[69] Children with Bronchial Hyperresponsiveness
The principal subject of my research activity is anaesthesia management of children with bronchial hyperresponsiveness (BHR). The choices of the optimal anaesthetic agent and its interaction with respiratory mechanics have been investigated both clinically and experimentally. My research projects have been focused on respiratory mechanics and implemented in Geneva the technique of partitioning lung mechanics into airway and tissue components by using the low-frequency forced oscillatory technique (LFFOT). This technique was first applied experimentally in rodents with healthy and diseased lungs. My group then developed 2 models of BHR in guinea pigs and in rabbits. These models have been validated and allow the investigation of the action of different anaesthetic agents on both the airways and the parenchymal mechanical parameters under wide variety of conditions encountered in clinical practice. The LFFOT was also used in healthy children, and in children with BHR and congenital heart disease. The application of this technique to both experimental and clinical studies and the accomplishment of these research projects have been achieved with a strong collaboration with Professor Z. Hantos, from the Dept of Medical Informatics at the University of Szeged-Hungary, and Professor P. D. Sly, from the Institute for Child Health Research at the University of Western Australia.
The new ongoing research programs are aiming at extending these previous investigations towards 2 new areas:
- To combine respiratory mechanical measurements with an in vivo moprohological technique using synchrotron radiation imaging. With the combination of state-of-the-art lung functional and structural measurements, this project has a promise to better characterize the pathophysiological mechanisms leading to BHR.
- To better understand diseases such as pulmonary hypertension, acute lung injury and left ventricular failure, that all lead to a serious imbalance between the lung mechanics and pulmonary haemodynamics.