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Twitch airway pressure elicited by magnetic phrenic nerve stimulation in anesthetized healthy children
Author(s) -
Rafferty Gerrard F.,
Mustfa Naveed,
Man William D.,
Sylvester Karl,
Fisher Antony,
Plaza Miguel,
Davenport Mark,
Blaney Sean,
Moxham John,
Greenough Anne
Publication year - 2005
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.20241
Subject(s) - medicine , anesthesia , phrenic nerve , diaphragm (acoustics) , contractility , airway , mechanical ventilation , ventilation (architecture) , diaphragmatic breathing , stimulation , respiratory system , cardiology , physics , alternative medicine , pathology , acoustics , loudspeaker , mechanical engineering , engineering
Children with diaphragm dysfunction may be unable to maintain adequate ventilation. Accurate diagnosis is important, but can only be achieved using an appropriate test and reference range. The aim of this study, therefore, was to measure diaphragm contractility and examine the influence of age and maturation, using magnetic phrenic nerve stimulation in healthy children. Anterolateral magnetic stimulation (MS) of the phrenic nerves was performed using a 43‐mm figure‐eight coil in 23 children (14 male; mean age, 7.8 years; range, 1.8–15.7) anesthetized for minor surgery with sevoflurane gas. The airway was maintained with a cuffed laryngeal mask airway (LMA) which was briefly occluded during MS. Diaphragm contractility was assessed by measuring the airway pressure (TwPaw) elicited by MS. TwPaw responses were obtained in all subjects, with mean (SD) TwPaw 18.2 (6.8) cm H 2 O bilateral, 7.3 (3.2) cm H 2 O left unilateral, and 8.6 (3.1) cm H 2 O right unilateral. Subgroup analysis was performed in 17 of the children who were prepubertal. Their mean (SD) TwPaw was 17.3 (6.8) cm H 2 O bilateral, 7.1 (3.7) cm H 2 O left unilateral, and 8.3 (3.3) right unilateral. The mean (SD) intrapatient coefficients of variation for bilateral and left and right unilateral TwPaw were 8.4% (5.2), 6.7% (3.5), and 11.7% (10.3), respectively. Bilateral and left and right unilateral TwPaw were significantly related to age ( P < 0.05). In healthy prepubertal children, diaphragm contractility is primarily influenced by age. Pediatr Pulmonol. 2005; 40:141–147. © 2005 Wiley‐Liss, Inc.