Air intussusception reduction: "the winds of change".
AIR is an excellent example of the application of the scientific process to the treatment of pediatric disease. For more than 40 years, pediatric radiologists in North America were comfortable with hydrostatic enemas for the diagnosis and treatment of intussusception. Initial clinical trials in the 1980s suggested the efficacy of AIR. Subsequent clinical studies demonstrated that fluoroscopy time and radiation are less, accurate pressure measurements are possible, and reduction rates are higher with AIR than with hydrostatic techniques. Questions regarding safety and types of perforation were answered in the laboratory with an animal model. Moreover, this experimental work clarified issues regarding maximum pressures and the importance of the Valsalva maneuver during AIR. Experimental data has been transferred to the radiological treatment of childhood intussusception. The "winds of change", generated by clinical and basic research, have now swept across North America. More and more radiologists are performing AIR. Many of the pediatric radiologists who still doubt the efficacy of AIR have had no experience with the technique. Air insufflation is safe and effective for the diagnosis and treatment of intussusception in infants and children. It is replacing the hydrostatic enema in an ever-increasing number of institutions. AIR is quicker, safer, and more effective than hydrostatic enemas. If you are using AIR, I hope this overview will further improve the radiological care of your pediatric patients. If you are not using AIR, I hope that these personal observations will stimulate your interest. "Try it; you'll like it!"
Kirks
D R
DR
Department of Radiology, Children's Hospital, Boston, MA 02115, USA.
D000388:Air; D002648:Child; D003106:Colon / Q000293:injuries; D004733:Enema / Q000009:adverse effects; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology; D007443:Intussusception / Q000628:therapy*; D011029:Pneumoradiography / Q000009:adverse effects