• Jéssica Danielle Medeiros da Fonsêca, Resqueti Vanessa Regiane VR PneumoCardioVascular Lab, Hospital Universitário Onofre Lopes, Natal, Rio Grande do Norte, Brazil. , Kadja Benício, Valéria Soraya de Farias Sales, Luciana Fontes Silva da Cunha Lima, Andrea Aliverti, Antonio Sarmento, and Guilherme Augusto de Freitas Fregonezi.
• PneumoCardioVascular Lab, Hospital Universitário Onofre Lopes, Natal, Rio Grande do Norte, Brazil.
• Respir Care. 2020 Sep 1; 65 (9): 1285-1294.

BackgroundWe sought to evaluate the acute effects of different inspiratory loads using nasal and oral interfaces on the volumes of the chest wall and its compartments, breathing pattern, and respiratory muscle activation in children with mouth-breathing syndrome.MethodsChildren with mouth-breathing syndrome were randomized into 2 groups, one with an inspiratory load intensity 20% of maximum inspiratory pressure (n = 14), and the other with an inspiratory load intensity 40% of maximum inspiratory pressure (n = 15). The chest wall volumes and electromyography of sternocleidomastoid, rectus abdominis, scalene, and internal intercostal muscles were used to analyze respiration against the 2 load intensities and using 2 interfaces (ie, nasal and oral).ResultsA total of 72 children with mouth-breathing syndrome were recruited, and 29 were evaluated in this study. The use of inspiratory load promoted improvement in the components of the breathing pattern: breathing frequency (P = .039), inspiratory time (P = .03), and total respiratory time (P = .043); and increases in tidal volume (P < .001), end-inspiratory volume (P < .001), and electrical activity of scalene muscles and sternocleidomastoid muscles (P < .001) when compared to quiet breathing. The load imposed via a nasal interface versus an oral interface provided an increase in tidal volume (P = .030), end-inspiratory volume (P = .02), and electrical activity of scalene muscles (P < .001) and sternocleidomastoid muscles (P = .02).ConclusionsThe use of acute inspiratory loads improved the breathing pattern and increased lung volume and electrical activity of inspiratory muscles. This work brings new perspective to the investigation of using nasal interfaces during the application of inspiratory loads. The nasal interface was more effective compared to the oral interface commonly used in clinical practice.Copyright © 2020 by Daedalus Enterprises.

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