Ventilatory response to nitrogen multiple-breath washout in infants

Singer, Florian; Yammine, Sophie; Schmidt, Anne; Proietti, Elena; Kieninger, Elisabeth; Barben, Juerg; Casaulta, Carmen; Regamey, Nicolas; Gustafsson, Per; Frey, Urs; Latzin, Philipp (2014). Ventilatory response to nitrogen multiple-breath washout in infants. Pediatric pulmonology, 49(4), pp. 342-347. Wiley-Blackwell 10.1002/ppul.22841

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BACKGROUND Nitrogen multiple-breath washout (N2 MBW) using 100% oxygen (O2 ) has regained interest to assess efficiency of tracer gas clearance in, for example, children with Cystic Fibrosis (CF). However, the influence of hyperoxia on the infants' respiratory control is unclear. We assessed safety and impact on breathing pattern from hyperoxia, and if exposure to 40% O2 first induces tolerance to subsequent 100% O2 for N2 MBW. METHODS We prospectively enrolled 39 infants aged 3-57 weeks: 15 infants with CF (8 sedated for testing) and 24 healthy controls. Infants were consecutively allocated to the protocols comprising of 100% O2 or 40/100% O2 administered for 30 breaths. Lung function was measured using an ultrasonic flowmeter setup. Primary outcome was tidal volume (VT ). RESULTS None of the infants experienced apnea, desaturation, or bradycardia. Both protocols initially induced hypoventilation. VT temporarily declined in 33/39 infants across 10-25 breaths. Hypoventilation occurred independent of age, disease, and sedation. In the new 40/100% O2 protocol, VT returned to baseline during 40% O2 and remained stable during 100% O2 exposure. End-tidal carbon dioxide monitored online did not change. CONCLUSION The classical N2 MBW protocol with 100% O2 may change breathing patterns of the infants. The new protocol with 40% O2 induces hyperoxia-tolerance and does not lead to changes in breathing patterns during later N2 washout using 100% O2 . Both protocols are safe, the new protocol seems an attractive option for N2 MBW in infants. Pediatr Pulmonol. © 2013 Wiley Periodicals, Inc.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Pneumologie (Pädiatrie)
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Singer, Florian; Yammine, Sophie; Proietti, Elena; Kieninger, Elisabeth; Casaulta Aebischer, Carmen; Regamey, Nicolas and Latzin, Philipp

Subjects:

600 Technology > 610 Medicine & health

ISSN:

8755-6863

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

André Schaller

Date Deposited:

10 Apr 2014 11:40

Last Modified:

01 Nov 2016 13:26

Publisher DOI:

10.1002/ppul.22841

PubMed ID:

23853006

Uncontrolled Keywords:

cystic fibrosis, inert gases, lung function tests, respiratory physiology

BORIS DOI:

10.7892/boris.44133

URI:

https://boris.unibe.ch/id/eprint/44133

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