Leak measurements in spontaneously breathing premature newborns by using the flow-through technique

A new method for measuring and correcting airleaks during lung-function testing in infants has been validated invitro and in vivo by using a flow-through system that measured theinflow and outflow of a face mask. An adjustable leak was quantified byusing suction flow to validate the accuracy of leak measurements. Tovalidate the leak correction, the volume of a pump was measured withdifferent air leaks (0-30%). The method developed was tested in67 infants breathing spontaneously. There was good agreement betweenmeasured and simulated leaks (r = 0.998, P < 0.001; 95% limits ofagreement were 0.3 and 0.1%, respectively). The volume wasgenerally underestimated because of leaks, and the volume error was upto 94% compared with the maximum error of 5% after leak correction.With continuous leak measurements in vivo, there were <4% actualleaks (median 2.6%), and we did not observe any leaks in >7% ofcases. The leak correction improved the accuracy of ventilatorymeasurements. The monitoring of leaks is helpful for airtight placementof the face mask and for prevention of serious measurement errorscaused by leaks.