Pediatric pulmonology
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Pediatric pulmonology · Sep 2014
Physiological correlates of pulmonary function in children with cystic fibrosis.
Although peak aerobic capacity (VO(2peak)) has been linked to outcome in patients with cystic fibrosis (CF), measuring is time consuming, and requires expensive equipment and expertise that is not readily available in all centers. Other fitness parameters such as peak anaerobic power, measures of power and strength may be simpler to deliver in the clinic. The relationship between these measures and established outcomes such as forced expiratory volume in one second (FEV(1)) and peak aerobic power (VO(2peak)) in CF remains unclear. Therefore we evaluated (a) aerobic fitness, (b) anaerobic fitness, and (c) upper and lower body muscle strength to determine their relationship to FEV(1) and VO(2peak) in children with CF. ⋯ Simple fitness tests such as hand grip strength and anaerobic cycle tests may be useful indicators of lung health and fitness.
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Pediatric pulmonology · Aug 2014
Pediatric long-term home mechanical ventilation: twenty years of follow-up from one Canadian center.
Canadian longitudinal data from a pediatric domiciliary long-term mechanical ventilation (LTMV) program is lacking. ⋯ In summary, our 20-year retrospective study has shown that there has been an exponential growth in the number of children receiving domiciliary LTMV with the majority of children having favorable outcomes. Our study represents a step towards developing a Canadian registry to design and implement programmatic change for this medically complex population to ensure best practice for these children as well as their families.
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Pediatric pulmonology · Aug 2014
Application of NT-proBNP in ventilator weaning for preterm infants with RDS.
To evaluate the value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels along with spontaneous breathing trial (SBT) in the prediction of ventilator weaning outcome among respiratory distress syndrome (RDS) preterm infants ready to wean. ⋯ NT-proBNP is an independent factor that could predict weaning failure. Measurement of NT-proBNP prior to SBT may be helpful in promoting successful ventilator weaning along with SBT.
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Pediatric pulmonology · Aug 2014
Multicenter StudyThe use of convex probe endobronchial ultrasound-guided transbronchial needle aspiration in a pediatric population: a multicenter study.
The presence of intrathoracic lymphadenopathy and mediastinal masses in the pediatric population often presents a diagnostic challenge. With limited minimally invasive methodologies to obtain a diagnosis, invasive sampling via mediastinoscopy or thoracotomy is often pursued. Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, outpatient procedure that has demonstrated significant success in the adult population in the evaluation of such abnormalities. Within the pediatric literature there is limited data regarding the use of EBUS-TBNA. We report the first multicenter review of a pediatric population undergoing EBUS-TBNA procedures identifying the feasibility, safety, utility, and outcomes of this procedure. ⋯ We report the first multicenter study to date confirming the feasibility and utility of EBUS-TBNA in the pediatric population. Due to the low overall procedural risk of EBUS-TBNA, it should be considered as a potential first line diagnostic option for children presenting with mediastinal or hilar abnormalities but further prospective studies are needed.
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Pediatric pulmonology · Aug 2014
Challenging a paradigm: positional changes in ventilation distribution are highly variable in healthy infants and children.
Current understanding is that infants and children preferentially ventilate non-dependent lungs, a reversal of that of adults, based on studies using krypton-81m ventilation scanning. Participants in these studies had lung disease and were either sedated or ventilated. There is little understanding of the distribution of ventilation in spontaneous breathing healthy infants and children. ⋯ This study demonstrates that the distribution of ventilation in spontaneously breathing infants and children is not as straightforward as previously described. The distribution of ventilation was variably affected by body position with no clear reversal of the adult pattern evident.