The Hering-Breuer reflex in ventilated children. 1996

F Giffin, and A Greenough, and S Naik
Department of Child Health, King's College Hospital, London, U.K.

The authors tested the hypothesis that, in the paediatric population, the Hering-Breuer reflex would be provoked by the positive pressure inflation of mechanical ventilation (IPPV), and that the strength of the reflex would relate to the child's age and compliance of the respiratory system (CRS). During IPPV, changes in air flow, volume and airway pressure were recorded simultaneously. From the traces, expiratory times and CRS were calculated. The mean expiratory time (Te1) prior to each inflation and the mean expiratory time (Te2) immediately following an inflation were determined. The presence of the reflex was indicated by Te2 being longer than Te1, and the strength of the reflex was calculated as the difference between Te2 and Te1 expressed as a percentage of Te1. Twenty children were studied who had a mean age of 0.7 years (range 0.1-9.8 years). The reflex was provoked in 19 of the 20 patients and was not seen in the oldest patient. The strength of the reflex varied from 22 to 144% and was inversely related to postnatal age significantly (r = -0.73) but not CRS or inflation volume. It is concluded that the Hering-Breuer reflex is provoked during IPPV in young children; whether, as in neonates, this influences the efficacy of ventilation deserves investigation.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D011175 Positive-Pressure Respiration A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange. Positive End-Expiratory Pressure,Positive-Pressure Ventilation,End-Expiratory Pressure, Positive,End-Expiratory Pressures, Positive,Positive End Expiratory Pressure,Positive End-Expiratory Pressures,Positive Pressure Respiration,Positive Pressure Ventilation,Positive-Pressure Respirations,Positive-Pressure Ventilations,Pressure, Positive End-Expiratory,Pressures, Positive End-Expiratory,Respiration, Positive-Pressure,Respirations, Positive-Pressure,Ventilation, Positive-Pressure,Ventilations, Positive-Pressure
D012018 Reflex An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord.
D012119 Respiration The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration ( Breathing
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000375 Aging The gradual irreversible changes in structure and function of an organism that occur as a result of the passage of time. Senescence,Aging, Biological,Biological Aging

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