{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T01:59:38Z","timestamp":1774663178371,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2005,10,21]],"date-time":"2005-10-21T00:00:00Z","timestamp":1129852800000},"content-version":"vor","delay-in-days":3703,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[1995,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Newborn infants with intractable respiratory failure who require extracorporeal membrane oxygenation (ECMO) experience diffuse pulmonary atelectasis shortly after initiation of ECMO. Atelectasis is likely due to the primary lung injury and the reduction of applied inspiratory ventilator pressure when the respirator settings are changed to the \u201crest settings.\u201d These pathophysiologic changes result in a decrease in lung compliance and lung volumes. We hypothesized that improving lung functions observed during ECMO and indicated by an increase in lung volumes will predict successful weaning from ECMO. Sixteen infants (mean SEM: gestational age, 40.3 \u00b1 0.3 weeks; birth weight, 3.5 \u00b1 0.1 kg) with meconium aspiration syndrome (n = 13), sepsis (n = 2), and persistent pulmonary hypertension (n = 1) were studied. We measured passive respiratory system mechanics and lung volumes initially during full ECMO support (115 \u00b1 18 h on ECMO, Study I), and then within 24 h prior to weaning from ECMO (Study 11). Respiratory system compliance (C<jats:sub>rs<\/jats:sub>), respiratory system resistance (Rrs), functional residual capacity (FRC), and tidal volume (V<jats:sub>T<\/jats:sub>) were measured. Prior to Study I lung volumes were too small to be detected. C, increased between Study I and Study II (0.41\u00b10.05 to 0.63\u00b10.05 mL\/cmH<jats:sub>2<\/jats:sub>O\/kg, <jats:italic>P<\/jats:italic> &lt; 0.05), and V<jats:sub>T<\/jats:sub>, increased between Study I and Study II (5.6 \u00b1 0.6 to 10.4 \u00b1 0.8mL\/kg, <jats:italic>P<\/jats:italic> = 0.0005). FRC increased from 3.6 \u00b1 1.0 to 7.9 \u00b1 0.9mL\/kg(<jats:italic>P<\/jats:italic> = 0.0001). There was no change in R<jats:sub>rs<\/jats:sub> (88\u00b18 to 89 \u00b1 6 cm H<jats:sub>2<\/jats:sub>O\/Us, <jats:italic>P<\/jats:italic> = 0.9). The combination of C<jats:sub>rs<\/jats:sub> &gt; 0.5 mL\/cmH<jats:sub>2<\/jats:sub>O\/kg and FRC &gt; 5 mL\/kg was a better predictor (<jats:italic>P<\/jats:italic> = 0.0002) of readiness to wean from ECMO than either C (&gt;0.5 mL\/cmH<jats:sub>2<\/jats:sub>O\/kg, <jats:italic>P<\/jats:italic> = 0.057) or FRC (&gt;5 mL\/kg, <jats:italic>P<\/jats:italic> = 0.007) alone. The combination of FRC and C<jats:sub>rs<\/jats:sub> had a sensitivity of 73.3% and specificity of 100% for successful decannulation. We conclude that repeated measurements of FRC and C<jats:sub>rs<\/jats:sub> can assess lung recovery and may assist in establishing criteria for successful weaning from ECMO. <jats:bold>Pediatr Pulmonol. 1995; 20:145\u2013151<\/jats:bold>. \u00a9 1995 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ppul.1950200304","type":"journal-article","created":{"date-parts":[[2007,3,6]],"date-time":"2007-03-06T21:11:51Z","timestamp":1173215511000},"page":"145-151","source":"Crossref","is-referenced-by-count":16,"title":["Measurement of lung volumes and pulmonary mechanics during weaning of newborn infants with intractable respiratory failure from extracorporeal membrane oxygenation"],"prefix":"10.1002","volume":"20","author":[{"given":"Amir","family":"Kugelman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Saiki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnold C. 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J Clin Invest.1973;52:39\u2013565.","DOI":"10.1172\/JCI107216"},{"key":"e_1_2_1_18_2","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/S0022-5223(19)36088-X","article-title":"Inhibition of pulmonary surfactant by plasma from normal adults and from patients having cardiopulmonary bypass","volume":"91","author":"Phang PT","year":"1986","journal-title":"J Thorac Cardiovasc Surg."},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI115523"},{"key":"e_1_2_1_20_2","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1152\/jappl.1985.58.2.326","article-title":"Alteration of surfactant function due to protein leakage: Special interaction with fibrin monomer","volume":"58","author":"Seeger W","year":"1985","journal-title":"J Appl Physiol."},{"key":"e_1_2_1_21_2","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1051\/ject\/198820120","article-title":"Complement activation during long\u2010term extracorporeal membrane oxygenation in neonates","volume":"20","author":"Darling EM","year":"1988","journal-title":"J Extra\u2010Corporeal Tech."},{"key":"e_1_2_1_22_2","first-page":"210","article-title":"Complement depletion prevents pulmonary hypertension and leukopenia in sheep extracorporeal membrane oxygenation","volume":"29","author":"Wonders T","year":"1983","journal-title":"Trans Am SOC Artif Intern Organs."},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.161.2.3763898"},{"key":"e_1_2_1_24_2","first-page":"74","article-title":"Early prediction of ultimate outcome in infants with severe respiratory failure","volume":"118","author":"Ortega M","year":"1988","journal-title":"J Pediatr."},{"key":"e_1_2_1_25_2","first-page":"425","article-title":"Extracorporeal membrane oxygenation for newborn respiratory failure: 45 cases","volume":"92","author":"Bartlett RH","year":"1982","journal-title":"Surgery."},{"key":"e_1_2_1_26_2","first-page":"552","article-title":"Passive respiratory mechanics in newborns and children","volume":"129","author":"LeSouef PN","year":"1984","journal-title":"Am Rev Respir Dis."},{"key":"e_1_2_1_27_2","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1152\/jappl.1982.52.5.1209","article-title":"Dynamics of breathing in infants","volume":"52","author":"Mortola JP","year":"1982","journal-title":"J Appl Physiol"},{"key":"e_1_2_1_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950050410"},{"key":"e_1_2_1_29_2","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-198511000-00010"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fppul.1950200304","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.1950200304","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T02:39:43Z","timestamp":1698374383000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.1950200304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,9]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1995,9]]}},"alternative-id":["10.1002\/ppul.1950200304"],"URL":"https:\/\/doi.org\/10.1002\/ppul.1950200304","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,9]]}}}