Pediatric pulmonology
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Pediatric pulmonology · Jan 2011
Safety in treatment of ventilator-associated pneumonia due to extensive drug-resistant Acinetobacter baumannii with aerosolized colistin in neonates: a preliminary report.
Infections caused by extensive drug-resistant Acinetobacter baumannii (XDR-AB) have been increasingly observed and are associated with a high mortality rate. We present our experience using aerosolized colistin for the treatment of ventilator-associated pneumonia (VAP) due to XDR-AB in neonates. ⋯ Aerosolized colistin may be a useful adjunctive therapy in VAP due to XDR-AB. The use of aerosolized colistin in neonates should be investigated in a larger controlled study.
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Pediatric pulmonology · Jan 2011
High-flow nasal cannula: impact on oxygenation and ventilation in an acute lung injury model.
High-flow nasal cannula therapy (HFNC) has been shown to be more effective than continuous positive airway pressure (CPAP) in reducing intubations and ventilator days. HFNC likely provides mechanisms to support respiratory efficiency beyond application of distending pressure. We reason that HFNC washout of nasopharyngeal dead space impacts CO(2) removal along with oxygenation. The aim of this study was to demonstrate the flow dependence of CO(2) reduction and improved oxygenation during HFNC and the dependence on leak around the nasal prongs. ⋯ HFNC improves gas exchange in a flow-dependent manner; double prong had greater impact on O(2;) single prong had greater impact on CO(2) elimination.
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Pediatric pulmonology · Dec 2010
Clara cell protein in full-term pregnancies: the influence of intrauterine growth restriction.
Clara cell protein (CC16) is an immunomodulatory/anti-inflammatory broncho-alveolar-derived molecule and a biomarker of pulmonary epithelial cells maturity and alveolo-capillary membrane injury. Intrauterine growth-restricted (IUGR) neonates may present with structural lung immaturity, impaired immunocompetence and increased risk for respiratory infections and chronic obstructive lung disease in later life. ⋯ The lack of differences in CC16 concentrations between IUGR and AGA groups possibly suggests that the lung immaturity and later respiratory diseases, associated with the former, may not be related to early CC16 deficiency. CC16 concentrations increase with advancing gestational age and peak on the first day of life, possibly indicating a vital role of the protein in fetal lung maturation and extrauterine pulmonary adaptation.
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Pediatric pulmonology · Dec 2010
Multicenter StudyPulmonary outcome prediction (POP) tools for cystic fibrosis patients.
Loss of lung function in patients with cystic fibrosis (CF) is associated with increased mortality and varies between individuals and over time. Predicting this decline could improve patient management. ⋯ These simple integer-based POP algorithms employ variables available at clinic visits and can be used to predict the probability of different future pulmonary outcomes for individual patients and patient populations.
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Pediatric pulmonology · Dec 2010
Case ReportsIdiopathic acute eosinophilic pneumonia requiring ECMO in a teenager smoking tobacco and cannabis.
We describe what we believe is an entirely novel case of a 15-year-old boy with idiopathic acute eosinophilic pneumonia and unusual, resistant hypoxemia which necessitated extracorporeal membrane oxygenation. Response to corticosteroids was excellent and a full recovery was observed. Smoking cigarettes and cannabis on the day the symptoms began may have contributed to the occurrence of this rare disease.