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Manual external chest compression reverses respiratory failure in children with severe air trapping

Rebecca Brooks1, Malena Cohen-Cymberknoh2, Charlotte Glicksman1

  • 1Department of Pediatrics, Pediatric Intensive Care Unit, Hadassah Medical Center Mount Scopus and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Pediatric Pulmonology
|September 28, 2021
PubMed

Insights

Manual external chest compression (MECC) effectively treats acute respiratory failure in children with severe air trapping. This method avoided intubation and mechanical ventilation in five pediatric patients, leading to rapid recovery.

Area of Science:

  • Pediatric Critical Care Medicine
  • Respiratory Physiology
  • Emergency Medicine

Background:

  • Severe air trapping in children, often due to asthma or bronchiolitis, can lead to acute respiratory failure.
  • Acute respiratory failure necessitates prompt and effective interventions to prevent severe outcomes.
  • Intubation and mechanical ventilation are common but invasive treatments for such conditions.

Purpose of the Study:

  • To evaluate the effectiveness of manual external chest compression (MECC) as a non-invasive treatment for acute respiratory failure caused by severe air trapping in children.
  • To assess the impact of MECC on ventilation and blood gas parameters in pediatric patients.
  • To determine if MECC can obviate the need for intubation and mechanical ventilation.

Main Methods:

  • Retrospective case series of five pediatric patients admitted to the Pediatric Intensive Care Unit (PICU) with acute respiratory failure due to severe air trapping.
  • MECC was administered prior to planned intubation.
  • Blood gas parameters (including PCO2) were monitored before, during, and after MECC application.

Main Results:

  • MECC application led to gradual improvements in blood gas parameters, specifically indicating enhanced ventilation and tidal volume.
  • All five children experienced resolution of respiratory failure within 4 hours of MECC.
  • No complications were reported during or after MECC administration.
  • The need for intubation and mechanical ventilation was successfully avoided in all cases.

Conclusions:

  • Manual external chest compression (MECC) is a safe and effective emergent treatment for acute respiratory failure associated with severe air trapping in children.
  • MECC can rapidly improve ventilation and obviate the need for mechanical ventilation, allowing for shorter PICU stays.
  • This intervention offers a promising non-invasive alternative for managing severe pediatric respiratory distress.

Keywords:
asthmabronchiolitisintubationmanual external chest compressionmechanical ventilation

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