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Head circumference and chronic positive pressure ventilation in children: a pilot study
Virginia S Kharasch1, Ning Tat Hamilton Hui, Helene M Dumas
1Pediatric Pulmonary Rehabilitation, Franciscan Hospital for Children, Boston, MA 02135, USA. virginia.kharasch@childrens.harvard.edu
Summary
Children requiring chronic positive pressure ventilation (CPPV) often show larger head circumferences (HC) than expected. This head size appears linked to the peak inspiratory pressure used during ventilation.
Area of Science:
- Pediatric critical care medicine
- Respiratory physiology
- Medical device technology
Background:
- Complex medical conditions and respiratory failure in children necessitate advanced respiratory support.
- Chronic positive pressure ventilation (CPPV) is a critical intervention for pediatric patients with respiratory insufficiency.
- Understanding the physiological impact of CPPV on growth parameters like head circumference (HC) is important for long-term patient management.
Purpose of the Study:
- To investigate head circumference (HC) in children requiring chronic positive pressure ventilation (CPPV).
- To compare HC percentiles in children on CPPV with age-expected values and with children not on ventilation.
- To explore the relationship between HC, peak inspiratory pressure (PIP), and duration of CPPV.
Main Methods:
- Retrospective review of 11 children under 12 years with complex medical conditions on CPPV.
- Within-group comparison of average HC percentiles against the 50th percentile.
- Between-groups comparison with children not on ventilation; correlation analysis between HC, PIP, and ventilation duration.
Main Results:
- Children on CPPV exhibited an average HC at the 71st percentile, significantly higher than the 50th percentile (p=0.009).
- Average HC percentile was significantly greater in children on CPPV compared to those with similar conditions but not on ventilation (p=0.003).
- Peak inspiratory pressure (PIP) showed a moderately strong positive correlation with HC (r=0.689, p=0.019).
Conclusions:
- Children requiring CPPV demonstrate larger than expected head circumferences.
- Head circumference in these children appears to be associated with the peak inspiratory pressure levels utilized.
- Further research is warranted to elucidate the relationship between HC and CPPV in pediatric populations.