Bedside lung mechanics predict survival in hypoplastic lung disease

Abdul Haleem, Muhammad T. Zia, Ravi Mishra, Lance A. Parton, Gustavo Stringel, Edmund F. La Gamma

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Newer bedside pulmonary mechanics using conventional ventilators allow for continuous serial determinations of tidal volume (VT). We sought to determine whether the degree of pulmonary hypoplasia could be measured using bedside pulmonary graphics and whether survival could be predicted in potential extracorporeal membrane oxygenation (ECMO) candidates. Data on all neonates considered for or treated with ECMO at our center between April 2000 and March 2005 were collected. The maximal bedside VT was measured daily at the peak pressure where beaking began with a peak end expiratory pressure of 4 cm H2O. Twenty-two patients were reviewed: eight ECMO plus fourteen similar patients in whom the threshold for ECMO intervention was not achieved. Independent of need for ECMO, any patient with VT of < 3 mL/kg or < 0.2 mL/cm length died (n = 4). All other measures of lung capacity or blood gas assessments were less valuable than VT in predicting survival. We conclude that bedside VT can be easily measured and that values < 3 mL/kg or < 0.2 mL/cm length demarcate severe lung hypoplasia, which in our patient population was incompatible with survival. We speculate that bedside VT may assist in evaluating the utility of ECMO.

Original languageEnglish (US)
Pages (from-to)305-314
Number of pages10
JournalAmerican Journal of Perinatology
Volume28
Issue number4
DOIs
Publication statusPublished - Jan 1 2011
Externally publishedYes

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Keywords

  • CDH
  • ECMO
  • Hypoplasia
  • lung

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Haleem, A., Zia, M. T., Mishra, R., Parton, L. A., Stringel, G., & La Gamma, E. F. (2011). Bedside lung mechanics predict survival in hypoplastic lung disease. American Journal of Perinatology, 28(4), 305-314. https://doi.org/10.1055/s-0030-1268715