Static respiratory compliance in the newborn. II: Its potential for improving the selection of infants for early surfactant treatment.

Static respiratory system compliance (Crs) and lecithin/sphingomyelin (L/S) ratios in tracheal aspirates were estimated in two independent groups of mechanically ventilated infants. Crs was measured rapidly at the cotside using a passive expiratory flow technique and L/S ratios were estimated in the laboratory by high performance liquid chromatography. In the reference group of 22 infants, Crs < 1.8 ml/cm H2O/m predicted surfactant deficiency with a positive predictive value of 100% and a negative predictive value of 92%. In the validation group of 23 infants, Crs < 1.8 ml/cm H2O/m predicted surfactant deficiency with a positive predictive value of 94% and a negative predictive value of 83%. Measurement of static Crs is a rapid, non-invasive technique which may usefully supplement current methods of selecting infants at high risk of respiratory distress syndrome.