Pediatric pulmonology
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Pediatric pulmonology · Nov 2011
Use of flexible bronchoscopy in pediatric patients receiving extracorporeal membrane oxygenation (ECMO) support.
Critically ill children treated with extracorporeal membrane oxygenation (ECMO) support frequently have respiratory complications amenable to evaluation by flexible bronchoscopy (FB). The safety and efficacy of FB in this setting has not been well described in children. ⋯ FB is a well-tolerated and safe procedure in critically ill pediatric patients on ECMO. FB may have a diagnostic as well as therapeutic benefit in such patients.
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Pediatric pulmonology · Oct 2011
Non-invasive ventilation in pediatric status asthmaticus: a prospective observational study.
Non-invasive ventilation (NIV) has been shown to be effective in different causes of respiratory failure in both adult and pediatric patients. However, its role in status asthmaticus (SA) remains unclear. We designed a prospective study to assess the feasibility of NIV in children with SA. ⋯ These results show that NIV is a feasible therapy in children with SA unresponsive to conventional treatment. Pediatr. Pulmonol. 2011; 46:949-955. © 2011 Wiley-Liss, Inc.
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Pediatric pulmonology · Oct 2011
Comparative StudyBronchoalveolar lavage versus bolus administration of lucinactant, a synthetic surfactant in meconium aspiration in newborn lambs.
This study was designed to study effects of lung lavage versus the classical bolus instillation with a peptide-based synthetic surfactant (lucinactant) in a model of Meconium Aspiration Syndrome (MAS). Eighteen newborn lambs received meconium and were randomized to: the experimental meconium installation (eMAS) group-lambs with eMAS kept on conventional mechanical ventilation (control); the SF-Bolus group-eMAS receiving a lucinactant bolus (30 mg/ml); or the D-SF-Lavage group-eMAS treated with dilute lucinactant bronchoalveolar lavage (10 mg/ml). Systemic and pulmonary arterial pressures, blood gases, and pulmonary mechanics were recorded for 180 min. ⋯ Further, only in the lavage group did pulmonary arterial pressure return to basal values and dynamic compliance significantly increased. Both lung lavage and bolus techniques for the administration of lucinactant resulted in a non-uniform lung distribution. In conclusion, in newborn lambs with respiratory failure and pulmonary hypertension induced by meconium, lung lavage with dilute lucinactant seems to be an effective and safe alternative for treatment for MAS.
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Pediatric pulmonology · Sep 2011
Obstructive sleep apnea in poorly controlled asthmatic children: effect of adenotonsillectomy.
Asthma and obstructive sleep apnea (OSA) in children share multiple epidemiological risk factors and the prevalence of snoring is higher in asthmatic children, suggesting that the latter may be at increased risk for OSA. Since both asthma and OSA are inflammatory disorders, we hypothesized that polysomnographically demonstrated OSA would be more frequent among poorly controlled asthmatics (PCA), and that treatment of OSA, if present, would ameliorate the frequency of acute asthmatic exacerbations (AAE). ⋯ The prevalence of OSA is markedly increased among PCA children and treatment of OSA appears to be associated with substantial improvements in the severity of the underlying asthmatic condition.
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Pediatric pulmonology · Sep 2011
Clinical TrialCapnography in spontaneously breathing preterm infants with bronchopulmonary dysplasia.
In adult patients with chronic obstructive pulmonary disease, there is a gradient between end-tidal carbon dioxide (EtCO(2)) and arterial carbon dioxide pressure (PaCO(2)), and the slope of the ascending phase of the capnogram is decreased due to obstruction. Corresponding data are lacking in infants with bronchopulmonary dysplasia (BPD). ⋯ Compared with healthy infants, a higher PcCO(2) -EtCO(2) gradient was observed in infants with BPD, suggesting that ventilation-perfusion mismatch may be present in these infants. The capnogram did not exhibit the characteristic shape of airway obstruction.