Sustained pharyngeal inflation with oxygen tube effects on upper airway
pressure and lumen changes in infants---flexible bronchoscopy
measurement
Abstract
Sustained pharyngeal inflation (SPI) with pharyngeal oxygen and
nose-close (PhO2-NC) can create positive inflation pressure (PIP) inside
the pharyngolaryngeal space (PLS). This study measured and compared
effects of different SPI durations in the PLS. Method: A one-year
prospective study, 20 consequent infants whose age less than 3-year-old
and scheduled for elective FB were enrolled. SPI performed in four
different durations (0.0, 1.0, 3.0 and 5.0 seconds) consequently. Each
infant did two cycles of SPI. Measured the PIP of each SPI in the
pharynx, and simultaneously took images at three locations of
oropharynx, supra-larynx and larynx. Data of infant’s demographics, PIP
levels, space expansion scores and images were collected and analyzed.
Results: Total 20 studied infants, the mean (SD) age was 11.6 (9.1)
month-old, the mean (SD) body weight was 6. 8 (2.4) kg and the mean (SD)
study time was 3.8 (1.1) minutes. The measured mean (SD) pharyngeal PIPs
were 4.1 (3.3), 21.9 (7.0), 42.2 (12.3) and 65.5 (18.5) cmH2O at SPI
duration of 0.0, 1.0, 3.0 and 5.0 seconds, respectively. Which showed
positively and significantly (p<0.001) correlations. At these
assigned locations, the corresponding PLS images also show significant
lumen expansion correlated with the PIP. Especially, when there existed
pathologic or occult lesions. No any study related complication was
noted. Conclusions: SPI with PhO2-NC up to 5 seconds is a simple, safe
and feasible clinical ventilation modality. Which could provide enough
PIP to expand the PLS and benefit FB performance in infants.