Background: Describing the association of the peak inflation pressure (PIP) with end-tidal carbon dioxide (ETCO) is a prerequisite for the development of closed loop ventilation in neonatal intensive care. We aimed to develop an in-vitro system to study this relationship.
Methods: A ventilator was connected to a test lung, supplied with a stable CO concentration from a cylinder. The PIP was altered and the change in ETCO per unit of PIP was calculated in three models mimicking respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD) and viral bronchiolitis.
Results: The median (IQR) change in ETCO per unit of PIP was 0.23(0.13-0.38) kPa/cmHO, using 138 paired measurements of PIP and ETCO. The median (IQR) change in ETCO per unit of PIP, was higher when starting at an ETCO > 6 kPa [0.43(0.33-0.58) kPa/cmHO] compared to starting at an ETCO < 6 kPa [0.14(0.08-0.20) kPa/cmHO, p < 0.001]. The median (IQR) change in ETCO per unit of PIP, was larger in the model of RDS [0.33(0.13-0.51) kPa/cmHO] compared to the BPD [0.23(0.13-0.33) kPa/cmHO, p = 0.043] and the bronchiolitis models [0.15(0.10-0.31) kPa/cmHO, p = 0.017].
Conclusions: The change in ETCO in response to increasing PIP was larger for higher ETCO values and in a model simulating neonatal RDS, compared to BPD and bronchiolitis.
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| http://dx.doi.org/10.1016/j.medengphy.2023.104052 | DOI Listing |
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