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Work of breathing in children with diffuse parenchymal lung disease

Sonia Khirani1, Nadia Nathan2, Adriana Ramirez3

  • 1ASV Santé, 125 avenue Roche, 92230 Gennevilliers, France; AP-HP, Hôpital Necker, Pediatric noninvasive ventilation and sleep unit, 149 rue de Sèvres, 75015 Paris, France.

Respiratory Physiology & Neurobiology
|December 3, 2014
PubMed

Insights

Respiratory mechanics monitoring is useful for children with diffuse parenchymal lung disease (DPLD). Studies show increased work of breathing and reduced lung compliance, indicating altered lung function.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Physiology
  • Critical Care Medicine

Background:

  • Chronic diffuse parenchymal lung disease (DPLD) in children is poorly understood regarding respiratory mechanics.
  • Assessing lung function alterations in pediatric DPLD requires effective monitoring tools.

Purpose of the Study:

  • To evaluate the utility of respiratory mechanics in monitoring lung function changes in pediatric DPLD.
  • To identify key respiratory parameters indicative of disease progression or stability.

Main Methods:

  • Respiratory mechanics, including work of breathing (total, elastic, resistive), gas exchange, and lung function, were measured.
  • Respiratory muscle strength was assessed in 10 pediatric patients (1.8-18.4 years) with DPLD.
  • Measurements included tidal volume (Vt), respiratory rate (fr), dynamic lung compliance (Cldyn), and oesophageal pressure-time product.

Main Results:

  • Children with DPLD exhibited increased respiratory rate (fr), fr/Vt ratio, and total lung resistance.
  • Mean total work of breathing (WOBt) was elevated, primarily due to increased elastic work (WOBe).
  • Dynamic lung compliance (Cldyn) was significantly reduced and correlated with vital capacity and functional residual capacity.

Conclusions:

  • Respiratory mechanics parameters serve as valuable complementary or alternative markers for functional abnormalities in pediatric DPLD.
  • Monitoring lung mechanics can provide crucial insights into the physiological impact of DPLD in children.
  • Despite normal respiratory muscle strength, altered lung mechanics highlight the disease's effect on respiratory function.

Keywords:
Breathing patternChildDiffuse parenchymal lung diseaseInterstitial lung diseaseLung complianceWork of breathing

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