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Heliox simulations for initial management of congenital laryngotracheal stenosis.
Del Puppo, Marine; Meister, Lionel; Médale, Marc; Allary, Chloé; Nicollas, Richard; Moreddu, Eric.
Afiliación
  • Del Puppo M; Department of Pediatric Otolaryngology Head and Neck Surgery, La Timone Children's Hospital, AP-HM, Aix Marseille Université, Marseille, France.
  • Meister L; Energetic Mechanics Department, Institut Universitaire des Systèmes Thermiques et Industriels, UMR 7343 CNRS, Aix Marseille Université, Marseille, France.
  • Médale M; Energetic Mechanics Department, Institut Universitaire des Systèmes Thermiques et Industriels, UMR 7343 CNRS, Aix Marseille Université, Marseille, France.
  • Allary C; Energetic Mechanics Department, Institut Universitaire des Systèmes Thermiques et Industriels, UMR 7343 CNRS, Aix Marseille Université, Marseille, France.
  • Nicollas R; Department of Pediatric Anesthesia and Intensive Care, La Timone Children's Hospital, AP-HM, Aix Marseille Université, Marseille, France.
  • Moreddu E; Department of Pediatric Otolaryngology Head and Neck Surgery, La Timone Children's Hospital, AP-HM, Aix Marseille Université, Marseille, France.
Pediatr Pulmonol ; 58(1): 230-238, 2023 01.
Article en En | MEDLINE | ID: mdl-36208011
OBJECTIVES: Congenital laryngotracheal stenosis is rare, potentially severe, and difficult to manage. Heliox is a medical gas effective in obstructive airway pathologies, given its physical properties. This study aims to model the interest of Heliox in reducing the respiratory work in congenital laryngotracheal stenosis, using numerical fluid flow simulations, before considering its clinical use. DESIGN: This is a retrospective study, performing Computational Fluid Dynamics numerical simulations of the resistances to airflow and three types of Heliox, on 3D reconstructions from CT scans of children presenting with laryngotracheal stenosis. PATIENTS: Infants and children who were managed in the Pediatric ENT department of a tertiary-care center and underwent CT scanning for laryngotracheal stenosis between 2008 and 2018 were included. RESULTS: Fourteen models of congenital laryngotracheal stenosis were performed in children aged from 16 days to 5 years, and one model of the normal trachea in a 5-year-old child. Tightest stenosis obtained the highest airway resistances, ranging from 40 to 10 kPa/L/s (up to 800 times higher than in the normal case). Heliox enabled a decrease in pressure drops and airway resistances in all stenosis cases, correlated to increasing Helium concentration. CONCLUSIONS: Heliox appears to reduce pressure drops and airway resistances in 3D models of laryngotracheal stenosis. It may represent a supportive treatment for laryngotracheal stenosis, while waiting for specialized care, thanks to the reduction of respiratory work.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis Traqueal / Laringoestenosis Tipo de estudio: Observational_studies Límite: Child / Child, preschool / Humans / Infant Idioma: En Revista: Pediatr Pulmonol Asunto de la revista: PEDIATRIA Año: 2023 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis Traqueal / Laringoestenosis Tipo de estudio: Observational_studies Límite: Child / Child, preschool / Humans / Infant Idioma: En Revista: Pediatr Pulmonol Asunto de la revista: PEDIATRIA Año: 2023 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos