STATIC RESPIRATORY COMPLIANCE IN THE NEWBORN .1. A CLINICAL AND PROGNOSTIC INDEX FOR MECHANICALLY VENTILATED INFANTS

Accurate measures of the severity of respiratory disease are important , both clinically and epidemiologically. The apparent prognostic value of static respiratory system compliance (Crs) on the first day and me an appropriate fractional inspired oxygen (FIO2) in the first 12 hours of life were compared in 48 infants who received mechanical ventilati on in a regional neonatal unit. Their median (range) gestation was 30 (25-41) weeks and they were representative of all 140 newborn infants born to residents of a geographically defined area who received mechan ical ventilation over a 30 month period. Using the best cut off value (less than or equal to 0.6 ml/cm H2O/m corrected for body length), sta tic Crs predicted hospital death with 98% accuracy, 80% sensitivity, a nd 100% specificity. Using the best cut off value (>0.60), mean FIO2 i n the first 12 hours predicted hospital death with 81% accuracy, 80% s ensitivity, and 81% specificity. Static Crs appeared to be a more accu rate measure of respiratory function and disease severity than mean FI O2, perhaps because static Crs is less dependent on ventilator managem ent than routine indices based on blood gases. Static Crs now merits w ider evaluation, both as an aid to routine clinical management and as a prognostic index in comparative studies.