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Sustained pharyngeal inflation on upper airway effects in children—Flexible bronchoscopy measurement
Author(s) -
Soong WenJue,
Chen ChiehHo,
Lin ChienHeng,
Yang ChiaFeng,
Lee YuSheng,
Tsao PeiChen,
Sung YiHung,
Dhochak Nitin
Publication year - 2021
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.25608
Subject(s) - medicine , pharynx , larynx , lumen (anatomy) , airway , bronchoscopy , complication , nose , nuclear medicine , surgery , anesthesia
Objective Sustained pharyngeal inflation (SPI) with pharyngeal oxygen and nose‐closure (PhO 2 ‐NC) can create positive peak inflation pressure (PIP) inside the pharyngolaryngeal space (PLS). This study measured and compared the effects of four different SPI durations in the PLS. Methods A prospective study, 20 consecutive children aged between 6 months and 3 years old, scheduled for elective flexible bronchoscopy (FB) suspected positive PLS findings were enrolled. SPI was performed twice in four different durations (0, 1, 3, and 5 s) sequentially in each infant. PIP was measured for each SPI in the pharynx, while simultaneously record images at two locations of the oropharynx and supra‐larynx. Patient demographic details, PIP levels, lumen expansion scores, and images of PLS were measured and analyzed. Results Twenty patients with 40 measurements were collected. The mean ( SD ) age and weight were 11.6 (9.1) months and 6.8 (2.4) kg, respectively. The measured mean ( SD ) pharyngeal PIPs were 4.1 (3.3), 21.9 (7.0), 42.2 (12.3), and 65.5 (18.5) cmH 2 O at SPI duration of 0, 1, 3, and 5 s, respectively, indicating significant ( p <.001) positive correlation. At assigned locations, corresponding PLS images also displayed a significant increase in lumen expansion scores and a number of detected lesions with an increase in SPI duration ( p < .004). The mean ( SD ) procedural time was 5.7 (1.2) min. No study‐related complication was noted. Conclusions FB utilizing PhO 2 ‐NC as SPI of 1–3 s is a simple, less invasive, and valuable ventilation modality. It provides an adequate PIP level to expand the PLS and improve FB performance in children.