Pediatric pulmonology
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With the progression of Duchenne muscular dystrophy (DMD) cough becomes inefficient leading to recurrent chest infections. Several factors determine the effectiveness of cough in DMD patients. The aim of this study was to investigate how weakened inspiratory muscles alter operating lung and thoraco-abdominal volumes and whether they contribute to cough efficiency. ⋯ Inefficient cough in DMD is associated to reduced operating lung and chest wall volume secondary to weakened inspiratory muscles. Abdominal contribution to tidal volume during spontaneous breathing represents a non-volitional and noninvasive index able to discriminate efficient and inefficient cough.
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Pediatric pulmonology · Apr 2014
Case ReportsCongenital central hypoventilation syndrome; safety of early transition to non-invasive ventilation.
Congenital central hypoventilation syndrome (CCHS) is a rare disorder of autonomic dysregulation, characterized by alveolar hypoventilation especially during sleep. As a result, lifelong ventilatory assistance is necessary in these patients. ⋯ Associated complications and psychosocial pressure may prompt early transition to non-invasive ventilation. We present the details of a patient with CCHS who successfully transitioned from tracheostomy to bilevel positive airway pressure ventilation at an early age of 3 years.
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Pediatric pulmonology · Apr 2014
Colistin inhalation monotherapy for ventilator-associated pneumonia of Acinetobacter baumannii in prematurity.
Ventilator-associated pneumonia (VAP) caused by Acinetobacter baumannii is increasing. It has a high mortality rate but experience in using inhaled colistin as monotherapy for VAP in children, especially pre-term infants, is limited. This study presents experiences using aerosolized colistin as monotherapy for VAP due to A. baumannii infection in pre-term infants. ⋯ Aerosolized colistin may be used as monotherapy for VAP due to A. baumannii infection in pre-term infants. A larger controlled study is warranted to corroborate the findings.
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Pediatric pulmonology · Mar 2014
Prevalence of pediatric periodic leg movements of sleep after initiation of PAP therapy.
Positive-airway-pressure (PAP) is a treatment for obstructive-sleep-apnea (OSA). In adults, initiation of PAP-therapy may unmask periodic-limb movements-of-sleep (PLMS). We present a series of children in whom PLMS was aggravated or induced following initiation of PAP therapy. ⋯ PLMS were seen in 5.1% of children after initiation of PAP. OSA may mask PLMS, which appears as breathing improves. Alternatively, PAP may unmask or induce PLMS. PLMS may potentially be a cause of treatment failure in children on recent-onset PAP therapy.
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Pediatric pulmonology · Mar 2014
Case ReportsA case of mucoepidermoid carcinoma of the bronchus presented with hydropneumothorax in a child.
Mucoepidermoid carcinoma is a rare pulmonary neoplasm seen in the pediatric population. We report a low grade mucoepidermoid carcinoma in a 12-year-old boy who presented with spontaneous pneumothorax.