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Effects of CPAP on lung mechanics in infants with acquired tracheobronchomalacia
Journal article   Peer reviewed

Effects of CPAP on lung mechanics in infants with acquired tracheobronchomalacia

H B Panitch, J L Allen, B E Alpert and D V Schidlow
American journal of respiratory and critical care medicine, v 150(5 Pt 1), pp 1341-1346
Nov 1994
PMID: 7952562

Abstract

Bronchial Diseases - physiopathology Lung Compliance Humans Child, Preschool Infant Airway Resistance Functional Residual Capacity Tidal Volume Bronchial Diseases - therapy Positive-Pressure Respiration Tracheal Diseases - etiology Bronchial Diseases - etiology Tracheal Diseases - physiopathology Respiratory Mechanics Tracheal Diseases - therapy
Continuous positive airway pressure (CPAP) has been used in the treatment of infants with tracheobronchomalacia (TBM). However, the effects of CPAP on lung mechanics in these infants are unknown. We hypothesized that CPAP prevents airway collapse and improves forced exhalation. We studied respiratory mechanics of nine infants (age 15 +/- 3 mo, SEM) with acquired TBM documented by bronchoscopy, during quiet respiration and forced exhalation, using the esophageal balloon and rapid thoracic compression techniques, respectively. Measurements were made when infants received no CPAP and repeated when 5 and 8 cm H2O CPAP were applied to the airway opening via a modified Mapleson anesthesia circuit. Expiratory resistance (RL), midexpiratory tidal flow (VE50), and maximal flow at functional residual capacity (Vmax FRC) were compared at each level of CPAP. Vmax FRC increased threefold from baseline to 8 cm H2O CPAP (p < 0.005). In contrast, there was no difference in expiratory RL or in VE50 at any level of CPAP. These data suggest that in infants with acquired TBM, assessments of forced expiratory flow reflect the amount of CPAP necessary to prevent airway collapse during forced exhalation better than can measurements of tidal mechanics.

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Critical Care Medicine
Respiratory System
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