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A critical evaluation of respiratory function testing in spontaneously breathing and ventilated infants

Jackson, Elizabeth Anne; (1998) A critical evaluation of respiratory function testing in spontaneously breathing and ventilated infants. Doctoral thesis (Ph.D.), University College London (United Kingdom). Green open access

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Abstract

At the inception of this thesis in 1991, there was increasing interest in infant respiratory function measurements following the development of simpler methods of testing including the tidal breathing parameter tPTEF:tE passive respiratory mechanics using the occlusion techniques and the rapid thoraco-abdominal compression technique (RTC). In addition, there were technological advances including the introduction of automated equipment for use in intensive care. The main aim of this thesis was to evaluate critically these recent advances. Factors influencing the variability of tPTEF:tE were assessed, tPTEF:tE was higher with greater within-subject variability during the first few weeks of life. Twenty to fifty breaths are needed to obtain a representative value. Suggestions that tPTEF:tE could be measured using uncalibrated respiratory inductance plethysmography were not confirmed. Only a weak association between tPTEF:tE and established plethysmographic measures of airway function could be demonstrated. Passive respiratory mechanics measurements had a higher failure rate than plethysmography. An extremely variable relationship between respiratory and airway resistance was observed within infants although both were significantly higher in infants with a history of wheeze. The RTC proved useful in detecting airway disease in symptomatic infants. In contrast to passive respiratory mechanics, the RTC is more satisfactory in the presence of airway disease than in healthy infants. The method continues to be refined and is the most promising of the recent developments. Assessments of automated measurement systems show the need to establish standards and ensure awareness of technical limitations of the equipment and the underlying assumptions of the measurement methods. The display of flow, volume and pressure data may be all that is routinely possible in the clinical management of unparalysed ventilated infants. Technological advances in the measurement of dynamic mechanics, including the development of catheter tipped microtransducers, may lead to the resurgence of dynamic mechanics measurements for research studies in this population.

Type: Thesis (Doctoral)
Qualification: Ph.D.
Title: A critical evaluation of respiratory function testing in spontaneously breathing and ventilated infants
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by ProQuest.
Keywords: (UMI)AAIU644210; Health and environmental sciences; Respiratory function
URI: https://discovery.ucl.ac.uk/id/eprint/10102057
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