Pediatric pulmonology
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Pediatric pulmonology · May 2012
Nasal airflow and thoracoabdominal motion in children using infrared thermographic video processing.
The assessment of apnea and asynchronous breathing requires the application of a facemask connected to a pneumotachograph and inductive transducer bands placed around the chest wall. These contact devices may alter the breathing pattern and are difficult to implement, especially in infants and children. This study validates a contactless image-processing system that simultaneously retrieves breath-related thermal variations from nasal, ribcage, and abdomen regions of interest (ROI) from infrared thermographic video recordings of children. ⋯ A Cronbach's Alpha value of 0.976 (0.992-0.944 95% CI) suggests a small-scale measurement error between thermographic and control periods. The ribcage-abdomen time delay in children with respiratory disease (-0.42 ± 0.707 sec) significantly differed from healthy children (0.22 ± 0.426 sec, P = 0.0125). This novel system reliably acquired time-aligned nasal airflow and thoracoabdominal motion estimates without relying on attached sensor performance and detected asynchronous breathing in pediatric patients.
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Pediatric pulmonology · Apr 2012
Clinical predictors of nasal continuous positive airway pressure requirement in acute bronchiolitis.
There is growing use of nasal continuous positive airway pressure ventilation (nCPAP) for infants with bronchiolitis, based on clinical assessment of severity. Despite this there have been no studies which identify clinical predictors for the requirement of nCPAP. ⋯ We have identified clinical variables that were predictive of nCPAP requirement in infants admitted to our unit with bronchiolitis, oxygen requirement in the ED being the strongest single predictor. This is the first such study in the UK, and we hope it may be a starting point for further work that may provide an evidence base to aid clinicians in predicting the use of nCPAP in infants with bronchiolitis.
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Pediatric pulmonology · Apr 2012
End-tidal carbon dioxide monitoring in very low birth weight infants: correlation and agreement with arterial carbon dioxide.
We aimed to determine the correlation and the agreement between end-tidal carbon dioxide (ETCO(2)) and partial pressure of arterial carbon dioxide (PaCO(2) ) in very low birth weight infants (VLBWI); furthermore, we assessed factors that could affect the ETCO(2)-PaCO(2) relationship. ⋯ In ventilated VLBWI, the correlation between mainstream ETCO(2) and PaCO(2) is good, but the agreement is poor and negatively influenced by the severity of pulmonary disease. Capnography is feasible in ELBWI. ETCO(2) should not replace PaCO(2) measurements in ventilated VLBWI, but may have a role to detect trends of PaCO(2).
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Pediatric pulmonology · Mar 2012
Comparative StudyInpatient healthcare trends among adult cystic fibrosis patients in the U.S.
Adult cystic fibrosis (CF) patients are an expanding cohort that is taken care of in a variety of hospital settings including adult centers located within pediatric institutions. This study compared costs and discharge rates among adult CF patient hospitalizations in terms of location of hospitalization. ⋯ LOS for adult CF inpatient admissions was significantly lower in adult facilities compared to pediatric facilities without a significant difference in hospital charges and is influenced by geographic hospital location. Depressed patients had longer lengths of stay regardless of facility type. Self-insured adult CF patients have a significant reduction in LOS and hospital charges when compared to all other payers regardless of hospital type.