Optoelectronic plethysmography demonstrates abrogation of regional chest wall motion dysfunction in patients with pectus excavatum after Nuss repair

Abstract Purpose We previously demonstrated that patients with pectus excavatum (PE) have significantly decreased chest wall motion at the pectus defect compared with the rest of the chest vs unaffected individuals and use abdominal respiratory contributions to compensate for decreased upper chest w...

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Bibliographic Details
Published in:Journal of pediatric surgery 2012, Vol.47 (1), p.160-164
Main Authors: Redlinger, Richard E, Wootton, Ashley, Kelly, Robert E, Nuss, Donald, Goretsky, Michael, Kuhn, M. Ann, Obermeyer, Robert J
Format: Article
Language:English
Subjects:
Adolescent
Electronics, Medical
Female
Funnel Chest - physiopathology
Funnel Chest - surgery
Humans
Male
Minimally invasive
Motion analysis
Nuss
Optical Phenomena
Pectus excavatum
Pediatrics
Plethysmography
Plethysmography - methods
Prospective Studies
Surgery
Thoracic Wall - physiopathology
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Summary:Abstract Purpose We previously demonstrated that patients with pectus excavatum (PE) have significantly decreased chest wall motion at the pectus defect compared with the rest of the chest vs unaffected individuals and use abdominal respiratory contributions to compensate for decreased upper chest wall motion. We hypothesize that PE repair will reverse chest wall motion dysfunction. Methods A prospective, institutional review board–approved study compared patients with PE before and after Nuss repair. Informed consent was obtained before motion analysis. Sixty-four patients with uncorrected PE ages 10 to 21 years underwent optoelectronic plethysmography analysis. Repeat analysis was performed in 42 patients 6 months postoperative (PO). Results Volume of the chest wall and its subdivisions were calculated. Total chest wall volume at rest was significantly increased after repair and in each thoracic compartment. PO patients developed increased midline marker excursion at the pectus defect and significantly decreased excursion at the level of the umbilicus. Conclusions Optoelectronic plethysmography kinematic analysis demonstrates that chest wall remodeling during Nuss repair results in increased thoracic volume. Chest wall motion dysfunction at the pectus defect is reversed after Nuss repair. Abdominal respiratory contributions are also markedly decreased. These findings may help to explain why patients with PE report an improvement in endurance after the Nuss procedure.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2011.10.038