Division of Pediatric Pulmonology, Children's Hospital, China Medical University, Taichung, Taiwan.
Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan.
Pediatr Pulmonol. 2021 Oct;56(10):3293-3300. doi: 10.1002/ppul.25608. Epub 2021 Aug 18.
Sustained pharyngeal inflation (SPI) with pharyngeal oxygen and nose-closure (PhO -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.
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.
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 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.
FB utilizing PhO -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.
咽充气（SPI）联合咽氧和鼻闭（PhO-NC）可以在咽喉腔（PLS）内产生正峰充气压力（PIP）。本研究测量并比较了 PLS 内四种不同 SPI 持续时间的效果。
这是一项前瞻性研究，纳入了 20 名年龄在 6 个月至 3 岁之间、拟行择期软性支气管镜（FB）检查且有 PLS 阳性发现可疑的连续患儿。在每个婴儿中，依次进行四种不同持续时间（0、1、3 和 5 秒）的 SPI 两次。为每个 SPI 测量咽部的 PIP，同时在口咽和上咽的两个位置记录图像。测量并分析患者的人口统计学资料、PIP 水平、管腔扩张评分和 PLS 图像。
共收集了 20 名患儿的 40 次测量结果。平均（SD）年龄和体重分别为 11.6（9.1）个月和 6.8（2.4）kg。测量的咽部 PIP 均值（SD）分别为 SPI 持续时间为 0、1、3 和 5 秒时的 4.1（3.3）、21.9（7.0）、42.2（12.3）和 65.5（18.5）cmH2O，差异具有统计学意义（p<0.001）。在指定的位置，相应的 PLS 图像也显示出管腔扩张评分的显著增加，并且随着 SPI 持续时间的增加，检测到的病变数量也增加（p<.004）。平均（SD）操作时间为 5.7（1.2）min。未观察到与研究相关的并发症。
FB 采用 PhO-NC 作为 1-3 秒的 SPI 是一种简单、微创、有价值的通气方式。它提供了足够的 PIP 水平来扩张 PLS，并提高了儿童 FB 的性能。
