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 (SpO2) 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; SpO2, HR (heart rate), FiO2 (fraction of inhale oxygen) and PIP (peak inspiratory pressure) have been simultaneously acquired. Results show that, in average, max SpO2 values are obtained with a PEEP value of 8 mmH2O. 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.