Pediatric pulmonology
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Pediatric pulmonology · May 2013
Role of spontaneous breathing trial in predicting successful extubation in premature infants.
The ability of clinicians to predict successful extubation in mechanically ventilated premature neonates is limited. Identifying objective criteria for predicting successful extubation may reduce the incidence of failed extubation and the duration of mechanical ventilation. ⋯ A SBT prior to extubation may be a practical objective adjunct in predicting successful extubation in ventilated premature infants.
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Pediatric pulmonology · Apr 2013
Abbreviated multi-breath washout for calculation of lung clearance index.
Various functional residual capacity (FRC) repeatability criteria have been proposed for lung clearance index (LCI) measurement by multiple breath washout (MBW). Adult guidelines recommend three technically acceptable tests with FRC values within 10%, whilst preschool guidelines recommend two such tests. Feasibility of and need for recommendations in children is unclear. ⋯ Adult FRC repeatability recommendations improved LCI repeatability in pediatric subjects, but poor feasibility limited utility. In an experienced pediatric MBW center, recent preschool recommendations can be extended to two technically acceptable tests, irrespective of FRC repeatability, without significantly affecting mean LCI or compromising sensitivity.
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Pediatric pulmonology · Apr 2013
A 4 year prospective study to determine risk factors for severe community acquired pneumonia in children in southern China.
Pneumonia is the major cause of death under 5 years. With high CAP numbers in China and growing access to PICUs, factors associated with severe CAP need to be determined to optimize care. ⋯ Young age and underlying congenital heart disease were associated factors for PICU support in CAP in China. Early referral if altered sensorium, high respiratory rate, head nodding, grunting and anemia, and universal access to conjugated vaccines may decrease morbidity and mortality.
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Pediatric pulmonology · Mar 2013
Clinical TrialLung ultrasound characteristics of community-acquired pneumonia in hospitalized children.
The diagnosis of community-acquired pneumonia (CAP) is based mainly on the patient's medical history and physical examination. However, in severe cases a further evaluation including chest X-ray (CXR) may be necessary. At present, lung ultrasound (LUS) is not included in the diagnostic work-up of pneumonia. ⋯ LUS is a simple and reliable imaging tool, not inferior to CXR in identifying pleuro-pulmonary alterations in children with suspected pneumonia. During the course of the disease, LUS allows a radiation-free follow-up of these abnormalities.
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Pediatric pulmonology · Mar 2013
Weakly acidic gastroesophageal refluxes are frequently triggers in young children with chronic cough.
To evaluate whether the proportion of acid and weakly acidic refluxes preceding cough bursts could be different in infants, preschool- and school-aged children with chronic, unexplained cough. ⋯ In addition to acid, also a significant proportion of WA GER may precede cough episodes in young children with persistent cough, possibly explaining the inconstant effects of anti-acid treatment on respiratory symptoms.