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Assessment of passive respiratory mechanics in infants: double versus single occlusion?

Portex Anaesthesia, Intensive Therapy and Respiratory Unit, Institute of Child Health, London, UK

CORRESPONDENCE: I. Goetz, Portex Anaesthesia, Intensive Therapy and Respiratory Unit, Institute of Child Health, 30 Guilford Street, London, UK. Fax: 44 207 8298634

Keywords: infant, respiratory function tests, respiratory mechanics

Received: September 8, 2000
Accepted April 23, 2000

The single breath or occlusion technique (SOT) is widely used to assess passive respiratory mechanics in infants, but depends on various underlying assumptions. Recently, it has been proposed that such measurements could be internally validated by performing two brief airway occlusions during the same expiration. The aim of this study was to evaluate the use of the double occlusion technique (DOT) using a new commercially available program (Jaeger MasterScreen BabyBody Erich Jaeger GmbH, Würzburg, Germany).

Paired measurements of respiratory system compliance (C_rs) and resistance (R_rs) using both SOT and DOT were obtained in 18 healthy sedated infants (age range 4–41 weeks, weight 2.7–9.9 kg).

There was close agreement between both methods of assessing C_rs in all infants, the mean within-subject difference (95% confidence interval (CI)) for DOT–SOT being –0.06 (–0.55–+0.42) mL·kPa^–1·kg^–1. By contrast, estimates of R_rs,_DO were on average 20% lower than those for R_rs,_SO, (mean within-subject difference (95% CI) being –0.67 (–1.04––0.31) kPa·L^–1·s; p<0.01).

The relatively lower values obtained for R_rs,_DO may reflect the higher mean lung volume at which it was calculated. Further work is required to investigate the clinical and epidemiological relevance of this new approach, and whether there are any advantages of using both techniques when assessing passive mechanics in infants.

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