Related Experiment Videos
Paralysis of the diaphragm
Insights
Diaphragmatic paralysis is an uncommon cause of respiratory issues in children. While some neonates and older children recover spontaneously, others require interventions like mechanical ventilation or diaphragm plication, with some cases resulting in mortality.
Area of Science:
- Pediatric Surgery
- Neonatology
- Pulmonology
Background:
- Diaphragmatic paralysis is a rare cause of respiratory symptoms in pediatric patients.
- It can occur in neonates due to birth trauma or thoracotomy, and in older children post-thoracotomy.
Purpose of the Study:
- To investigate the incidence and outcomes of diaphragmatic paralysis in pediatric patients.
- To analyze the causes, recovery rates, and treatment modalities for diaphragmatic paralysis in neonates and older children.
Main Methods:
- Retrospective review of pediatric patients diagnosed with diaphragmatic paralysis over a three-year period.
- Analysis of patient demographics, etiology, clinical presentation, interventions, and outcomes.
Main Results:
- Twelve neonates and four older children developed diaphragmatic paralysis.
- Spontaneous recovery was observed in all older children and 50% of neonates.
- Two neonates died from secondary pneumonia, while three required diaphragm plication for recovery.
Conclusions:
- Diaphragmatic paralysis in children, though infrequent, can lead to significant respiratory morbidity and mortality.
- Outcomes vary based on age and etiology, with neonates facing higher risks.
- Interventions such as mechanical ventilation and diaphragm plication may be necessary for management.
Abstract:
Diaphragmatic paralysis has been mentioned infrequently as a cause of respiratory symptoms in children. During a three-year period, diaphragmatic paralysis has occurred in 12 neonates following birth trauma (six) or thoracotomy (six) and in four older children following thoracotomy. Spontaneous recovery occurred in all four older children and in five of the 12 neonates. Although two neonates became asymptomatic despite persistent paralysis, the remaining five neonates required prolonged intermittent positive-pressure breathing; two eventually died of secondary pneumonia, and three became asymptomatic only after plication of the affected diaphragm.