Resp Care
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Children with double aortic arch most often present in infancy. This report presents 3 patients in whom the diagnosis of double aortic arch was not revealed until later in childhood. They were all given a misdiagnosis of asthma, but abnormalities detected on the flow-volume curve led to the true diagnosis.
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A practitioner questioned whether moisture that collected in the ventilator circuit and spacer affected the delivery of aerosol from a pressurized metered-dose inhaler (pMDI). An in vitro model was used to quantify the impact of accumulated humidity in a pMDI spacer and ventilator over time. ⋯ Aerosol delivery from a pMDI with spacer during mechanical ventilation was greater with a dry spacer and unchanged for the first hour after initiating heated humidification. Turning off the heated humidifier did not increase drug delivered.