Respiratory system compliance assessed by the multiple occlusion and weighted spirometer method in non-intubated healthy newborns

Abstract

In 28 healthy newborn infants (median age 3.5 days), we compared the weighted spirometer (WS) with the multiple occlusion (MO) method for measuring respiratory system compliance (Crs). The MO method was unsuccessful in 8 infants. On average the two methods gave comparable results for compliance (Crs,ws = 40.4 +/- 13.8 and Crs,MO = 45.2 +/- 10.4 mL.kPa-1) in the remaining 20 infants; however, within-individual differences were often considerable, so that the methods did not give interchangeable results. Individual pressure-volume curves almost always intercepted the volume axis below the functional residual capacity with the MO technique, compatible with dynamic elevation of end-expiratory lung volume (EEL) due to inspiratory muscle activity during expiration. A (small) negative volume intercept occurred in less than 50% of curves with the WS method; in these cases it probably reflects alinearity of the compliance curve, an alteration in laryngeal braking or in respiratory muscle control of EEL, or all of these. Both methods provide valuable means for the non-invasive determination of respiratory system compliance in newborn infants, the differences in Crs being small and of minimal physiological significance; however, for individual follow-up they should not be used interchangeably.