Measurement of lung volume and ventilation distribution with an ultrasonic flow meter in healthy infants

Small airway disease in infants is characterised by abnormal lung volume and uneven ventilation distribution. An inert tracer gas washin/washout technique using a pulsed ultrasonic flow meter is presented to measure functional residual capacity (FRC) and ventilation distribution in spontaneously breathing and unsedated infants. With a pulsed ultrasound sent through the main stream of the flow meter, flow, volume and MM of the breathing gas can be calculated. Sulphur hexafluoride was used as a tracer gas. In a mechanical lung model (volume range 53–188 mL) and in 12 healthy infants (aged 38.3±9.2 days; mean±sd) accuracy and reproducibility of the technique was assessed. Indices of ventilation distribution such as alveolar-based mean dilution number (AMDN) and pulmonary clearance delay (PCD) were calculated. Mean error of volume measurement in the lung model was 0.58% (coefficient of variance (CV) 1.3%). FRC was in the low predicted range for normal infants (18.0±2.0 mL·kg−1) and highly reproducible (5.5±1.7% intra-subject CV). AMDN was 1.63±0.15 and PCD was 52.9±11.1%. Measurement of functional residual capacity and ventilation distribution using a sulphur hexafluoride washin/washout and an ultrasonic flow meter proved to be highly accurate and reproducible in a lung model and in healthy, spontaneously breathing and unsedated infants. This study was supported by the Swiss National Foundation (SCORE 32-51974.97), Australian National Health and Medical Research Council, Swiss CF Foundation, AstraZeneca (Switzerland)