Related Experiment Video
Updated: Jun 14, 2026
09:36
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Manual hyperinflation in children
Daiane Menezes Lorena1, Maria Cecília Moraes Frade2, Thalis Henrique da Silva1
1Programa de Pós-Graduação, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brasil.
Revista Brasileira De Terapia Intensiva
|January 26, 2022
Summary
Manual hyperinflation in pediatric intensive care units can improve lung function in children. This review analyzes the technique's application, safety, and effectiveness, supporting its positive impact.
Area of Science:
- Pediatric critical care medicine
- Respiratory therapy
- Evidence-based practice
Background:
- Manual hyperinflation is a technique used in neonatal and pediatric intensive care units (NICU/PICU) to enhance expiratory flow bias.
- There is a lack of consensus regarding the benefits and optimal application of manual hyperinflation.
Purpose of the Study:
- To systematically review the literature on manual hyperinflation in NICU/PICU settings.
- To analyze evidence on its application, safety, manual resuscitator performance, and the influence of therapist experience.
- To evaluate the methodological quality of included studies.
Main Methods:
- A comprehensive literature search was conducted across six major databases (Web of Science, ScienceDirect, PubMed, Scopus, CINAHL, SciELO).
- Two independent researchers selected and reviewed articles based on predefined criteria, assessing methodological quality using the PEDro scale.
- Six relevant articles were included in the final analysis.
Main Results:
- The positive end-expiratory pressure valve contributes to increased lung volumes.
- Chest compressions can optimize expiratory flow bias.
- Operator experience negatively influences peak inspiratory flow; however, the technique is safe, maintaining hemodynamic stability and improving oxygen saturation.
Conclusions:
- Available evidence suggests manual hyperinflation has a positive effect on children in intensive care units.
- Further high-quality research is needed to fully elucidate the benefits and optimize the application of this technique.
Related Concept Videos
01:20Inborn Errors of Metabolism
Phenylketonuria (PKU) is a protein metabolism disorder characterized by high blood levels of the amino acid phenylalanine. This results from a mutation in the gene responsible for phenylalanine hydroxylase, an enzyme that converts phenylalanine into tyrosine. When this enzyme is deficient, phenylalanine builds up in the blood, leading to symptoms such as vomiting, rashes, seizures, growth deficiency, and severe mental retardation. An early diagnosis and a diet restricting phenylalanine intake...
01:29Drug Dosing: Infants and Children
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...