Sustained pharyngeal inflation on upper airway effects in
infants---flexible bronchoscopy measurement
Abstract
OBJECTIVE: Sustained pharyngeal inflation (SPI) with pharyngeal oxygen
and nose-close (PhO2-NC) can create positive peak inflation pressure
(PIP) inside the pharyngolaryngeal space (PLS). This study measured and
compared effects of four different SPI durations in the PLS. METHOD: In
this prospective observational study, 20 consecutive infants aged less
than 3 years, scheduled for elective flexible-bronchoscopy were
enrolled. SPI was performed twice in four different durations (0, 1, 3
and 5 seconds) sequentially in each infant. PIP was measured for each
SPI in the pharynx, and simultaneously took images at two locations of
oropharynx and supra-larynx. Infants’ demographic details and PIP
levels, lumen expansion scores and images of PLS were measured and
analyzed. RESULTS: Twenty infants 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) cm H2O at SPI duration of 0, 1,
3 and 5 seconds, respectively; which showed significant positive
association (p<0.001). At assigned locations, the
corresponding PLS images also show significant increase in lumen
expansion scores and number of detected lesions with increase in SPI
duration (p<0.001). The mean (SD) study time was 5.7 (1.2)
minutes. No study related complication was noted. CONCLUSIONS: SPI with
PhO2-NC up to 5 seconds is a simple, safe and feasible clinical
ventilation modality. It may provide enough PIP to expand the PLS and
facilitate flexible-bronchoscopy performance in infants.