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Respiratory muscle testing in children
1Pediatric Pulmonology and INSERM E 213, Hôpital Armand Trousseau, 28 avenue du Docteur Arnold Netter, 75012, Paris, France. brigitte.fauroux@trs.ap-hop-paris.fr
Insights
Evaluating respiratory muscle weakness in children has many new techniques. Sniff nasal pressure and magnetic stimulation are increasingly important for diagnosing conditions like neuromuscular diseases causing breathlessness.
Area of Science:
- Pediatric Pulmonology
- Neuromuscular Physiology
Background:
- Respiratory muscle weakness assessment techniques have advanced significantly.
- Current methods include non-invasive and invasive testing.
Purpose of the Study:
- To review current and emerging techniques for assessing respiratory muscle strength and endurance in children.
- To highlight the importance of evaluating respiratory muscles in pediatric patients with unexplained breathlessness.
Main Methods:
- Review of non-invasive tests (lung function, maximal static pressures, sniff nasal pressure).
- Review of invasive tests (transdiaphragmatic pressures, magnetic stimulation of phrenic nerves).
Main Results:
- Sniff nasal pressure and magnetic stimulation show growing importance for pediatric assessment.
- Respiratory muscle strength evaluation is crucial for diagnosing conditions like neuromuscular diseases.
Conclusions:
- A broader range of techniques aids in diagnosing pediatric respiratory muscle weakness.
- Further development is needed for assessing respiratory muscle endurance in children.
Abstract:
The range of techniques available to assess respiratory muscles weakness has greatly expanded over recent years. Respiratory muscle tests can be divided into non-invasive tests, such as lung function parameters, maximal static pressures and sniff nasal pressure and invasive tests, such as transdiaphragmatic pressures during crying, maximal static pressures and magnetic stimulation of the phrenic nerves. Sniff nasal pressure and magnetic stimulation should have increasing relevance in children in the coming years. However, probably the most important message is to arrange for the evaluation of respiratory muscles in children with unexplained or disproportionate breathlessness such as in patients with neuromuscular diseases. Improvements are needed to evaluate respiratory muscle endurance in children, which is more difficult but complementary to the assessment of respiratory muscle strength.