Pulmonary physiology preterm infants, heterogenous preterm lung diseases Normal air distribution in the preterm lung, inhomogenous lung disease in preterm infants
Conditions
Interventions
None
Sponsors
Amsterdam UMC
Eligibility
Inclusion criteria
Inclusion criteria: Cohort A - normative valuesGestational age at birth 24–32 weeksPostnatal age between 3 and 28 daysPostmenstrual age > 25 weeksReceiving non-invasive respiratory support (nCPAP = 6 cmH2O or HFNC = 6 L/min, FiO2 = 0.3)Clinically stable at the time of measurementWritten informed consent from both parents or legal guardiansCohort B - intubation and lung recruitmentGestational age at birth 24–32 weeksPostmenstrual age > 25 weeksPostnatal age > 72 hoursIndication for intubation and mechanical ventilation with HFOV (e.g. sepsis, necrotizing enterocolitis, BPD, post-surgery)Written informed consent from both parents or legal guardians
Exclusion criteria
Exclusion criteria: Presence of congenital anomalies affecting the respiratory system (e.g. congenital diaphragmatic hernia, pulmonary hypoplasia).Severe congenital heart disease.Skin lesions or conditions preventing safe placement of the EIT belt.Lack of parental or guardian consent.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Cohort A: Distribution of spontaneous tidal ventilation (ventral–dorsal, left–right distribution), center of ventilation (CoV), proportion and regional distribution of silent spaces, regional end-expiratory lung impedance (EELI) distribution, global inhomogeneity (GI) index, and aeration homogeneity ratio (AHR) in stable preterm infants on non-invasive respiratory support. These parameters will be used to describe the normative (regional) ventilation distribution, (regional) aeration distribution and homogeneity in stable preterm infants.Cohort B: Regional changes in end-expiratory lung volume (EELV), ventilation distribution, silent spaces, impedance–pressure relationships and time constants during intubation and lung recruitment under HFOV. | — |
Secondary
| Measure | Time frame |
|---|---|
| Distribution of the EIT variables across subgroups of data, divided based on gestational age and/or level of respiratory support (cohort A). Correlation of EIT-derived measures with conventional monitoring (heart rate, SpO2, respiratory rate, transcutaneous blood gases, ventilator settings).Effect of standardized clinical events (e.g. repositioning, daily care, apnoea) on ventilation distribution.Early detection of malposition of the endotracheal tube using EIT (cohort B). | — |
Countries
Netherlands
Contacts
Public ContactR.W. van Leuteren
Amsterdam UMC
Outcome results
None listed