Pediatric pulmonology
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Pediatric pulmonology · Sep 2015
Randomized Controlled TrialElectrical activity of the diaphragm during neurally adjusted ventilatory assist in pediatric patients.
Neurally adjusted ventilatory assist (NAVA) is a ventilation mode which provides respiratory support proportional to the electrical activity of the diaphragm (Edi). The aims of this trial were to assess the feasibility of aiming at peak Edi between 5 and 15 µV during NAVA in clinical practice, to study the effect of age, sedation level and ventilatory settings on the Edi signal and to give some reference values for Edi in a pediatric population. ⋯ Optimizing the level of support during NAVA by aiming at a peak Edi between 5 and 15 µV was an applicable strategy in our pediatric population. Relatively high post-extubation Edi signal levels were seen in patients recovering from respiratory distress. Information revealed by the Edi signal could be used to find patients with a potential risk of extubation failure.
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Pediatric pulmonology · Sep 2015
Observational StudyTranscutaneous electromyography of the diaphragm: A cardio-respiratory monitor for preterm infants.
Chest impedance (CI) is the current standard for cardio-respiratory monitoring in preterm infants but fails to provide direct and quantitative information on diaphragmatic activity. Transcutaneous electromyography (dEMG) is able to measure diaphragmatic activity, but its feasibility and repeatability to monitor respiratory rate (RR) and heart rate (HR) in preterm infants needs to be established. ⋯ This study shows that monitoring RR and HR with transcutaneous dEMG is feasible and repeatable in preterm infants.
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Pediatric pulmonology · Aug 2015
Case ReportsSurvival of a child with spinal muscular atrophy and acute respiratory distress syndrome.
Spinal muscular atrophy (SMA), a lower motor neuron anterior horn cell disease, causes significant respiratory morbidity and mortality in children. Acute respiratory distress syndrome (ARDS) accounts for 1-4% of all Pediatric Intensive Care Unit (PICU) admissions. ⋯ He improved with meticulous management of mechanical ventilation, airway clearance, fluid/nutrition, and sedation/analgesia. He was successfully extubated after 14 days of invasive mechanical ventilation and discharged home after a 20 day hospitalization.
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Pediatric pulmonology · Aug 2015
Positional effects on lung mechanics of ventilated preterm infants with acute and chronic lung disease.
The role of prone position in preterm infants has not been completely clarified. We investigated prone versus supine posture-related changes in respiratory system resistance (Rrs) and reactance (Xrs) measured by the Forced Oscillation Technique (FOT) in mechanically ventilated preterm newborns. ⋯ On short-term basis, prone positioning does not offer significant advantages in lung mechanics in mechanically ventilated infants with RDS, while it is associated with lower Rrs values in patients with evolving BPD.