Questionnaire-based subjective evaluation and analysis of factors influencing the effectiveness of treatment with the vacuum bell in children with pectus excavatum: a cross-sectional observational study

Lihuan Zhou; Fang Deng; Yunfei Tian; Jiayi Lin; Guihong Yang; Yunfei Li; Jos M Latour; Xicheng Deng

doi:10.3389/fped.2024.1467215

Questionnaire-based subjective evaluation and analysis of factors influencing the effectiveness of treatment with the vacuum bell in children with pectus excavatum: a cross-sectional observational study

Front Pediatr. 2024 Oct 7:12:1467215. doi: 10.3389/fped.2024.1467215. eCollection 2024.

Authors

Lihuan Zhou¹, Fang Deng¹, Yunfei Tian¹, Jiayi Lin¹, Guihong Yang^#¹, Yunfei Li¹, Jos M Latour^{2

3}, Xicheng Deng^#¹

Affiliations

¹ Cardiothoracic Surgery Department, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, China.
² Department of Nursing, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, China.
³ School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, United Kingdom.

^# Contributed equally.

Abstract

Background: Vacuum bell (VB) is a technique to treat pectus excavatum in children. Its effectiveness and influencing factors, however, remain under investigated. The aim of this study was to examine the therapeutic effect and its influencing factors of VB in children with pectus excavatum.

Methods: A cross-sectional observational study was conducted. Parents of children with pectus excavatum who underwent treatment with a VB between January 2018 and December 2019 were recruited. A survey was designed based on previously related studies and delivered to the parents in September-October 2021. The therapeutic effect was analyzed using subjective experiences by parents. Factors related to effectiveness were analyzed through univariate analysis and multivariate logistic regression.

Results: Of the 77 surveys distributed, 65 (84%) were returned. The mean duration of VB was 23.20 (SD 9.86) months. Caregivers rated the effect of VB treatment as moderate (41.5%), good (46.2%), excellent (12.3%). There were 39 children (60%) who had at least one pause of using VB for more than two weeks. Univariate analysis showed no significant difference between age, height, weight, duration of VB (months) and the effectiveness of VB therapy as defined by caregivers (p > 0.05) and significant difference were observed of the variables "complication of petechiae" (p = 0.034) and "device returned to manufacturer for repair" (p = 0.011). The multivariate logistic regression showed that the occurrence of complication petechiae (p = 0.046) was an influential factor for the effectiveness of VB.

Conclusions: The evaluations reported by the parents suggested that the VB treatment was effective, although with varying degrees. The complication of petechiae seems an influencing factor to successful VB treatment in children with pectus excavatum. Further studies are needed to assess the long-term outcome and effect of VB and to improve the device and to reduce complications in order to enhance compliance and improve effectiveness.

Keywords: caregivers; children; compliance; pectus excavatum; vacuum bell.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by Health Commission of Hunan Province (C202304028427) and Hunan Provincial Science and Technology Department (2021SK50521).