Mechanically ventilated premature babies have sex differences in specific elastance: A pilot study

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dc.contributor.authorKim KT
dc.contributor.authorKnopp J
dc.contributor.authorDixon B
dc.contributor.authorChase, Geoff
dc.date.accessioned2020-02-23T21:02:56Z
dc.date.available2020-02-23T21:02:56Z
dc.date.issued2020en
dc.date.updated2020-01-24T04:13:39Z
dc.description.abstract© 2019 Wiley Periodicals, Inc. Objectives: A pilot study to compare pulmonary mechanics in a neonatal intensive care unit (NICU) cohort, specifically, comparing lung elastance between male and female infants in the NICU. Hypothesis: Anecdotally, male infants are harder to ventilate than females. We hypothesize that males have higher model-based elastance (converse: lower specific compliance) compared to females, reflecting underlying stiffer lungs. Study Design: A clinically validated, single-compartment model is used to identify specific elastance (inverse of specific compliance) and resistance for each breath. Specific elastance accounts for weight differences when comparing male and female infants. Relative percent breath-to-breath variability (%ΔE) in specific elastance is also compared. Level of asynchrony was also determined. Patient-subject Selection: Ten invasively mechanically ventilated patients from Christchurch Women's Hospital. Methodology: Airway pressure and flow data from 10 invasive mechanical ventilation (MV) infants from Christchurch Women's Hospital Neonatal Intensive Care Unit, New Zealand was prospectively recorded under standard MV care. Model-based specific elastance and resistance are identified for each breath, as well as relative percent breath-to-breath variability (%ΔE) in specific elastance. Results: Male infants overall had higher specific elastance compared to females infants (P ≤.01), with median (interquartile range) for males of 1.91 (1.33-2.48) cmH2O·kg/mL compared to 1.31 (0.86-2.02) cmH2O·kg/mL in females. Male infants had lower variability with %ΔE of −0.03 (−7.56 to 8.01)% vs female infants of −0.59 (12.56-12.86)%. Males had 14.75% asynchronous breaths whereas females had 17.54%. Conclusion: Overall, males had higher specific elastance and correspondingly lower breath-to-breath variability. These results indicate male and female infants may require different MV settings, mode, and monitoring.en
dc.description.abstractAbstract Objectives: A pilot study to compare pulmonary mechanics in a NICU cohort, specifically, comparing lung elastance between male and female infants in the neonatal ICU (NICU). Hypothesis: Anecdotally, male infants are harder to ventilate than females. We hypothesise that males have higher model-based elastance (converse: lower specific compliance) compared to females, reflecting underlying stiffer lungs. Study design: A clinically validated, single compartment model is used to identify specific elastance (inverse of specific compliance) and resistance for each breath. Specific elastance accounts for weight differences when comparing male and female infants. Relative percent breath-to-breath variability (%ΔE) in specific elastance is also compared. Level of asynchrony was determined. Patient-subject selection: 10 invasively mechanically ventilated patients from Christchurch Women’s Hospital. Methodology: Airway pressure and flow data from 10 invasive MV infants from Christchurch Women’s Hospital Neonatal Intensive Care Unit, New Zealand was prospectively recorded under standard MV care. Model-based specific elastance and resistance are identified for each breath, as well as relative percent breath-to-breath variability (%ΔE) in specific elastance. Results: Male infants overall had higher specific elastance compared to females infants (p ≤ 0.01), with median [interquartile range (IQR)] for males of 1.91[1.33-2.48]cmH2O.kg/ml compared to 1.31[0.86-2.02]cmH2O.kg/ml in females. Male infants had lower variability with %ΔE of -0.03[-7.56 – 8.01]% versus female infants of -0.59[12.56 – 12.86]%. Males had 14.75% asynchronous breaths whereas females had 17.54%. Conclusion: Overall, males had higher specific elastance and correspondingly lower breathto-breath variability. These results indicate male and female infants may require different MV settings, modes and monitoringen
dc.identifier.citationKim KT, Knopp J, Dixon B, Chase JG (2020). Mechanically ventilated premature babies have sex differences in specific elastance: A pilot study. Pediatric Pulmonology. 55(1). 177-184.en
dc.identifier.doihttps://doi.org/10.1002/ppul.24538
dc.identifier.issn8755-6863
dc.identifier.issn1099-0496
dc.identifier.urihttp://hdl.handle.net/10092/18454
dc.languageEnglish
dc.language.isoen
dc.publisherWileyen
dc.subjectbiological modelen
dc.subjectfemaleen
dc.subjectmaleen
dc.subjectNICUen
dc.subjectpremature infanten
dc.subjectrespiratory mechanicsen
dc.subjectsex characteristicsen
dc.subject.anzsrcField of Research::11 - Medical and Health Sciences::1114 - Paediatrics and Reproductive Medicine::111403 - Paediatricsen
dc.subject.anzsrcFields of Research::32 - Biomedical and clinical sciences::3215 - Reproductive medicine::321501 - Foetal development and medicineen
dc.subject.anzsrcFields of Research::40 - Engineering::4003 - Biomedical engineering::400308 - Medical devicesen
dc.titleMechanically ventilated premature babies have sex differences in specific elastance: A pilot studyen
dc.typeJournal Articleen
uc.collegeFaculty of Engineering
uc.departmentMechanical Engineering
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