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il- "MY SUSPICION IS THAT ‘
  WE OVERUSE VENTILATORS I
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I l AND THAT SOME, IF NOT ALL,  I
  V
It  
z I I OF THE CHRONIC LUNG  ; t
;·    I t
t I ‘ t
I t , , DISEASE OF INFANCY IS - _ · . z
II I inS[mm€maUOn for measuring lung oflife hthe most unique aspect of their  I I andic
I mechanics on an infant for the first msearc · _ _ ` I again
I time The instruments measure airflow         Developing the Instruments was ‘   diflcr
'1 · ’ . — .
fl transpulmonary pressure, intrathoracic SERVOCONTROL VENTI TORS Ciiinil-il} Th€1;`f>$€3T€h€}1;S };{1T<;i3€€?ed   I this n
I and airway pressures, and tidal volume ' S OVY Y In VYOY mg Out I C 1 cu UCS` · I ` have
  (volume of each breath respired). This msnng 20 Infants by 1983- Tnc nrsl  I t m01`€
{I mtormrttm meats two important THE TREATMENT WOULD ¤¤Str¤m$>¤t was unwieldy and time- I Du
II mechanical properties of the newborn Consnmmg SO> In 19847 the team began * devclt
  lung; compliance and resistance. Lung BE SAFER _ , _" budding 3 Second Cnc- MOYC Compaq  I I slioult
tl compliance refers to how inflatable the ‘  · ~ time 2
I · • I | Q I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I | y I _
I lungs are and how easily, by elastic 0ng01
  recoil, they return to a deflated state;       ` I    . j distur
7 resistance reflects the narrowness 0f the _   `   ~  I   II   __L_ g pttlmt
_ _ _ »·,» I   2-  V       ,_,_    I .     · ~ ‘``·    $£$°··=;eZ;i’*-f"- s `. * i
II the neonatologtst can now begin t0   -3  _  ·  _ -    ,2-::.: -; ‘‘__     ; .sI I j·3   ; · Tm? F
· . ·   · ·  ‘ · ···»   ”`  r     "   .»  i   Y  r¥‘r?= !¤» " ‘  2 `· `* ’ · `
Jl accurately set the mechanics Ol thc ¥;t§€$€—‘ .I,;j;;I__~ _ .,;—;=4 > , y"’       tér  . I  ·   r Ol V3]
" . · · V   . » .~      `        I·      li! ·.`i‘   t .t.‘ ';·‘ t  '
I I ~ ventilator to match the blophyslciil   “ »I_` V   `   ’=·‘‘   .I·’=· Q     ` · -§a5 !l I I HDCI Vt
I properties of the baby s lungs and . I               I r Thl
I support their respiratory needs more ‘ I   ·``’     .i_       `‘“· "   · induc
- » ..   ·’.· ‘*     x sie;   ti, .
“‘l"lY·           _ imprc
I           I ` 0l var
  . . . . . . . . . ..... . . . . . . . . . . _ ` I      I {umd
I      {       _` IQIEJI. al`_O b
II   I  __ _I   I_ _   I __.v I   _  ..
I .  '  ` .,  ».*"` _ ·» · * "  ‘ » ":,` • . _
  "THE TOLERANCES AND   -- - »       I I M   I .   1 min
‘) »  . »‘ “ * " ` . ..I.‘;:>-·."-»"r‘=t,r I bablc.
in CAPACITY OF THE LUNGS gg? ,~··¤   . ‘I
Ii III_ . I   _ ·‘ és?.   ,.,.,\ “‘   I telogi
  0t= mass INFANTS Q ”``i »"   r   I     I I    ? wp
l` 1  —.  - ..·-"“`   A I  II ..I. I..  r       I IIII . I . I    . mc}
I F H `       _j   "    _  s   gg; . mmui
l VARY GREATLY. ,   » tr     _I_I i      r Comp
I   I       I- I “`  i`ii I ’ J  » fj C °°
I • • • • • • • • • • • • • • • • • • • • • • • • I` ""     I . I WU "»_.>;)s2%;~;\§\} . x  \ I C  
{    ·.   Lv I ·   ':é§`v>`  I   »°’;»_v"  Zz }  i
{I   Sitnilar instruments are used and   ` -   I   · .:325; — ":   r- ;’I   ··»·   *  N   I   Q ul) di?
, . . t *<    in`- , 3I I - »_ t . ‘    . »» ` . `·      I., r   ,‘-  s t ·
  I researcli is underway at Columbia ». _ ~ __ I   f        “`  gnu
  University, the University of l\/Iiami, `A .»  il`     ‘;·`  I   __ _ .   `  i s       _ Lmkri
1 Indiana University, and the University ,_I*’; li _ “ -      "f— T ·     I-   ~ wml .1
I ol Pennsylvania Children`s Hospital. _.   { · `-\ i   ` _ ‘ .. ..,._   I _.       _   A mgmt
llowcver, the UK instrument is _ I       » `·   · ’   II.-   9*   ?_ SQNST
progratntned to record the mechanical   I     I . ¤       —ii_. Y    i   rm
` ventilator breaths, or the spontaneous     I ,.     ’ . C PL
1* — - s ."   t -.   `   instru
1 I breaths ol the infant separately and — —. F=* ·`‘·     Q   M   - \ 1 . h
4* . I _   3*:  . Eg. is V V
  provtde separate calculations for each I.   “    I {ICI
I Iireittli. Other instruments used in _ — i I   ’  Ca Cel
~I similar research do not make separate .     `    I WPUI
I <‘:ilculations tor each but average them   , _ _' I, "°€"*\t* '=   I — Ca Cu
{ together. thus oflering less precise data.  E; _ I     ·~r· i   I =  Q-f—li$i>”' i HM
4 lillv UK rcsearcliers stress that their I  `°" ` ?   ` I V€Ht1l2
  ‘
i I ltreatth—to·breatli assessnients·at the     — I the ch
§_   ltvtlsltle enables tlteni to monitor the   .  .- » I    » mcurr
is I lmlu tht ougliout the critical first week A NICU boby lies, protected in on incubator.   Alvin
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S.