Pediatric pulmonology
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Pediatric pulmonology · Sep 2012
Non-invasive ventilation for severe bronchiolitis: analysis and evidence.
(1) To examine whether infants with severe bronchiolitis, fulfilling criteria for further respiratory support, could be managed outside a Pediatric Intensive Care Unit (PICU) with non-invasive ventilation (NIV) alone. (2) To study the characteristics, clinical course and outcome of NIV responders and non responders to assess safety and efficacy and inform guideline construction. ⋯ NIV was effective in 80% of infants receiving respiratory support for severe bronchiolitis.
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Pediatric pulmonology · Sep 2012
Case ReportsDyspnea in a patient with Raynaud's phenomenon: the uncovering of interstitial lung disease.
Interstitial lung disease (ILD) can develop in patients with connective tissue disease (CTD) in the context of progressive multiorgan involvement, but ILD can also be the predominant manifestation of active CTD. A high index of suspicion for CTD in patients presenting with pulmonary disease might facilitate timely, accurate diagnosis and management.
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Pediatric pulmonology · Aug 2012
Non-invasive measurements of carboxyhemoglobin and methemoglobin in children with sickle cell disease.
Assessment of oxyhemoglobin saturation in patients with sickle cell disease (SCD) is vital for prompt recognition of hypoxemia. The accuracy of pulse oximeter measurements of blood oxygenation in SCD patients is variable, partially due to carboxyhemoglobin (COHb) and methemoglobin (MetHb), which decrease the oxygen content of blood. This study evaluated the accuracy and reliability of a non-invasive pulse co-oximeter in measuring COHb and MetHb percentages (SpCO and SpMet) in children with SCD. ⋯ The precision of the measured SpCO was ± 2.1% within a COHb range of 0.4-6.1%, and the precision of the measured SpMet was ± 0.33% within a MetHb range of 0.1-1.1%. Non-invasive pulse co-oximetry was useful in measuring COHb and MetHb levels in children with SCD. Although the non-invasive technique slightly overestimated the invasive COHb measurements and slightly underestimated the invasive MetHb measurements, there was close agreement between the two methods.
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Pediatric pulmonology · Aug 2012
Lung aeration changes after lung recruitment in children with acute lung injury: a feasibility study.
There are several adult studies using computed tomography (CT-scan) to examine lung aeration changes during or after a recruitment maneuver (RM) in ventilated patients with acute lung injury (ALI). However, there are no published data on the lung aeration changes during or after a RM in ventilated pediatric patients with ALI. ⋯ Lung recruitment results in improved lung aeration as detected by lung tomography. This is accompanied by improvements in oxygenation and ventilation. However, the clinical significance of these findings is uncertain. Transporting patients in early ALI to the CT-scanner seems safe and feasible.
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Pediatric pulmonology · Aug 2012
Validation of sleep-related breathing disorder scale in Hong Kong Chinese snoring children.
The purpose of this study is to validate the previously-validated Taiwan Chinese version of Sleep-Related Breathing Disorder scale (SRBD scale) in Hong Kong Chinese snoring children. SRBD scale is an instrument used for prediction of obstructive sleep apnea syndrome. (OSA) The Chinese version of SRBD scale were previously translated and validated in Taiwan. The same questionnaire were administered in a group of 102 snoring children (mean age: 10.7 and 65 boys) from a sleep laboratory in Hong Kong before their sleep studies. ⋯ The sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of the previously validated cut-off of SRBD score > 0.33 for OSA were 0.5, 0.55, 1.12, and 0.90, respectively. The area under ROC curve was only 0.58, indicates suboptimal performance of SRBD score in predicting OSA. In summary, our study concluded that the previously reported Chinese SRBD scale is not accurate in identifying presence of OSA in Hong Kong Chinese snoring children.