Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)
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Intermittent mandatory ventilation (IMV) is a mode of ventilation that allows the patient to make spontaneous breaths during the expiratory phase of mandatory ventilator breaths. There are two types of IMV according to whether respirator breaths are synchronized with the patient's respiratory efforts: Non-synchronized IMV and synchronized IMV (SIMV), and according to whether SIMV is volume- or pressure programmed. The main advantage of SIMV is that the respirator delivers the preset ventilator pressure and rate while allowing the patient to breath spontaneously, thus facilitating progressive weaning from mechanical ventilation. It diminishes the risk of barotrauma, produces less hemodynamic com-promise than control ventilation, reduces atrophy of respiratory muscles and the need for sedation and muscle relaxation and can be associated with pressure support ventilation.
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To study the utility and efficacy of transpyloric enteral nutrition (TEN) in critically-ill children by analyzing the factors that determine enteral tolerance. ⋯ TEN is a useful method of nutrition in critically-ill children.
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To determine the profile of neonatal visits to a pediatric emergency service and to compare this profile with that of other pediatric age groups. ⋯ Most neonatal utilization of emergency services is due to trivial problems that could be solved in primary care. Appropriate training is required to avoid unnecessary tests without overlooking potentially serious conditions.
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In the last few years new mechanical ventilation modalities have been developed that aim to improve the characteristics of mechanical ventilation and its adaptation to the patient. Volume-programmed and pressure-controlled ventilation (volume-controlled pressure-adjusted, adaptable pressure ventilation, autoflow ventilation) attempt to combine the advantages of volume and pressure ventilation by controlling volume but with decelerated flow. These types of ventilation can be programmed in controlled, assisted, intermittent mandatory ventilation, or support ventilation mode. ⋯ These new modalities can improve the adaptation of mechanical ventilation to the patient. None of these modalities are superior to the others. The choice of ventilation mode should be individualized according to each patient's characteristics.
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To provide good asthma care to children and adolescents the following conditions are required: well-trained health professionals with the structure and resources necessary to perform their work efficiently, and client satisfaction as a measure of compliance and self-management. The aims of this study were to determine the current situation of asthma management by primary care pediatricians and to promote improvement of the healthcare and quality of life of these children and their families. ⋯ This is the first study to present results on the current situation of asthma management by primary care pediatricians in Spain. The results show the need to improve record-keeping, facilitate the resources required for diagnosis and follow-up and prioritize education in order to achieve an optimal level of self-management by patients and their families.