Developmental Pattern of Maximal Transdiaphragmatic Pressure in Infants during Crying

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Abstract
Summary: Diaphragm strength was measured as maximal transdiaphragmatic pressure (Pdi) during airway occlusion in 38 infants aged 11.6 ± 0.5 (S.E.) months postconception (mpc), range 8–21 mpc. All infants were asymptomatic at the time of study and required no mechanical ventilatory assistance. Ten infants had previous surgical correction of abdominal wall defects (gastroschisis/omphalocele); 10 infants had previous surgical correction of congenital diaphragmatic hernia; and 18 infants had no thoracic or abdominal surgery. The mean maximal Pdi for all infants was 72 ± 3 cmH2O. There were no significant differences between the three groups. All infants with a maximal Pdi of less than 60 cmH2O were aged less than 10 mpc. After 13 mpc there was no significant increase in maximal Pdi. Between the ages 8–13 mpc there was a significant positive correlation between maximal Pdi and age postconception (r = 0.87, P < 0.0005), reflecting a developmental pattern of increasing maximal transdiaphragmatic pressure in infants during crying.

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