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3. Lung volume recruitment and airway clearance for children at home in France

Author

Khirani, Sonia, Griffon, Lucie, Thébault, Charlotte, Aubertin, Guillaume, Dupont, Pierre, Mbieleu, Blaise, Galodé, François, Canavesio, Coline, Fleurence, Emmanuelle, Labouret, Géraldine, Cros, Pierrick, Barzic, Audrey, Lubrano Lavadera, Marc, Giovannini-Chami, Lisa, Gilardoni, Jean-Marc, Gourdan, Pierre, Moreau, Johan, Matecki, Stefan, Zitvogel, Françoise, Durand, Marine, Perisson, Caroline, Le Clainche, Laurence, Taytard, Jessica, and Fauroux, Brigitte

Published
2024
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7. Correlation between three-dimensional echocardiography and cardiopulmonary fitness in patients with univentricular heart: A cross-sectional multicentre prospective study

Author

Femenia, Valentin, Pommier, Victor, Huguet, Helena, Iriart, Xavier, Picot, Marie-Christine, Bredy, Charlene, Lorca, Laura, Villeon, Gregoire De La, Guillaumont, Sophie, Pasquie, Jean-Luc, Matecki, Stefan, Roubertie, François, Leobon, Bertrand, Thambo, Jean-Benoît, Jalal, Zakaria, Thomas, Julie, Mouton, Jean-Baptiste, Avesani, Martina, and Amedro, Pascal

Published
2023
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8. Long term noninvasive ventilation and continuous positive airway pressure in children with neuromuscular diseases in France

Author

Allaer, Laura, Khirani, Sonia, Griffon, Lucie, Massenavette, Bruno, Bierme, Priscille, Aubertin, Guillaume, Stremler, Nathalie, Baravalle-Einaudi, Melisande, Mazenq, Julie, Ioan, Iulia, Schweitzer, Cyril, Binoche, Alexandra, Lampin, Marie Emilie, Mordacq, Clemence, Bergounioux, Jean, Mbieleu, Blaise, Rubinsztajn, Robert, Sigur, Elodie, Labouret, Geraldine, Genevois, Aline, Becourt, Arnaud, Hullo, Eglantine, Debelleix, Stéphane, Galodé, François, Bui, Stéphanei, Moreau, Johan, Renoux, Marie Catherine, Matecki, Stefan, Lubrano Lavadera, Marc, Heyman, Rachel, Pomedio, Michael, Clainche, Laurence Le, Bokov, Plamen, Dudoignon, Benjamin, Masson, Alexandra, Hangard, Pauline, Menetrey, Celine, Jokic, Mikael, Gachelin, Elsa, Perisson, Caroline, Pervillé, Anne, Fina, Agnes, Giovannini-Chami, Lisa, Fleurence, Emmanuelle, Barzic, Audrey, Cros, Pierrick, Breining, Audrey, Ollivier, Morgane, Labbé, Guillaume, Coutier, Laurianne, Taytard, Jessica, and Fauroux, Brigitte

Published
2022
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10. Diaphragm Involvement

Author

Jung, Boris, Matecki, Stefan, Jaber, Samir, Cecconi, Maurizio, Series Editor, De Backer, Daniel, Series Editor, Preiser, Jean-Charles, editor, Herridge, Margaret, editor, and Azoulay, Elie, editor

Published
2020
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11. Paediatric long term continuous positive airway pressure and noninvasive ventilation in France: A cross-sectional study

Author

Fauroux, Brigitte, Khirani, Sonia, Amaddeo, Alessandro, Massenavette, Bruno, Bierme, Priscille, Taytard, Jessica, Stremler, Nathalie, Baravalle-Einaudi, Melisande, Mazenq, Julie, Ioan, Iulia, Schweitzer, Cyril, Lampin, Marie Emilie, Binoche, Alexandra, Mordacq, Clemence, Bergounioux, Jean, Mbieleu, Blaise, Rubinsztajn, Robert, Sigur, Elodie, Labouret, Geraldine, Genevois, Aline, Becourt, Arnaud, Hullo, Eglantine, Pin, Isabelle, Debelleix, Stéphane, Galodé, François, Bui, Stéphanie, Moreau, Johan, Renoux, Marie Catherine, Matecki, Stefan, Lavadera, Marc Lubrano, Heyman, Rachel, Pomedio, Michael, Le Clainche, Laurence, Bokov, Plamen, Masson, Alexandra, Hangard, Pauline, Menetrey, Celine, Jokic, Mikael, Gachelin, Elsa, Perisson, Caroline, Pervillé, Anne, Fina, Agnes, Giovannini-Chami, Lisa, Fleurence, Emmanuelle, Barzic, Audrey, Breining, Audrey, Ollivier, Morgane, Labbé, Guillaume, Coutier, Laurianne, and Aubertin, Guillaume

