PneumoCardioVascular Lab, Hospital Universitário Onofre Lopes, Natal, Rio Grande do Norte, Brazil.
Empresa Brasileira de Serviços Hospitalares and Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
Respir Care. 2020 Sep;65(9):1285-1294. doi: 10.4187/respcare.06908. Epub 2020 Apr 7.
We sought to evaluate the acute effects of different inspiratory loads using nasal and oral interfaces on the volumes of the chest wall and its compartments, breathing pattern, and respiratory muscle activation in children with mouth-breathing syndrome.
Children with mouth-breathing syndrome were randomized into 2 groups, one with an inspiratory load intensity 20% of maximum inspiratory pressure ( = 14), and the other with an inspiratory load intensity 40% of maximum inspiratory pressure ( = 15). The chest wall volumes and electromyography of sternocleidomastoid, rectus abdominis, scalene, and internal intercostal muscles were used to analyze respiration against the 2 load intensities and using 2 interfaces (ie, nasal and oral).
A total of 72 children with mouth-breathing syndrome were recruited, and 29 were evaluated in this study. The use of inspiratory load promoted improvement in the components of the breathing pattern: breathing frequency ( = .039), inspiratory time ( = .03), and total respiratory time ( = .043); and increases in tidal volume ( < .001), end-inspiratory volume ( < .001), and electrical activity of scalene muscles and sternocleidomastoid muscles ( < .001) when compared to quiet breathing. The load imposed via a nasal interface versus an oral interface provided an increase in tidal volume ( = .030), end-inspiratory volume ( = .02), and electrical activity of scalene muscles ( < .001) and sternocleidomastoid muscles ( = .02).
The use of acute inspiratory loads improved the breathing pattern and increased lung volume and electrical activity of inspiratory muscles. This work brings new perspective to the investigation of using nasal interfaces during the application of inspiratory loads. The nasal interface was more effective compared to the oral interface commonly used in clinical practice.
我们旨在评估经鼻和经口接口在患有口呼吸综合征的儿童中使用不同吸气负荷对胸廓容积及其各腔室、呼吸模式和呼吸肌激活的急性影响。
患有口呼吸综合征的儿童被随机分为 2 组，一组吸气负荷强度为最大吸气压力的 20%（=14），另一组为 40%（=15）。使用胸廓容积和胸锁乳突肌、腹直肌、斜角肌和肋间内肌的肌电图来分析在 2 种负荷强度和 2 种接口（即经鼻和经口）下的呼吸。
共招募了 72 例患有口呼吸综合征的儿童，其中 29 例在本研究中进行了评估。使用吸气负荷可改善呼吸模式的组成部分：呼吸频率（=0.039）、吸气时间（=0.03）和总呼吸时间（=0.043）；与安静呼吸相比，潮气量（<0.001）、吸气末容积（<0.001）以及斜角肌和胸锁乳突肌的电活动增加（<0.001）。与经口接口相比，经鼻接口提供了潮气量（=0.030）、吸气末容积（=0.02）以及斜角肌和胸锁乳突肌的电活动（<0.001）和胸锁乳突肌（=0.02）的增加。
使用急性吸气负荷可改善呼吸模式并增加肺容积和吸气肌的电活动。这项工作为在应用吸气负荷时使用经鼻接口的研究带来了新的视角。与临床实践中常用的经口接口相比，经鼻接口更有效。
