title: [Thoraco-abdominal binding in the treatment of overdistention of the lung bases in children].
abstract: In the patient with homogeneously or inhomogeneously distributed atelectasis, localized primarily in the apices, overdistension of the non-dependent portion of the lung bases, only partially surrounded by the rib cage, is generally observed during mechanical ventilation. This phenomenon is even more pronounced in the neonate and in the infant because their rib cage compliance is almost infinite. In order to protect the lung bases in the event of their overdistension and/or to reexpand the atelectasis of the upper lobes we apply an external resistance, in form of thoracoabdominal binding, to limit the movement of the diaphragm. The degree of the binding's tension is regulated according to the degree of the distension of the lung bases detected on chest x-ray. This restriction was so far applied in 12 children using elastic bandages. We have used the thoraco-abdominal binding with good result in the treatment of atelectasis of the upper lobes, in extensive atelectasis as well as in the treatment of primitive lung bases overdistension, as described in 3 cases reports. We suggest this technique in order to obtain an homogeneous ventilation along the longitudinal axis of the lung. This method does not interfere with prone-supine postural changes, systematically applied in our department, and therefore, the homogeneous ventilation along the vertical axis is also provided.
authors.affiliation: Divisione di Anestesia e Rianimazione, Ospedale San Carlo Borromeo, Milano.
authors.forename: D
authors.initials: D
authors.lastname: Ripamonti
authors.forename: A
authors.initials: A
authors.lastname: Favero
authors.forename: A
authors.initials: A
authors.lastname: Fantoni
mesh_terms: D000005:Abdomen; D001458:Bandages; D003250:Constriction; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D001261:Pulmonary Atelectasis / Q000628:therapy*; D012121:Respiration, Artificial / Q000009:adverse effects*; D013909:Thorax
vernacular_title: Il binding toraco-addominale nel trattamento della sovradistensione delle basi polmonari nel bambino.