Respiratory muscle testing allows a quantitative assessment of inspiratory and expiratory muscles in children of any age with primary or secondary respiratory muscle impairment, in order to better understand the pathophysiology of respiratory impairment and guide therapeutic management. The use of an invasive technique (esogastric probe) makes it possible to specifically explore the diaphragm, the accessory inspiratory muscles and the expiratory muscles in order to detect dysfunction or paralysis of these muscles, and to estimate the work of breathing in order to better guide the respiratory management.
The primary objective of the study is to evaluate the respiratory effort in children with primary or secondary impairment of the respiratory muscles during spontaneous breathing or during mechanical ventilation.
Patients aged less than 18 years old with primary or secondary impairment of respiratory muscles and followed at Necker Hospital
Patients under spontaneous breathing or noninvasive or invasive mechanical ventilation
Written informed consent
No social insurance
Significant psychomotor retardation
Absence of cooperation
Significant agitation
Single group
Esogastric pressure measurement
Other interventionMeasurement of work of breathing and respiratory muscles strength using an esogastric catheter. One measurement or before and after (6 months and 1 year) the initiation of a pharmacological treatment in order to assess the effect of the treatment on respiratory muscle function.
Esophageal pressure-time product (PTPoes)
The integral of the esophageal pressure signal over inspiratory time
Diaphragmatic pressure-time product (PTPdi)
The integral of the transdiaphragmatic pressure signal over inspiratory time
Work of breathing (WOB)
Total work of breathing (WOBt) is calculated (in Joules/L) as the area under the pressure-volume curve, using the Campbell diagram. Elastic (WOBe) and resistive (WOBr) are estimated as the 2/3 and 1/3 of WOBt value, respectively.
Vital capacity
Vital capacity is the maximum amount of air a person can expel from the lungs after a maximum inhalation, using spirometry
Maximal respiratory static pressures
Maximal static inspiratory and expiratory airway pressures
Maximal sniff pressure
Airway pressure during a sniff test
Maximal whistle pressure
Airway pressure during a whistle test
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Assistance Publique - Hôpitaux de Paris
Lead sponsor
URC-CIC Paris Descartes Necker Cochin
Collaborator
