Hypnosis a Big Help to Kids on a Ventilator
In a small pilot study at the Pediatric Pulmonary Department of Armand Trousseau Hospital in Paris, France, investigators assessed the efficacy of medical hypnosis to reduce anticipatory anxiety and acclimatization time in children who are candidates for long-term ventilator use or NPPV (noninvasive positive pressure ventilation).
The hypnosis was performed by a trained nurse, and acclimatization time and long-term compliance with NPPV were evaluated.
Hypnosis was performed in nine children aged 2 to 15 years. Seven children had a high level of anticipatory anxiety because of a tracheotomy since birth (n=2), a history of maxillofacial surgery (n=2), severe dyspnea because of lung disease (n=2), and morbid obesity and depression (n=1), and two children with obstructive sleep apnea failed standard NPPV initiation.
The hypnosis techniques were based on distraction in the youngest patient and indirect or direct hypnotic suggestions in the older children, to obtain a progressive mind-body relaxation.
All patients accepted the interface and the NPPV after the first hypnosis session. A median of three sessions was needed for overnight (>6 h) NPPV acceptance.
The 6-month compliance with NPPV was excellent, with a median use of 7.5 h per night.
The researchers conclude that medical hypnosis is an effective, safe, noninvasive, and inexpensive tool for reducing the anticipatory distress and acclimatization time for NPPV. Additionally, this therapy seems to be particularly useful in children with traumatic experiences, such as a tracheotomy or facial surgical procedures.
Citation: Delord V, Khirani S, Ramirez A, Joseph EL, Gambier C, Belson M, Gajan F, Fauroux B. Medical hypnosis as a tool to acclimatize children to noninvasive positive pressure ventilation: a pilot study. Chest. 2013 Jul;144 (1): pages 87-91.