Study of thoracic compliance in children on different ventilatory programs using digital video cameras : Preliminary results

12th International Conference on Home Mechanical Ventilation, BARCELONE, ESPAGNE, 27-/03/2009 - 28/03/2009The CMP (Pediatric Medical Center) in la Maisonnée receives children with neuromuscular pathologies ventilated with invasive or non-invasive methods. The respiratory function of these children naturally deteriorates over time, and breathing development programs, that may or may not be associated with thoracic pressure, are put in place to minimize this mostly restrictive aggravation. The traditional use of IPPB lacks precise evaluation, especially of thoracic mobility. In collaboration with INRETS (the French National Institute for Transport and Safety Research), a measurement table, used in association with two digital video cameras, has been designed to record both pressure and thoracic movements. Seven children were recorded using two or three ventilation modes : - via spontaneous ventilation if the child is breathing unassisted - via mechanical ventilation - via IPPB. The targets were placed on the sternum, the abdomen, the xiphoid process and the ribs. All these children suffer from respiratory failure of neuromuscular origin. Their average age is seven (14 months to 16 years old). Initial results highlight a much higher thoracic compliance under IPPB in all cases. IPPB versus spontaneous ventilation : + 64,8% (the highest result is registred on costal targets +65,4%) IPPB versus barometric or volumetric ventilation : +54,1% An abdominal contention increase thoracic movement but decrease abdominal movement Conclusion This new tool enables the precise measurement of children's thoracic compliance, thereby making it easier to appreciate whether there is a need to implement hyperinsufflation programs that will limit the restriction of the respiratory function and thoracic stiffening in these children. Other measurements need to be carried out to confirm these initial results