Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
PLoS One. 2023 Nov 22;18(11):e0294029. doi: 10.1371/journal.pone.0294029. eCollection 2023.
Sustained pharyngeal inflation (SPI) with pharyngeal oxygen flow and nasal closure (PhO2-NC) technique create positive inflation pressure in the airway. This study measured the peak inflation pressure (PIP) levels and image changes with SPI-assisted flexible bronchoscopy (SPI-FB) and compared the effects in the pharyngeal space and mid-tracheal lumen. This prospective study enrolled 20 participants aged 6 months to 3 years. Each participant underwent sequential SPI-FB of four different durations (0, 1s, 3s, and 5s) for three cycles. We used a 3.8 mm OD flexible bronchoscope to measure and analyze PIP levels, images, and lumen dimension scores. A total of 480 data were collected. The mean (SD) age and body weight were 12.0 (11.5) months and 7.8 (7.5) kg, respectively. The mean (IQR) PIPs were 4.2 (2.0), 18.5 (6.1), 30.6 (13.5), and 46.1 (25.0) cmH2O in the pharynx and 5.0 (1.6), 17.5 (6.5), 28.0 (12.3), 46.0 (28.5) cmH2O in the mid-trachea at SPI durations of 0, 1s, 3s, and 5s, respectively. The PIP levels had a positive correlation (p <0.001) with different SPI durations in both pharynx and trachea, and were nearly identical (p = 0.695, 0.787, and 0.725 at 1s, 3s, and 5s, respectively) at the same duration except the 0 s (p = 0.015). Lumen dimension scores also significantly increased with increasing SPI durations (p <0.05) in both locations. The identified lesions significantly increased as PIP levels increased (p <0.001). Conclusion: SPI-FB using PhO2-NC with durations up to 3s is safe and informative technique that provides controllable PIP, dilates airway lumens, and benefits lesion detection in the pharyngeal space and mid-tracheal lumen.
持续咽充气（SPI）联合咽氧流和鼻腔闭气（PhO2-NC）技术可在气道中产生正压充气。本研究通过 SPI 辅助软性支气管镜检查（SPI-FB）测量峰值充气压力（PIP）水平和图像变化，并比较咽腔和气管中段的效果。这项前瞻性研究纳入了 20 名 6 个月至 3 岁的参与者。每位参与者依次进行 4 种不同持续时间（0、1s、3s 和 5s）的 SPI-FB，共进行 3 个周期。我们使用 3.8mm OD 软性支气管镜测量和分析 PIP 水平、图像和管腔尺寸评分。共收集 480 组数据。参与者的平均（标准差）年龄和体重分别为 12.0（11.5）个月和 7.8（7.5）kg。SPI 持续时间为 0、1s、3s 和 5s 时，咽腔的平均（IQR）PIP 分别为 4.2（2.0）、18.5（6.1）、30.6（13.5）和 46.1（25.0）cmH2O，气管的平均（IQR）PIP 分别为 5.0（1.6）、17.5（6.5）、28.0（12.3）和 46.0（28.5）cmH2O。PIP 水平与咽和气管的不同 SPI 持续时间呈正相关（p<0.001），除持续时间为 0s 时（p=0.015）外，同一持续时间的 PIP 水平在 1s、3s 和 5s 时分别接近一致（p=0.695、0.787 和 0.725）。管腔尺寸评分也随着 SPI 持续时间的增加而显著增加（p<0.05）。随着 PIP 水平的升高，确定的病变显著增加（p<0.001）。结论：使用 PhO2-NC 的 SPI-FB 持续时间可达 3s，是一种安全且信息量丰富的技术，可提供可控的 PIP、扩张气道管腔，并有助于在咽腔和气管中段检测病变。
