Advances in mechanical ventilation and pulmonary research for the enhancement of preterm and premature infant respiratory assistance

2017-02-15T23:39:47Z (GMT) by Silverii, Adam Phillip
Chronic lung disease in premature and preterm infancy occurs due to the physiology of the underdeveloped pulmonary system. Therefore it is generally accepted that preterm and premature infants need significant respiratory support and a lung-protective strategy, starting from the delivery room where an inadequate respiratory approach may result in a poor outcome. However, there has been evidence to show that mechanical ventilation may aggravate or even cause lung disease if it is not expertly applied. Pulmonary research is continually unearthing new methodologies and concepts in regard to how mechanical ventilation can be optimally provided for infants that require mechanical ventilation after birth. Our understanding of lung physiology under normal and pathological conditions is constructed from classic studies in dogs and sheep, as well as many that use rabbits and mice as the subject for their research. The reasons for the use of animal subjects are numerous and advantageous for lung research, primarily that the pace of human studies is slow, the majority of human tissues are not routinely accessible for research purposes and there is a very limited opportunity for clinical trials. By contrast, animals (especially rodents) can be bred and studied in shorter time periods and clinical trials for these animals are relatively straightforward. The work in this Masters thesis has developed advances in mechanical ventilation and pulmonary research for the enhancement of preterm and premature human infant respiratory assistance. This was undertaken through the completion of multiple, interrelated areas within this field of research. Principally, the design of an original flow resistance system that increases the level of functionality in current ventilators was completed. This device has provided new data regarding both the impact of mechanical ventilation on the newborn lung and the potential of mechanical ventilation to improve the capabilities of preterm infant respiratory assistance. Preliminary phase contrast X-ray lung imaging captured new information regarding lung mechanics. This information may redefine our understanding of human lung physiology. In addition, a flow sensor for pulmonary research has been designed, developed and implemented and a carbon dioxide sensor has been modified for pulmonary research and implemented into this system. These devices enrich the scope for data collection and broaden the capabilities of pulmonary research. Finally, mechanical ventilation software has been redesigned to improve the proficiency and efficiency of mechanical ventilation. Thus, this research makes a significant contribution to allow efficient and effective mechanical premature and preterm infant ventilation support.