Published
2021
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12. Impact of Sophrology on cardiopulmonary fitness in teenagers and young adults with a congenital heart disease: The SOPHROCARE study rationale, design and methods

Author

Moreau, Johan, Lavastre, Kathleen, Romieu, Huguette, Charbonnier, Françoise, Guillaumont, Sophie, Bredy, Charlene, Abassi, Hamouda, Werner, Oscar, De La Villeon, Gregoire, Requirand, Anne, Auer, Annie, Matecki, Stefan, Karsenty, Clement, Guitarte, Aitor, Hadeed, Khaled, Dulac, Yves, Souletie, Nathalie, Acar, Philippe, Bajolle, Fanny, Bonnet, Damien, Negre-Pages, Laurence, Mura, Thibault, Mounier, Maria, Seguela, Pierre-Emmanuel, Thomas, Julie, Iriart, Xavier, Jean-Benoit-Thambo, and Amedro, Pascal

Published
2020
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13. Health-related quality of life and physical activity in children with inherited cardiac arrhythmia or inherited cardiomyopathy: the prospective multicentre controlled QUALIMYORYTHM study rationale, design and methods

Author

Amedro, Pascal, Werner, Oscar, Abassi, Hamouda, Boisson, Aymeric, Souilla, Luc, Guillaumont, Sophie, Calderon, Johanna, Requirand, Anne, Vincenti, Marie, Pommier, Victor, Matecki, Stefan, De La Villeon, Gregoire, Lavastre, Kathleen, Lacampagne, Alain, Picot, Marie-Christine, Beyler, Constance, Delclaux, Christophe, Dulac, Yves, Guitarte, Aitor, Charron, Philippe, Denjoy-Urbain, Isabelle, Probst, Vincent, Baruteau, Alban-Elouen, Chevalier, Philippe, Di Filippo, Sylvie, Thambo, Jean-Benoit, Bonnet, Damien, and Pasquie, Jean-Luc

Published
2021
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15. Early hybrid cardiac rehabilitation in congenital heart disease: the QUALIREHAB trial.

Author

Amedro, Pascal, Gavotto, Arthur, Huguet, Helena, Souilla, Luc, Huby, Anne-Cecile, Matecki, Stefan, Cadene, Anne, Villeon, Gregoire De La, Vincenti, Marie, Werner, Oscar, Bredy, Charlene, Lavastre, Kathleen, Abassi, Hamouda, Cohen, Sarah, Hascoet, Sebastien, Dauphin, Claire, Chalard, Aurelie, Dulac, Yves, Souletie, Nathalie, and Bouvaist, Helene

Subjects
CONGENITAL heart disease, CARDIAC rehabilitation, QUALITY of life, CARDIOPULMONARY fitness, TREATMENT programs
Abstract

Background and Aims Cardiopulmonary fitness in congenital heart disease (CHD) decreases faster than in the general population resulting in impaired health-related quality of life (HRQoL). As the standard of care seems insufficient to encourage and maintain fitness, an early hybrid cardiac rehabilitation programme could improve HRQoL in CHD. Methods The QUALIREHAB multicentre, randomized, controlled trial evaluated and implemented a 12-week centre- and home-based hybrid cardiac rehabilitation programme, including multidisciplinary care and physical activity sessions. Adolescent and young adult CHD patients with impaired cardiopulmonary fitness were randomly assigned to either the intervention (i.e. cardiac rehabilitation) or the standard of care. The primary outcome was the change in HRQoL from baseline to 12-month follow-up in an intention-to-treat analysis. The secondary outcomes were the change in cardiovascular parameters, cardiopulmonary fitness, and mental health. Results The expected number of 142 patients was enroled in the study (mean age 17.4 ± 3.4 years, 52% female). Patients assigned to the intervention had a significant positive change in HRQoL total score [mean difference 3.8; 95% confidence interval (CI) 0.2; 7.3; P =.038; effect size 0.34], body mass index [mean difference −0.7 kg/m2 (95% CI −1.3; −0.1); P =.022; effect size 0.41], level of physical activity [mean difference 2.5 (95% CI 0.1; 5); P =.044; effect size 0.39], and disease knowledge [mean difference 2.7 (95% CI 0.8; 4.6); P =.007; effect size 0.51]. The per-protocol analysis confirmed these results with a higher magnitude of differences. Acceptability, safety, and short-time effect of the intervention were good to excellent. Conclusions This early hybrid cardiac rehabilitation programme improved HRQoL, body mass index, physical activity, and disease knowledge, in youth with CHD, opening up the possibility for the QUALIREHAB programme to be rolled out to the adult population of CHD and non-congenital cardiac disease. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Pediatric long‐term noninvasive respiratory support in children with central nervous system disorders

