Analysis of Neonatal Pulmonary Mechanics

Mechanical ventilation (MV) is widely used in the Neonatal Intensive Care Unit (NICU) for patients suffering from respiratory distress syndrome (RDS). MV treatment is difficult due to intra-patient and inter-patient differences in lung mechanics over time, highlighting the need for patient-specific methods. Model-based methods allow identification of patient-specific lung mechanics which can be used to guide care. The aim of this study is to determine if the single compartment lung model can be used with neonatal MV data to provide more insight into their lung mechanics. Neonatal patient data was collected from published literature, and results were compared to data obtained from previously conducted clinical trials in the adult ICU. The single compartment lung model was found to fit the data very well (model fit error range: 2.2 - 6.6%) giving patient-specific elastance and resistance values for each breath. Lung elastance was compared for adults and infants and it was found that infants have ~30x stiffer lungs than adults (elastance: 1 — 1.75 cmH2O/mL vs. 0.017 — 0.059 cmH2O/mL) for similar driving pressures. The ventilated neonatal lung has different lung mechanics to an adult's, suggesting that the lung of a neonate should not be treated as a small adult lung. Further work will validate these results using patient data collected from the NICU. Ultimately, this research will provide more knowledge into neonatal pulmonary mechanics and can be used as the first step towards optimised patient-specific care in the NICU.