Journal of Applied Physiology, Vol 76, Issue 4 1411-1416, Copyright © 1994 by American Physiological Society

ARTICLES

Transmission of pressure across the chest wall during the rapid thoracic compression technique in infants

S. Stick, D. Turner and P. LeSouef
Department of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, West Australia.

During the rapid thoracic compression maneuver in infants, the transmission of pressure from compression jacket to pleural space and airway is less at functional residual capacity than at end inspiration. To examine whether reduced pressure transmission at functional residual capacity vs. higher lung volumes is explained by passive characteristics of the chest wall rather than by respiratory muscle activity, we assessed the pressure transmitted across the chest wall in nine anesthetized infants and young children after muscle relaxation. We measured esophageal and airway occlusion pressure during chest compressions at different lung volumes determined by varying distending pressure. In six subjects studied under static conditions, there was an approximately linear relationship between distending pressure and the proportion of pressure transmitted to the airway and esophagus from the compression jacket. The mean r2 value (95% confidence interval) was 0.80 (0.09) for pressure transmission to the airway and 0.85 (0.04) for pressure transmission to the esophagus. This relationship between lung volume and pressure transmission observed under static conditions was also demonstrated dynamically. Thus the reduced transmission of pressure from compression jacket to airway and pleural space at low lung volumes occurs independently of respiratory muscle activity.

This article has been cited by other articles:

				A. B. GOLDSTEIN, R. G. CASTILE, S. D. DAVIS, D. A. FILBRUN, R. L. FLUCKE, K. S. McCOY, and R. S. TEPPER Bronchodilator Responsiveness in Normal Infants and Young Children Am. J. Respir. Crit. Care Med., August 1, 2001; 164(3): 447 - 454. [Abstract] [Full Text] [PDF]

				M. MODL, E. EBER, E. WEINHANDL, W. GRUBER, and M. S. ZACH Assessment of Bronchodilator Responsiveness in Infants with Bronchiolitis . A Comparison of the Tidal and the Raised Volume Rapid Thoracoabdominal Compression Technique Am. J. Respir. Crit. Care Med., March 1, 2000; 161(3): 763 - 768. [Abstract] [Full Text] [PDF]

				M. HENSCHEN and J. STOCKS Assessment of Airway Function Using Partial Expiratory Flow-Volume Curves . How Reliable are Measurements of Maximal Expiratory Flow at FRC during Early Infancy? Am. J. Respir. Crit. Care Med., February 1, 1999; 159(2): 480 - 486. [Abstract] [Full Text]

				M. Henschen, J. Stocks, A.-F. Hoo, and P. Dixon Analysis of forced expiratory maneuvers from raised lung volumes in preterm infants J Appl Physiol, November 1, 1998; 85(5): 1989 - 1997. [Abstract] [Full Text] [PDF]

				J Stocks, M Henschen, A. Hoo, K Costeloe, and C Dezateux Influence of ethnicity and gender on airway function in preterm infants Am. J. Respir. Crit. Care Med., December 1, 1997; 156(6): 1855 - 1862. [Abstract] [Full Text]

				M. Hayden, P. Sly, S. Devadason, L. Gurrin, J. Wildhaber, and P. LeSouef Influence of driving pressure on raised-volume forced expiration in infants Am. J. Respir. Crit. Care Med., December 1, 1997; 156(6): 1876 - 1883. [Abstract] [Full Text]