PURPOSE: Pressure has been used since the early 1970s by burn care providers to help minimize the formation of hypertrophic scars. Compressive jackets are used in infants with thoracic burns.Physiologically it is known that the newborn and infant have high chest wall compliance. The chest wall is easily distorted and the breathing strategy is different from that in adults.The aim of our study was to determine whether compressive jackets would disturb breathing in the children, especially during sleep.
METHODS: The study population includes infants under 2 years of age with thoracic burns diagnosed in our institution between April 2000 and November 2005. The study design was a prospective case-control study. All infants underwent pulmonary function testing (PFT) wearing compressive jacket, with the vest unfastened and fastened. Tidal breathing and single occlusion technique measurements were done according the ATS/ERS recommendations for infant respiratory function testing. Paired t-tests were performed.
RESULTS: Nineteen out of 24 patients completed the study. The oxygen saturation dropped by 1.27 % after sedation. We analysed the variation with the vest unfastened and fastened for each value. The following differences were noted with the vest fastened: a mean decrease of 0.67% in oxygen saturation; a decrease of 0.71 cc/kg in tidal volume; an increase in respiratory rate of 4.5 breath per minute; an increase in minute ventilation and PTEF/Vt of 17.41 cc/min and 0.18 respectively; a decrease in compliance of 0.38 cc/cm H20/Kg.All these differences are statistically significant for a p-value under 0.05, but are not considered clinically significant. The residual functional capacity decreased by 1.78 cc (p>0.05).
CONCLUSION: In our study population oxygen saturation, ventilation and respiratory compliance were not significantly affected.
CLINICAL IMPLICATIONS: Healthy infants are able to adapt to the compressive jacket by slightly increasing their respiratory rate, thus keeping their oxygen saturation within the normal range.
DISCLOSURE: Karin Giebels, None.