Tidal Breathing Lung Function Test And Clinical Analysis Of Infants With RDS After Treatment

Fetal maturation is for the purpose that each organ or system is operated independently in the established and invitro environment, The maturity of the lung is the basis for the fetus to be able to breathe and to exchange the blood oxygen out of the maternal environment, is the fundamental survival, is the focus of the study of RDS neonatal. Tidal breathing lung function testing in recent years is the new technique for lung function of infants, this method is simple and has good repeatability, and tidal breathing test is more focused on parameter changes in physiological state, it will help us to provide objective clinical indicators for the development of lung and the maturity of the lungs. It will help us to provide objective clinical indicators for neonatal lung development and the maturity of the lungs. The respiratory system is basically adapted to the external environment in the 4 weeks after birth for full-term infants. Vital signs and pulmonary condition is stable. The premature infants also experienced the critical period of lung development at the age of 44 weeks. At this point the lung function test is relatively higher safety factor. To understand the lung function and to give reasonable intervention, which is helpful to improve the quality of life, improve exercise tolerance, reduce the incidence of respiratory diseases.Objective This paper is to study the lung function of the RDS infants with this new technology--the tidal breathing lung function.This study followed up the changes of pulmonary function in 107 infants with RDS after active treatment at corrected gestational age 44 weeks,which is in order to investigate the recovery of pulmonary function after treatment in infants with RDS, and to provide the data of pulmonary function for the prognosis of children with RDS.Materials and methods 1. Materials The study subjects were 194 infants who came to outpatient detection for tidle breathing lung function at 44 weeks of gestational age from the Third Affiliated Hospital of Zhengzhou University from February 2013 to July 2015, all infants are suitable for gestational age,107 cases of infants with RDS are diagnosed by the criteria of Practical of neonatology-- the medical history, clinical features and chest radiogram. Infants of non RDS are 87 cases. Screening 97 newborns with RDS whose X-ray appearances were in consonance with clinical manifestations, it can be divided into 2 groups according to the degree of RDS: mild RDS neonatal group( 76 cases), severe RDS neonatal group(21 cases).Infants with RDS were divided into 3 groups according to the gestational age at birth: early preterm infants with RDS group(< 34 weeks’ gestation,45 male infants and 20 female infants,) and late premature infants with RDS group(34-36+6 weeks’ gestation,12 males and 9 females),full-term infants with RDS group(37-41+6 weeks’ gestation,14 males and 7 females), the control group was 87 cases of non RDS of the same gestational age, early preterm infants with non RDS group(< 34 weeks’ gestation,25 male infants and 20 female infants,) and late premature infants with non RDS group(34-36+6 weeks’ gestation,14 males and 7 females), full-term infants with non RDS group(37-41+6 weeks’ gestation,13 males and 8 females);Infants with RDS were divided into 2 groups according to the degree of RDS: mild RDS group(male 46, female 30 cases), severe RDS group(male 15, female 6), control group for non RDS group(male 52 cases, female 35 cases)Exclusion criteria:⑴.Subjects have cough,wheezing,respiratory symptoms such as respiratory distress and so on when testing;⑵.The mother has a history of smoking;⑶.Parents and siblings have a family history of respiratory allergy such as atopic rhinitis or asthma;⑷.There are congenital diaphragmatic hernia,congenital heart disease,neuromuscular disease or thoracic wall deformities and so on that have an impack on lung function; ⑸.Respiratory system diseases affecting the lung function except for RDS: brochopulmonary dysplasia, pneumothorax, meconium aspiration syndrome, transient tachypnea of newborn and so on.This study was approved by the human body Test Committee of our hospital and the written informed consent of the patient’s family.2. MethodsThis study uses lung function tester of the German JAEGER company production.In order to avoid the effect of drugs on the respiratory, the use of 10% hydrate of chlorine aldehyde(0.3 ~ 0.5 ml / kg enema or oral) to make the children sleep in the supine position,In Non Rapid Eye Movement sleep phase, fasten your mouth and nose with a mask,the index finger and middle finger live on both sides of the nose, integrating the flow rate signal into the capacity by the flow rate sensor, the computer can automatically display the measured value. All of the patients were tested 3 times, each time 20 times record tidal breathing, by computer automatically calculates the average value. Measurable parameters are tidal volume/kg(VT/kg), respiratory rate(RR),time to peak tidal expiratory flow related to the expiratory time(TPTEF/TE),expiratory volume at peak tidal expiratory flow related to the expiratory volume(VPEF/VE).Results 1. Basic information and the difference of lung function parameters between the same gestational age between RDS and non RDS of newborn at the age of 44 weeks1.1. Basic information Six groups of subjects of sex, body height, body weight when testing had no significant difference.1.2. Comparison of lung function parameters 1.2.1. The lung function differences between the early preterm infants RDS group and non RDS group of the same gestational age:the early preterm infants RDS group in TPTEF/TE and VPEF/VE, the former value is lower than the latter, there were significant differences [(25.95±8.10%)VS(30.87±6.46%)、(25.87±7.53%)VS(28.84±5.59%),t/t ￠=3.394、2.250](P<0.05),the rest of the parameters of lung function had no significant difference.1.2.2. The lung function differences between the late preterm infants RDS group and non RDS group of the same gestational age:Compared with the late preterm infants with non RDS group, the late preterm infants with RDS group has a smaller TPTEF/TE and VPEF/VE, and there is significant difference [(26.24±10.09%)VS(33.52±6.33%)、(25.95±5.85%)VS(33.77±5.74%),t/t ￠=2.801、4.370](P<0.05),the rest of the parameters of lung function had no significant difference.1.2.3. The lung function differences between the full-term infants with RDS group and the full-term infants with non RDS group:Between the full-term infants with RDS group and the full-term infants with non RDS group, the former value is lower than the latter in TPTEF/TE and VPEF/VE, there were significant differences [(29.66±16.19%)VS(38.19±7.51%)、(30.32±5.64%)VS(34.34±5.71%),t/t ￠=2.190、2.295](P<0.05),the rest of the parameters of lung function had no significant difference.2. Differences in basic information and lung function parameters between different levels of RDS in newborn infants at the age of 44 weeks.2.1. Basic information Three groups were not statistically significant in sex, gestational age,height, weight when testing.2.2. Comparison of lung function parameters There were some differences between the three groups in TPTEF/TE and VPEF/VE[(34.19±7.66%)VS(29.59±10.14%)VS(25.12±8.19%),(32.32±6.20%)VS(30.16±6.84%)VS(26.79±6.34%),F/H=11.236,6.769](All P<0.05),and with the degree of RDS increased, the value was decreased. the rest of the parameters of lung function had no significant difference.Conclusion At corrected gestational age 44 weeks, the infants with RDS still have small airway obstruction, and the degree of obstruction is related to the severity of RDS.