A novel measurement technique for the assessment of best positive end-expiratory pressure in newborn patient

More than 10 million of infants born prematurely each year in the word. In case of a preterm delivery, there is a dramatic physiological transition from fetal to neonatal life often associated to some infant insufficiencies and/or pathologies. Respiratory diseases, such as distress syndrome and bronchopulmonary dysplasia, are common reasons for admission to a neonatal unit. In order to replace spontaneous breathing and to restore a physiologic gas exchanges, mechanical ventilation (MV) is very often required also in order to evaluate the degree of the insufficiency and/or of the diseases. To control the MV parameters, and the positive end-respiratory pressure, pulse oximetry is the leading instrumentation allowing the measurement of the saturation of the oxygen (SpO 2 ) molecules linked to the hemoglobin in the infant blood. The aim of this paper is to present a novel approach for the assessment of the best positive end-expiratory pressure (PEEP) values using pulse oximetry. Tests have been conducted on a small cohort of 5 infants. Subjects have been monitored using a Computer Aided Work for a period of 4 hours; SpO 2 , HR (heart rate), FiO 2 (fraction of inhale oxygen) and PIP (peak inspiratory pressure) have been simultaneously acquired. Results show that, in average, max SpO 2 values are obtained with a PEEP value of 8 mmH 2 O. Even if the number of subjects used in this study is limited to derive final conclusions, the prospective are extremely interesting in terms of optimal patient treatments.