Author

Carrara, Marion, primary, Aubertin, Guillaume, additional, Khirani, Sonia, additional, Massenavette, Bruno, additional, Bierme, Priscille, additional, Griffon, Lucie, additional, Ioan, Iulia, additional, Schweitzer, Cyril, additional, Binoche, Alexandra, additional, Lampin, Marie‐Emilie, additional, Mordacq, Clémence, additional, Rubinsztajn, Robert, additional, Debeilleix, Stéphane, additional, Galode, François, additional, Bui, Stéphanie, additional, Hullo, Eglantine, additional, Becourt, Arnaud, additional, Lubrano, Marc, additional, Moreau, Johan, additional, Renoux, Marie‐Catherine, additional, Matecki, Stefan, additional, Stremler, Nathalie, additional, Baravalle‐Einaudi, Melisande, additional, Mazenq, Julie, additional, Sigur, Elodie, additional, Labouret, Géraldine, additional, Genevois, Anne‐Laure, additional, Heyman, Rachel, additional, Pomedio, Michael, additional, Masson, Alexandra, additional, Hangard, Pauline, additional, Menetrey, Céline, additional, Le Clainche, Laurence, additional, Bokov, Plamen, additional, Dudoignon, Benjamin, additional, Fleurence, Emmanuelle, additional, Bergounioux, Jean, additional, Mbieleu, Blaise, additional, Breining, Audrey, additional, Giovannin‐Chami, Lisa, additional, Fina, Agnes, additional, Ollivier, Morgane, additional, Gachelin, Elsa, additional, Perisson, Caroline, additional, Pervillé, Anne, additional, Barzic, Audrey, additional, Cros, Pierrick, additional, Jokic, Mickaël, additional, Labbé, Guillaume, additional, Diaz, Véronique, additional, Coutier, Laurianne, additional, Fauroux, Brigitte, additional, and Taytard, Jessica, additional

Published
2023
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19. Aerobic physical capacity and health-related quality of life in children with sickle cell disease

Author

Laurent-Lacroix, Corentin, primary, Vincenti, Marie, additional, Matecki, Stefan, additional, Mahé, Perrine, additional, Moulis, Lionel, additional, Villeon, Grégoire De La, additional, Guillaumont, Sophie, additional, Requirand, Anne, additional, Moreau, Johan, additional, Lalande, Muriel, additional, Picot, Marie-Christine, additional, Amedro, Pascal, additional, and Gavotto, Arthur, additional

Published
2023
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26. Reference values of cardiopulmonary exercise test parameters in the contemporary paediatric population

Author

Amedro, Pascal, primary, Matecki, Stefan, additional, Santos, Taissa Pereira dos, additional, Guillaumont, Sophie, additional, Rhodes, Jonathan, additional, Yin, Suellen Moli, additional, Hager, Alfred, additional, Hock, Julia, additional, Villeon, Gregoire De La, additional, Moreau, Johan, additional, Requirand, Anne, additional, Souilla, Luc, additional, Vincenti, Marie, additional, Picot, Marie-Christine, additional, Huguet, Helena, additional, Mura, Thibault, additional, and Gavotto, Arthur, additional

Published
2023
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31. Reference values of aerobic fitness in the contemporary paediatric population

