Ventilation homogeneity improves with growth early in life.
Ventilation homogeneity improves with growth early in life.
复制标题
通气均匀性随着生命早期的生长而改善。
DOI：
10.1002/ppul.21553
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发表时间：
2012
影响因子：
3.1
通讯作者：
Tepper,RobertS
中科院分区：
文献类型：
--
作者：
Chakr,ValentinaC;Llapur,ConradoJ;Sarria,EdgarE;Mattiello,Rita;Kisling,Jeffrey;Tiller,Christina;Kimmel,Risa;Poindexter,Brenda;Tepper,RobertS
一些研究表明，健康受试者在生命早期的肺清除率指数（LCI）与年龄无关，这意味着通气分布不随生长而变化。然而，对年龄较大的儿童和青少年的其他研究表明，通气与躯体生长更加均匀。我们描述了一种使用缓慢增强充气呼吸在镇静婴儿和幼儿中获得多次呼吸冲洗（MBWO）的新技术，该技术可评估LCI和III期斜率，这是通气不均匀性的另一个指标。我们评估了通气是否随着早期年龄的增加而变得更加均匀，以及患有婴儿期慢性肺部疾病（CLDI）的婴儿相对于足月对照组（FT）是否通气不均匀性增加。FT （N = 28）和CLDI (N = 22) 3 - 28个月矫正年龄的受试者进行评估。LCI随年龄增加而降低；但两组间差异无统计学意义（9.3 vs. 9.5；P= 0.56）。在冲洗期间，根据过期体积（SND）调整的III期斜坡随着呼吸次数的增加而增加，随着年龄的增加而减少。全期和CLDI受试者的snd无显著差异（211 vs. 218；P= 0.77）。我们的研究结果表明，通气在生命早期随着肺的生长和成熟变得更加均匀；然而，没有证据表明通气不均匀性是CLDI肺病理生理的重要组成部分。儿科肺科杂志2012；47:373 - 380。©2011 Wiley期刊公司
Some studies have suggested that lung clearance index (LCI) is age‐independent among healthy subjects early in life, which implies that ventilation distribution does not vary with growth. However, other studies of older children and adolescents suggest that ventilation becomes more homogenous with somatic growth. We describe a new technique to obtain multiple breath washout (MBWO) in sedated infants and toddlers using slow augmented inflation breaths that yields an assessment of LCI and the slope of phase III, which is another index of ventilation inhomogeneity. We evaluated whether ventilation becomes more homogenous with increasing age early in life, and whether infants with chronic lung disease of infancy (CLDI) have increased ventilation inhomogeneity relative to full‐term controls (FT). FT (N = 28) and CLDI (N = 22) subjects between 3 and 28 months corrected‐age were evaluated. LCI decreased with increasing age; however, there was no significant difference between the two groups (9.3 vs. 9.5;P= 0.56). Phase III slopes adjusted for expired volume (SND) increased with increasing breath number during the washout and decreased with increasing age. There was no significant difference in SNDbetween full‐term and CLDI subjects (211 vs. 218;P= 0.77). Our findings indicate that ventilation becomes more homogenous with lung growth and maturation early in life; however, there is no evidence that ventilation inhomogeneity is a significant component of the pulmonary pathophysiology of CLDI. Pediatr Pulmonol. 2012; 47:373–380. © 2011 Wiley Periodicals, Inc.