Respiratory muscle function assessment in paediatric intensive

TY - JOUR

T1 - Respiratory muscle function assessment in paediatric intensive

AU - Harikumar, Gopinanthanair

AU - Greenough, Anne

AU - Rafferty, Gerrard

PY - 2006/6

Y1 - 2006/6

N2 - Respiratory muscle dysfunction complicates the management of critically ill, ventilated children. Imaging techniques can identify diaphragm dysfunction, but give no quantitative information, which makes interpretation of serial measurements difficult. Stimulation of the phrenic nerves is the standard, nonvolitional, quantitative technique, but is only available in specialist centres. Pressures generated against temporary airway occlusions also provide quantitative data of inspiratory and expiratory muscle strength, but as the tests are volitional respiratory muscle strength may be underestimated. Composite measures, however, relating occlusion pressures to respiratory cycle timing have been shown to predict diaphragm fatigue in adults. In this review we describe the techniques to assess respiratory muscle function and consider their strengths and limitations in the paediatric intensive care setting. In addition we report use of non-invasive measurements of respiratory muscle function in a child to illustrate how such measurements can be used to document changes in diaphragmatic function and facilitate successful extubation

AB - Respiratory muscle dysfunction complicates the management of critically ill, ventilated children. Imaging techniques can identify diaphragm dysfunction, but give no quantitative information, which makes interpretation of serial measurements difficult. Stimulation of the phrenic nerves is the standard, nonvolitional, quantitative technique, but is only available in specialist centres. Pressures generated against temporary airway occlusions also provide quantitative data of inspiratory and expiratory muscle strength, but as the tests are volitional respiratory muscle strength may be underestimated. Composite measures, however, relating occlusion pressures to respiratory cycle timing have been shown to predict diaphragm fatigue in adults. In this review we describe the techniques to assess respiratory muscle function and consider their strengths and limitations in the paediatric intensive care setting. In addition we report use of non-invasive measurements of respiratory muscle function in a child to illustrate how such measurements can be used to document changes in diaphragmatic function and facilitate successful extubation

M3 - Literature review

VL - 16

SP - 59

EP - 63

JO - British Journal of Intensive Care

JF - British Journal of Intensive Care

IS - 2

ER -