypoxemia, and hypercapnia. Recovery is usually complete by 60 days of age. The importance of CPIP is that an awareness of its existence can eliminate a false sense of security, often communicated to anxious parents, during the four-to-seven-day grace period before its appearance is clinically obvious. The physiologic similarities between CPIP and hyaline membrane disease suggest that lack of surfactant may play a role in the pathogenesis of CPIP.

scholarly journals In vitro and in vivo functional residual capacity comparisons between multiple-breath nitrogen washout devices

2017 ◽  
Vol 3 (4) ◽  
pp. 00011-2017 ◽  
Author(s):  
Katrina O. Tonga ◽  
Paul D. Robinson ◽  
Claude S. Farah ◽  
Greg G. King ◽  
Cindy Thamrin
Keyword(s):  
Functional Residual Capacity ◽  
Measurement Accuracy ◽  
Lung Model ◽  
Nitrogen Washout ◽  
Device Validation ◽  
Residual Capacity

Functional residual capacity (FRC) accuracy is essential for deriving multiple-breath nitrogen washout (MBNW) indices, and is the basis for device validation. Few studies have compared existing MBNW devices. We evaluated in vitro and in vivo FRC using two commercial MBNW devices, the Exhalyzer D (EM) and the EasyOne Pro LAB (ndd), and an in-house device (Woolcock in-house device, WIMR).FRC measurements were performed using a novel syringe-based lung model and in adults (20 healthy and nine with asthma), followed by plethysmography (FRCpleth). The data were analysed using device-specific software. Following the results seen with ndd, we also compared its standard clinical software (ndd v.2.00) with a recent upgrade (ndd v.2.01).WIMR and EM fulfilled formal in vitro FRC validation recommendations (>95% of FRC within 5% of known volume). Ndd v.2.00 underestimated in vitro FRC by >20%. Reanalysis using ndd v.2.01 reduced this to 11%, with 36% of measurements ≤5%. In vivo differences from FRCpleth (mean±sd) were 4.4±13.1%, 3.3±11.8%, −20.6±11% (p<0.0001) and −10.5±10.9% (p=0.005) using WIMR, EM, ndd v.2.00 and ndd v.2.01, respectively.Direct device comparison highlighted important differences in measurement accuracy. FRC discrepancies between devices were larger in vivo, compared to in vitro results; however, the pattern of difference was similar. These results represent progress in ongoing standardisation efforts.

PREVENTION OF HYALINE MEMBRANE DISEASE

PEDIATRICS ◽  
1972 ◽  
Vol 50 (4) ◽  
pp. 513-514
Author(s):  
Mary Ellen Avery
Keyword(s):  
Respiratory Distress ◽  
Premature Infants ◽  
Statistical Significance ◽  
Hyaline Membrane Disease ◽  
Hyaline Membrane

The articles by Liggins and Howie and Baden, et al. in this issue of Pediatrics are of great interest to perinatologists because they describe efforts to extend to premature infants results of recent studies on maturation of lungs of lambs and rabbits in the prevention of hyaline membrane disease. The two reports provide both promise and caution. When labor can be delayed at least 24 hours in infants under 32 weeks, infusion of betamethasone into the mother can prevent respiratory distress in the infant. Results in infants over 32 weeks' gestation suggest a positive benefit, but the number of infants in the series was too small to reach statistical significance.

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