Author

Gavotto, Arthur, primary, Mura, Thibault, additional, Rhodes, Jonathan, additional, Yin, Suellen Moli, additional, Hager, Alfred, additional, Hock, Julia, additional, Guillaumont, Sophie, additional, Vincenti, Marie, additional, De La Villeon, Gregoire, additional, Requirand, Anne, additional, Picot, Marie-Christine, additional, Huguet, Helena, additional, Souilla, Luc, additional, Moreau, Johan, additional, Matecki, Stefan, additional, and Amedro, Pascal, additional

Published
2023
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32. Cardiorespiratory fitness, muscle fitness, and physical activity in children with long QT syndrome: A prospective controlled study

Author

Souilla, Luc, primary, Avesani, Martina, additional, Boisson, Aymeric, additional, Requirand, Anne, additional, Matecki, Stefan, additional, Vincenti, Marie, additional, Werner, Oscar, additional, De La Villeon, Gregoire, additional, Pommier, Victor, additional, Pasquie, Jean-Luc, additional, Guillaumont, Sophie, additional, and Amedro, Pascal, additional

Published
2023
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34. Cardiopulmonary fitness in children with asthma versus healthy children

Author

Moreau, Johan, primary, Socchi, Floriane, additional, Renoux, Marie Catherine, additional, Requirand, Anne, additional, Abassi, Hamouda, additional, Guillaumont, Sophie, additional, Matecki, Stefan, additional, Huguet, Helena, additional, Avesani, Martina, additional, Picot, Marie-Christine, additional, and Amedro, Pascal, additional

Published
2022
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37. Use of new paediatric VO2maxreference equations to evaluate aerobic fitness in overweight or obese children with congenital heart disease

Author

Amedro, Pascal, Mura, Thibault, Matecki, Stefan, Guillaumont, Sophie, Requirand, Anne, Jeandel, Claire, Kollen, Laura, and Gavotto, Arthur

Abstract

The new paediatric VO2maxZ-score reference equations found a lower aerobic fitness in obese or overweight children with CHD than that in matched obese or overweight control children and a high proportion of children with impaired aerobic fitness in obese or overweight children with CHD and identified specific complex CHD at risk of aerobic fitness impairment.As opposed to Cooper’s weight-based or height-based linear equations, the new paediatric VO2maxZ-score equations can discriminate the aerobic fitness of obese or overweight children with CHD from that of obese or overweight children without any chronic disease.Graphical Abstract

Published
2023
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44. Cardiopulmonary fitness in children with asthma versus healthy children.

Author

Moreau, Johan, Socchi, Floriane, Renoux, Marie Catherine, Requirand, Anne, Abassi, Hamouda, Guillaumont, Sophie, Matecki, Stefan, Huguet, Helena, Avesani, Martina, Picot, Marie-Christine, Amedro, Pascal, and Avesanni, Martina

Subjects
ASTHMA in children, CARDIOPULMONARY fitness, WHEEZE, COUGH, EXERCISE-induced asthma, OBSTRUCTIVE lung diseases, AEROBIC capacity
Abstract

Objectives: To evaluate, with a cardiopulmonary exercise test (CPET), the cardiopulmonary fitness of children with asthma, in comparison to healthy controls, and to identify the clinical and CPET parameters associated with the maximum oxygen uptake (VO2max) in childhood asthma.Design: This cross-sectional controlled study was carried out in CPET laboratories from two tertiary care paediatric centres. The predictors of VO2max were determined using a multivariable analysis.Results: A total of 446 children (144 in the asthma group and 302 healthy subjects) underwent a complete CPET. Mean VO2max was significantly lower in children with asthma than in controls (38.6±8.6 vs 43.5±7.5 mL/kg/min; absolute difference (abs. diff.) of -4.9 mL/kg/min; 95% CI of (-6.5 to -3.3) mL/kg/min; p<0.01) and represented 94%±9% and 107%±17% of predicted values, respectively (abs. diff. -13%; 95% CI (-17 to -9)%; p<0.01). The proportion of children with an impaired VO2max was four times higher in the asthma group (24% vs 6%, p<0.01). Impaired ventilatory efficiency with increased VE/VCO2 slope and low breathing reserve (BR) were more marked in the asthma group. The proportion of children with a decreased ventilatory anaerobic threshold (VAT), indicative of physical deconditioning, was three times higher in the asthma group (31% vs 11%, p<0.01). Impaired VO2max was associated with female gender, high body mass index (BMI), FEV1, low VAT and high BR.Conclusion: Cardiopulmonary fitness in children with asthma was moderately but significantly altered compared with healthy children. A decreased VO2max was associated with female gender, high BMI and the pulmonary function.Trial Registration Number: NCT04650464. [ABSTRACT FROM AUTHOR]

