Full title: Medical hypnosis as a tool to acclimatize children to non-invasive positive pressure ventilation: a pilot study.

Patient cooperation is crucial for success of non-invasive positive pressure ventilation (NPPV). This study evaluated the efficacy of medical hypnosis to reduce the anticipatory anxiety and the acclimatization time in children candidates for long-term NPPV. METHODS Medical hypnosis was performed by a trained nurse. The acclimatization time and long-term compliance with NPPV were evaluated. RESULTS Hypnosis was performed in 9 children, aged 2 to 15 years old; 7 children with a high level of anticipatory anxiety because of a tracheotomy since birth (2 patients), a history of maxillofacial surgery (2 patients), severe dyspnea due to lung disease (2 patients), morbid obesity and depression (1 patient), and 2 children with obstructive sleep apnea who 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, in order to obtain a progressive psycho-corporal relaxation. All the patients accepted the interface and the NPPV after the first hypnosis session. A median of three sessions was needed for overnight (> 6 hours) NPPV acceptance. The 6-months compliance with NPPV was excellent with a median use of 7.5 hours/night. CONCLUSION Medical hypnosis is a very effective, safe, non-invasive, and cheap tool for reducing the anticipatory distress and acclimatizing time for NPPV. This therapy is particularly useful in children with traumatic experiences such as a tracheotomy or facial surgical procedures.

Chest. 2013 Feb 7. doi: 10.1378/chest.12-2259. Delord V, Khirani S, Ramirez A, Joseph EL, Gambier C, Belson M, Gajan F, Fauroux B.

Asthma is a chronic disease with intermittent acute exacerbations, characterized by obstructed airways, hyper-responsiveness, and sometimes by chronic airway inflammation. Critically reviewing evidence primarily from controlled outcome studies on hypnosis for asthma shows that hypnosis is possibly efficacious for treatment of symptom severity and illness-related behaviors and is efficacious for managing emotional states that exacerbate airway obstruction. Hypnosis is also possibly efficacious for decreasing airway obstruction and stabilizing airway hyper-responsiveness in some individuals, but there is insufficient evidence that hypnosis affects asthma's inflammatory process. Promising research needs to be replicated with larger samples and better designs with careful attention paid to the types of hypnotic suggestions given. The critical issue is not so much whether it is used but how it is used. Future outcome research must address the relative contribution of expectancies, hypnotizability, hypnotic induction, and specific suggestions.

Harvard Medical School, Cambridge, Massachusetts, USA. danbrown1@rcn.com

Researchers from B. J. Medical College in Ahmedabad, India, studied numeric measures of respiratory function, cardiovascular parameters and lipid profiles of those practicing Raja Yoga meditation. The profiles of short and longterm meditators were compared with those of non-meditators.

[More]

In a randomized, controlled, clinical trial, researchers from Saybrook Graduate School in San Francisco compared outcomes between biologically targeted imagery (BTI) and critical thinking asthma management (CTAM). Among 70 adults (53 women, 17 men) with asthma at Alaska Regional Hospital in Anchorage.

[More]

Researchers from Tai Po Hospital in Hong Kong explored the effects of guided imagery and relaxation in people with chronic obstructive pulmonary disease (COPD), using a randomized controlled design. Half of 26 participants were allocated to the treatment group, consisting of six practice sessions of guided imagery, while the control group was instructed to rest quietly during the six sessions. At the seventh session, physiological measures were taken and compared to previously, to see if there were any changes in partial percentage of oxygen saturation, heart rate, upper thoracic surface electromyography, skin conductance and peripheral skin temperature.

[More]