Lung volume recruitment: How it helps your child to take a deep breath

A healthy child can usually take in a deep breath to fill their lungs to their maximum volume. It is important to be able to take a deep breath to give the lungs a chance to clear mucus when breathing out.

What is lung volume recruitment?

Lung volume recruitment (LVR) is a way of filling the lungs using a source of air and a mouthpiece, facemask or tracheostomy adaptor. Air is pushed in from the air source while a child takes in a breath. This helps inflate the lung and stretch the muscles of the chest wall.

A child with weak chest muscles might find it difficult to breathe in deeply. Over time, under-filling the lungs can lead to:

• tightening of the chest wall muscles
• stiffening of the lungs
• areas of lung collapse called atelectasis

Using LVR can slow down these effects and help prevent lung infections such as pneumonia.

Who may benefit from LVR?

A child may benefit from LVR to help clear mucus if they have:

• a disease causing weak muscles, such as:
• spinal muscular atrophy (SMA)
• muscular dystrophy
• a spinal cord injury
• a tracheostomy, ventilator or other supports to help them breathe

What are the risks of LVR?

Although safe when used properly, LVR carries the following low risks:

• pneumothorax (air leak in the lungs) if too much force is used
• air entering the stomach and causing discomfort if child is not co-ordinated with therapy

Always stop doing LVR immediately if your child experiences chest pain, chest tightness or shortness of breath.

How do I perform LVR?

1. Your child will wear or use a facemask, mouthpiece or a tracheostomy adaptor.
2. While your child takes in a breath, you will squeeze a manual resuscitation bag that is attached to your child’s device and push extra air into your child’s lungs.
3. You will repeat this several times without the child breathing out. This is sometimes called “breath stacking” and helps to inflate the lungs fully and stretch the chest wall muscles.
4. After several breaths are “stacked”, your child will breathe out. The air will leave the lungs quickly, taking any mucus with it.

If your doctor decides that LVR is right for your child, a respiratory therapist (RT) will meet with you to teach you how to do it and review the equipment that best meets your child’s needs.

How much does LVR equipment cost?

Speak to your doctor about the costs of LVR equipment and which costs you need to cover and which may be covered by health insurance.