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口呼吸综合征患儿使用不同吸气阻力装置时的呼吸模式和肌肉活动

Breathing pattern and muscle activity using different inspiratory resistance devices in children with mouth breathing syndrome.

作者信息

Medeiros da Fonsêca Jéssica Danielle, Aliverti Andrea, Benício Kadja, de Farias Sales Valéria Soraya, Fontes Silva da Cunha Lima Luciana, Resqueti Vanessa Regiane, de Freitas Fregonezi Guilherme Augusto

机构信息

PneumoCardioVascular Lab/HUOL, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares and Departamento de Fisioterapia Universidade Federal do Rio Grande do Norte, Natal, Brazil.

Laboratório de Inovação Tecnológica em Reabilitação, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Brazil.

出版信息

ERJ Open Res. 2022 May 9;8(2). doi: 10.1183/23120541.00480-2021. eCollection 2022 Apr.

Abstract

AIM

The aim of this study was to evaluate the acute effects of different inspiratory resistance devices and intensity of loads nasal airway on the breathing pattern and activity of respiratory muscles in children with mouth breathing syndrome (MBS).

METHODS

Children with MBS were randomised into two groups based on inspiratory load intensity (20% and 40% of the maximal inspiratory pressure). These subjects were assessed during quiet breathing, breathing against inspiratory load nasal airway and recovery. The measurements were repeated using two different devices (pressure threshold and flow resistance). Chest wall volumes and respiratory muscle activity were evaluated by optoelectronic plethysmography and surface electromyography, respectively.

RESULTS

During the application of inspiratory load, there was a significant reduction in respiratory rate (p<0.04) and an increase in inspiratory time (p<0.02), total time of respiratory cycle (p<0.02), minute ventilation (p<0.03), tidal volume (p<0.01) and scalene and sternocleidomastoid muscles activity (root mean square values, p<0.01) when compared to quiet spontaneous breathing and recovery, regardless of load level or device applied. The application of inspiratory load using the flow resistance device showed an increase in the tidal volume (p<0.02) and end-inspiratory volume (p<0.02).

CONCLUSION

For both devices, the addition of inspiratory loads using a nasal interface had a positive effect on the breathing pattern. However, the flow resistance device was more effective in generating volume and, therefore, has advantages compared to pressure threshold.

摘要

目的

本研究旨在评估不同吸气阻力装置及负荷强度对口呼吸综合征(MBS)患儿鼻气道呼吸模式及呼吸肌活动的急性影响。

方法

根据吸气负荷强度(最大吸气压力的20%和40%)将MBS患儿随机分为两组。在安静呼吸、通过鼻气道对抗吸气负荷呼吸及恢复过程中对这些受试者进行评估。使用两种不同装置(压力阈值装置和流阻装置)重复测量。分别通过光电体积描记法和表面肌电图评估胸壁容积和呼吸肌活动。

结果

与安静自主呼吸及恢复过程相比,在施加吸气负荷期间,无论负荷水平或使用的装置如何,呼吸频率均显著降低(p<0.04),吸气时间、呼吸周期总时间(p<0.02)、分钟通气量(p<0.03)、潮气量(p<0.01)以及斜角肌和胸锁乳突肌活动(均方根值,p<0.01)均增加。使用流阻装置施加吸气负荷时,潮气量(p<0.02)和吸气末容积增加(p<0.02)。

结论

对于两种装置,通过鼻接口增加吸气负荷对呼吸模式均有积极影响。然而,流阻装置在增加容积方面更有效,因此与压力阈值装置相比具有优势。

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