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Please note: While some information will still be current in a year, other information may already be out of date in three months time. If you are in any doubt, please feel free to ask.

Thoracic hyperinflation


The last thoracic X-ray of my 3.5 years-old daughter revealed a thoracic hyperinflation. What does that exactly means? Is it temporary or permanent? My physiotherapist told us that a belt could help her. How considering the follow-up when such a hyperinflation is observed at a such young age?

A thoracic hyperinflation is one of the first X-ray abnormalities that could be detected very young in cystic fibrosis patients, even in patients without respiratory symptoms. It is frequently secondary to trapped air in the small airways/alveoli: the air is trapped because of obstructions due to thick mucus. When a thoracic hyperinflation is revealed by a thoracic X-ray, other explorations are usually proposed like pulmonary function tests that confirm the gas trapped. You could ask your CF center to detail for you the results of these explorations.
When such a hyperinflation is revealed by these explorations, additional therapies could be prescribed. They are, of course, very dependent of the various treatments your daughter is already receiving. Usually these therapies are inhaled, like hypertonic saline or rhDnase (Pulmozyme®) and are more frequently prescribed in older kids. These therapies aimed at decreasing the mucus viscosity, that leads to decrease the obstruction and, then, the thoracic hyperinflation.
Your physiotherapist proposed the use of a belt. There are indeed large and flexible belts that are well supported by young kids. Generally, the physiotherapists recommend placing the belt a few hours before the chest physiotherapist's session to help the distal territories clearance. The results seam good and trials are currently ongoing to confirm the belt efficacy. Your physiotherapist will, of course, propose several different techniques over the time, so your daughter won’t grow tired and will continue to actively participate to the sessions.

We hope to have responded to your interrogations and stay at your disposal if you have new questions.

Best regards

Harriet Corvol (Pediatrician) et Eric Beauvois (head of the French CF Physiotherapist Association)