Pediatric pulmonology
-
Pediatric pulmonology · Feb 1998
ReviewEvidence-based pediatric pulmonary medicine: how can it help?
Evidence-based medicine aims to identify, critically appraise, and apply the best available evidence in making decisions about the care of patients. These aims are similar to those conscientious clinicians have always sought to achieve, but an evidence-based approach applies a systematic and rigorous methodology to this process to ensure that the evidence applied is relevant and of high quality. Because of the volume of potentially relevant information that needs to be accessed from the medical literature, many clinicians rely on reviews of the evidence. ⋯ These challenges include diagnostic uncertainty, lack of objective endpoints, and aspects of generalizability of randomized controlled trials. Despite these difficulties, there are now many examples of systematic reviews and evidence-based approaches in pediatric pulmonology. If applied appropriately, they can ensure that management of patients is based on clinically useful diagnostic tests and treatments that have been shown to be effective and not harmful.
-
Pediatric pulmonology · May 1996
ReviewSurfactant replacement therapy for adult respiratory distress syndrome in children.
Surfactant replacement therapy may have a role in the treatment of ARDS in children. The current studies suggest that rapid instillation of exogenous surfactant is more effective than slow tracheal instillation or aerosolized delivery. Studies suggest that exogenous surfactant given early in the development of ARDS is more effective than therapy provided late in the course of the disease. ⋯ Well-planned placebo-controlled trials will be required to determine these differences. The data supporting the role of surfactant replacement for the treatment of ARDS in children is growing. However, before widespread use of surfactant is considered, a multi-center, placebo-controlled trial will be required to establish the safety and efficacy of surfactant replacement in such patients.
-
Pediatric pulmonology · Apr 1992
Editorial Review Comparative StudyIs there room for another pediatric bronchoscope?