Published
2023
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45. Vaccination for Respiratory Infections in Patients with Heart Failure

Author

Fauroux, Brigitte, Khirani, Sonia, Amaddeo, Alessandro, MASSENAVETTE, Bruno, Bierme, Priscille, Taytard, Jessica, Stremler, Nathalie, Baravalle-Einaudi, Melisande, Mazenq, Julie, Ioan, Iulia, Schweitzer, Cyril, Lampin, Marie Emilie, Binoche, Alexandra, Mordacq, Clemence, Bergounioux, Jean, Mbieleu, Blaise, Rubinsztajn, Robert, Sigur, Elodie, Labouret, Geraldine, Genevois, Aline, Becourt, Arnaud, Hullo, Eglantine, Pin, Isabelle, Debelleix, Stéphane, Galodé, François, Bui, Stéphanie, Moreau, Johan, Renoux, Marie Catherine, Matecki, Stefan, Lavadera, Marc Lubrano, Heyman, Rachel, Pomedio, Michael, Le Clainche, Laurence, Bokov, Plamen, Masson, Alexandra, Hangard, Pauline, Menetrey, Celine, Jokic, Mikael, Gachelin, Elsa, Perisson, Caroline, Pervillé, Anne, Fina, Agnes, Giovannini-Chami, Lisa, Fleurence, Emmanuelle, Barzic, Audrey, Breining, Audrey, Ollivier, Morgane, Labbé, Guillaume, Coutier, Laurianne, Aubertin, Guillaume, Girerd, Nicolas, Chapet, Nicolas, Roubille, Camille, Roncalli, Jérôme, Salvat, Muriel, Mouquet, Frédéric, Lamblin, Nicolas, Gueffet, Jean-Pierre, Damy, Thibaud, Galinier, Michel, Tartiere, Jean-Michel, Janssen, Cécile, Berthelot, Emmanuelle, Aguilhon, Sylvain, Escamilla, Roger, Roubille, François, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), CHU Toulouse [Toulouse], Centre Hospitalier Universitaire [Grenoble] (CHU), Hôpital Privé Le Bois Ramsay Santé [Lille], Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 (RID-AGE), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital privé du Confluent [Nantes], Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Henri Mondor, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer - Hôpital Sainte-Musse, Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Université Paris-Sud - Paris 11 (UP11), Hôpital de Rangueil, Hôpital Privé Le Bois Ramsay Santé, Fédération des services de cardiologie [Rangueil], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], CHITS, CHU Montpellier, Hôpital Larrey [Toulouse], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Toulouse (UT), and MORNET, Dominique

Subjects
medicine.medical_specialty, pneumococcal vaccine, Influenza vaccine, [SDV]Life Sciences [q-bio], heart failure, review article, Disease, Review, 030204 cardiovascular system & hematology, medicine.disease_cause, law.invention, 03 medical and health sciences, respiratory infections, 0302 clinical medicine, Randomized controlled trial, law, Streptococcus pneumoniae, Medicine, 030212 general & internal medicine, Intensive care medicine, vaccination coverage, business.industry, General Medicine, medicine.disease, 3. Good health, Review article, [SDV] Life Sciences [q-bio], Vaccination, Pneumococcal vaccine, Heart failure, influenza vaccine, business, COVID-19 vaccine
Abstract

International audience; Bronchopulmonary infections are a major trigger of cardiac decompensation and are frequently associated with hospitalizations in patients with heart failure (HF). Adverse cardiac effects associated with respiratory infections, more specifically Streptococcus pneumoniae and influenza infections, are the consequence of inflammatory processes and thrombotic events. For both influenza and pneumococcal vaccinations, large multicenter randomized clinical trials are needed to evaluate their efficacy in preventing cardiovascular events, especially in HF patients. No study to date has evaluated the protective effect of the COVID-19 vaccine in patients with HF. Different guidelines recommend annual influenza vaccination for patients with established cardiovascular disease and also recommend pneumococcal vaccination in patients with HF. The Heart Failure group of the French Society of Cardiology recently strongly recommended vaccination against COVID-19 in HF patients. Nevertheless, the implementation of vaccination recommendations against respiratory infections in HF patients remains suboptimal. This suggests that a national health policy is needed to improve vaccination coverage, involving not only the general practitioner, but also other health providers, such as cardiologists, nurses, and pharmacists. This review first summarizes the pathophysiology of the interrelationships between inflammation, infection, and HF. Then, we describe the current clinical knowledge concerning the protective effect of vaccines against respiratory diseases (influenza, pneumococcal infection, and COVID-19) in patients with HF and finally we propose how vaccination coverage could be improved in these patients.

