Pediatric pulmonology
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Pediatric pulmonology · May 2011
Case ReportsLife-threatening anaphylactic reaction after the administration of airway topical lidocaine.
A 9-year-old boy who developed a life-threatening anaphylaxis reaction of the airway and subsequent dyspnea and circulation collapse because of instilled the topical lidocaine into the airway within 2 min before performing flexible bronchoscopy (FB). FB revealed swollen airway mucosa and extensive foamy secretion that severely compromised the ventilation lumen. Rapid detection with FB and immediate resuscitation, including prompt administration of epinephrine, volume expander, and positive pressure ventilation with pure oxygen via an endotracheal tube, were successfully save the patient's life.
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Pediatric pulmonology · Apr 2011
Comparative StudyCosts of hospitalized ventilator-dependent children: differences between a ventilator ward and intensive care unit.
Hospitalizing clinically stable patients in critical care settings results in unnecessary healthcare costs and thwarts timely patient throughput. Some pediatric hospitals care for their stable ventilator-dependent children outside of pediatric intensive care units (PICUs). To date, no analysis of the costs of these pediatric ventilator units compared to PICUs has been performed. ⋯ The mean ward cost was $2,052 (SD ± 617). The mean PICU cost was significantly larger than the mean ward cost (paired t-test, P < 0.0001). Ventilator ward total and variable costs were significantly less than those in the PICU, and such units represent a potential cost saving measure for hospitals that care for ventilator-dependent children.
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Pediatric pulmonology · Mar 2011
Impact of environmental tobacco smoke on children admitted with status asthmaticus in the pediatric intensive care unit.
Environmental tobacco smoke (ETS) and allergens are risk factors in children with critical status asthmaticus. Genetic studies support that ETS-associated asthma is a special inflammatory entity, causing significant number of hospital admissions and relapses. Accordingly, the course and outcome of patients with ETS-induced status asthmaticus might also be different. ⋯ Patients with ETS-associated critical status asthmaticus deteriorate and recover slower than non-ETS-exposed patients.
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Pediatric pulmonology · Mar 2011
Randomized Controlled TrialTobramycin inhalation powder for P. aeruginosa infection in cystic fibrosis: the EVOLVE trial.
Tobramycin inhalation solution is used to treat chronic Pseudomonas aeruginosa lung infection in cystic fibrosis (CF) patients. We evaluated the efficacy and safety of a novel, light-porous particle, dry-powder formulation of tobramycin, which was developed to improve delivery efficiency to the airways and substantially reduce the delivery time. In this randomized, double-blind study, patients with CF (age 6-21 years) received tobramycin inhalation powder (112 mg tobramycin) twice daily (n = 46) or placebo (n = 49) via the T-326 Inhaler for one cycle, followed by two open-label cycles (all patients). ⋯ Tobramycin inhalation powder was not associated with ototoxicity or nephrotoxicity. Administration time was between 4 and 6 min. In conclusion, tobramycin inhalation powder was effective and well tolerated in CF patients, and may offer an important treatment option to decrease the treatment burden of CF pseudomonas lung infections.
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Pediatric pulmonology · Mar 2011
Randomized Controlled Trial Comparative StudyNasal high frequency percussive ventilation versus nasal continuous positive airway pressure in transient tachypnea of the newborn: a pilot randomized controlled trial (NCT00556738).
To determine whether nasal high frequency percussive ventilation (NHFPV) would decrease duration of transient tachypnea of the newborn (TTN) compared to nasal continuous positive airway pressure (NCPAP) in newborn infants. ⋯ NHFPV is well tolerated and more effective than NCPAP in treatment of TTN. NHFPV might be a novel and safe tool to manage TTN. Pediatr Pulmonol.