Pediatric pulmonology
-
Pediatric pulmonology · Nov 2015
The prevalence of sleep-disordered breathing in children with asthma and its behavioral effects.
To determine the prevalence of sleep-disordered breathing (SDB) in children with asthma compared to non-asthmatic children and to determine if behavior problems are associated with asthma and SDB. ⋯ There was a higher prevalence of SDB in asthmatic children compared to non-asthmatic children and the prevalence of SDB increased with increasing asthma severity. In multivariate analysis the role of asthma was much less clear as it predicted a positive PSQ in girls but not boys. SDB, but not asthma, was an independent predictor of behavioral problems.
-
Pediatric pulmonology · Nov 2015
Airway obstruction, upper airway artifact and response to bronchodilator in asthmatic and healthy children.
The forced oscillation technique (FOT) may be affected by the upper airway artifact in children with airway obstruction. The aim was to test the impact of the artifact on FOT ability to diagnose asthma in children as recommended by current guidelines. ⋯ In asthmatic children, the upper airway artifact significantly impacts FOT measurements. The diagnostic value may be improved by minimization of the shunt, such as the computation of Δ%Ars.
-
Pediatric pulmonology · Nov 2015
Comparison of HFNC, bubble CPAP and SiPAP on aerosol delivery in neonates: An in-vitro study.
Aerosol drug delivery via high flow nasal cannula (HFNC), bubble continuous positive airway pressure (CPAP), and synchronized inspiratory positive airway pressure (SiPAP) has not been quantified in spontaneously breathing premature infants. ⋯ Aerosol can be delivered via all three devices used in this study. Device selection and nebulizer position impacted aerosol delivery in this simulated model of a spontaneously breathing preterm infant.
-
Pediatric pulmonology · Nov 2015
RSV: Immunoprophylaxis and non-invasive respiratory support in ex-preterms: A northern UK perspective.
Recent guidance has suggested that immunoprophylaxis with monoclonal antibody against respiratory syncytial virus (RSV) should be extended to ex-preterm infants who are moderate-to-late-preterm and discharged home during the RSV season. Noninvasive respiratory support (NIV) for infants with bronchiolitis is becoming widespread with little supporting evidence for efficacy over nonpressure support methods. We used multicentre prospective audit and service evaluation to evaluate whether extension of current practice in line with the guidance would provide a clinical or cost benefit, and whether NIV provides any benefits in the ex-preterm population. ⋯ NIV use has been widely adopted (9% of 'bronchiolitic' admissions) in our region but the data do not support it as a useful adjunct for ex-preterms with RSV positive illness requiring respiratory support: it does not appear to reduce the need for subsequent formal ventilation. Our study does not support a case for change to more widespread, protocol driven immunisation for RSV. Further research is needed in a randomised, controlled setting to examine the use of NIV in bronchiolitis in a wider context.