Published
2021
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46. Skeletal Ryanodine Receptors Are Involved in Impaired Myogenic Differentiation in Duchenne Muscular Dystrophy Patients

Author

Meyer, Pierre, primary, Notarnicola, Cécile, additional, Meli, Albano C., additional, Matecki, Stefan, additional, Hugon, Gérald, additional, Salvador, Jérémy, additional, Khalil, Mirna, additional, Féasson, Léonard, additional, Cances, Claude, additional, Cottalorda, Jérôme, additional, Desguerre, Isabelle, additional, Cuisset, Jean-Marie, additional, Sabouraud, Pascal, additional, Lacampagne, Alain, additional, Chevassus, Hugues, additional, Rivier, François, additional, and Carnac, Gilles, additional

Published
2021
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48. Shear Wave Elastography, a New Tool for Diaphragmatic Qualitative Assessment: A Translational Study

Author

Aarab, Yassir, primary, Flatres, Aurelien, additional, Garnier, Fanny, additional, Capdevila, Mathieu, additional, Raynaud, Fabrice, additional, Lacampagne, Alain, additional, Chapeau, David, additional, Klouche, Kada, additional, Etienne, Pascal, additional, Jaber, Samir, additional, Molinari, Nicolas, additional, Gamon, Lucie, additional, Matecki, Stefan, additional, and Jung, Boris, additional

Published
2021
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50. Is treatment with a high flow nasal cannula effective in acute viral bronchiolitis? A physiologic study

Author

Milési, Christophe, Baleine, Julien, Matecki, Stefan, Durand, Sabine, Combes, Clémentine, Novais, Aline Rideau Batista, and Combonie, Gilles

Subjects
Pediatrics, Bronchiolitis, Health care industry
Abstract

Purpose The high flow nasal cannula (HFNC) has recently been proposed to support infants with respiratory syncytial virus (RSV)-related respiratory distress. However, in this disease, no physiologic data are currently available on the effects of this device. We assessed the capacity of HFNC to generate positive airway pressure, as well as the resulting effects on breathing pattern and respiratory effort. Methods Twenty-one infants less than 6 months old with acute RSV bronchiolitis were studied prospectively in the pediatric intensive care unit of a university hospital. Pharyngeal pressure (PP) and esophageal pressure (Pes) were measured simultaneously at four increasing flows of 1, 4, 6 and 7 L/min delivered through HFNC. Results The PP was correlated with flow rate (r = 0.65, p [less than or equal to] 0.0001), reaching mean and end-expiratory values of, respectively, 4 (95% CI 3-5) cmH.sub.2O and 6.5 (95% CI 5-8) cmH.sub.2O at 7 L/min. A flow [greater than or equal to]2 L/kg/min was associated with the generation of a mean pharyngeal pressure [greater than or equal to]4 cmH.sub.2O with a sensitivity of 67 %, a specificity of 96 %, a positive predictive value of 75 %, and a negative predictive value of 94.5%. Only flows [greater than or equal to]6 L/min provided positive PP throughout the respiratory cycle. From baseline to maximal flow rate, breathing frequency (p < 0.01), T.sub.i/T.sub.tot (p < 0.05), Pes swing (p < 0.05) and PTPes.sub.insp/min (p < 0.01), an index of respiratory effort, were reduced. Conclusions HFNC with a flow rate equal to or above 2 L/kg/min generated a clinically relevant PP, with improved breathing pattern and rapid unloading of respiratory muscles, in young infants with acute RSV bronchiolitis., Author(s): Christophe Milési [sup.1] [sup.4], Julien Baleine [sup.1], Stefan Matecki [sup.2] [sup.3], Sabine Durand [sup.1], Clémentine Combes [sup.1], Aline Rideau Batista Novais [sup.1], Gilles Combonie [sup.1] Author Affiliations: (1) grid.121334.6, [...]

Published
2013
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