The Journal of pediatrics
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The Journal of pediatrics · May 1994
Randomized Controlled Trial Comparative Study Clinical TrialEfficacy of the Flutter device for airway mucus clearance in patients with cystic fibrosis.
The Flutter is a handheld device designed to facilitate clearance of mucus in hypersecretory lung disorders. Exhalation through the Flutter results in oscillations of expiratory pressure and airflow, which vibrate the airway walls (loosening mucus), decrease the collapsibility of the airways, and accelerate airflow, facilitating movement of mucus up the airways. We studied 18 patients with cystic fibrosis and mild to moderate lung disease to determine the efficacy of the Flutter in clearing mucus from the airways. ⋯ The Flutter is simple to use, inexpensive, and fully portable, and once the patient and family are instructed in its use, it does not require the assistance of a caregiver. For hospitalized patients, elimination of the need for a therapist could reduce health care costs. Long-term studies of the use of the Flutter seem justified to determine its effects on pulmonary function and outcome.
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The Journal of pediatrics · Apr 1994
Randomized Controlled Trial Clinical TrialUse of lidocaine-prilocaine cream for vaccination pain in infants.
To determine whether use of lidocaine-prilocaine 5% cream (EMLA) decreases pain associated with diphtheria-pertussis-tetanus (DPT) vaccination in infants. ⋯ Pretreatment with EMLA decreases infant pain from DPT vaccinations. Application of these data is limited to healthy infants receiving DPT vaccinations.
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The Journal of pediatrics · Mar 1994
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialProspective, randomized comparison of high-frequency oscillation and conventional ventilation in candidates for extracorporeal membrane oxygenation.
To compare the safety and efficacy of high-frequency oscillation (HFO) with conventional ventilation in the treatment of neonates with respiratory failure. ⋯ We conclude that HFO is a safe and effective rescue technique in the treatment of neonates with respiratory failure in whom conventional ventilation fails.
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The Journal of pediatrics · Jan 1994
Randomized Controlled Trial Comparative Study Clinical TrialOral versus nebulized albuterol in the management of bronchiolitis in Egypt.
The efficacy of albuterol in the management of infants with first-time wheezing is controversial. This double-blind, placebo-controlled trial involved 128 Egyptian infants with first-time wheezing (mean age 5.9 months) who were randomly separated into four equivalent therapy groups: nebulized albuterol, nebulized saline solution, orally administered albuterol, and orally administered placebo. The nebulized therapy groups received two treatments 30 minutes apart; the oral therapy groups received one treatment. ⋯ No differences in the need for additional treatment were observed. Nebulized albuterol significantly improved the clinical score and reduced the respiratory rate of those with recurrent wheezing relative to those in the randomized groups. We conclude that nebulized albuterol is effective in the treatment of infants with recurrent wheezing, but there was no demonstrable efficacy of orally administered or nebulized albuterol in relieving the respiratory distress of infants with bronchiolitis in Egypt.
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The Journal of pediatrics · Nov 1993
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA multicenter randomized trial comparing two surfactants for the treatment of neonatal respiratory distress syndrome. National Institute of Child Health and Human Development Neonatal Research Network.
To compare the efficacy of two surfactants, Exosurf Neonatal (Burroughs Wellcome Co.) and Survanta (Ross Laboratories), for the treatment of neonatal respiratory distress syndrome. ⋯ We found no difference between treatment groups in the incidence of death or bronchopulmonary dysplasia, although we did observe a difference in the initial response to treatment as measured by FIO2 and MAP.