Paediatric respiratory reviews
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Paediatr Respir Rev · Jun 2013
ReviewManagement of acute severe upper airway obstruction in children.
There are many causes of acute severe upper airway obstruction (UAO) in children. The timing of symptom onset and the presence of fever will help to distinguish infectious from non-infectious conditions. Signs and symptoms from congenital malformations often present at birth but may also develop over time. ⋯ A child with partial airway obstruction may initially have an adequate airway. However, this situation can deteriorate rapidly. Therefore, providing supportive care and mobilizing resources for definitive airway management may be the most appropriate interventions.
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Asthma is usually treated with inhaled corticosteroids (ICS) and bronchodilators generated from pressurized metered dose inhalers (pMDI), dry powder inhalers (DPI), or nebulizers. The target areas for ICS and beta 2-agonists in the treatment of asthma are explained. ⋯ Myths regarding inhalation treatments lead to less than optimal use of these delivery systems. We discuss the origin of many of these myths and provide the background and evidence for rejecting them.
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Paediatr Respir Rev · Dec 2012
ReviewThe evolution of exercise capacity and its limiting factors in cystic fibrosis.
The ability to perform exercise is an important determinant of both longevity and quality of life for patients with Cystic Fibrosis. There are a variety of physical and behavioural factors that contribute to exercise limitation. ⋯ However, these factors can also be modified by treatments and interventions. This review discusses the various factors that contribute to exercise limitation in Cystic Fibrosis, and how these change with age.
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Congenital central hypoventilation syndrome (CCHS) is a rare, lifelong condition wherein control of breathing is abnormal and patients present with symptoms of alveolar hypoventilation. The severity of hypoventilation varies and although most patients present in the neonatal period, late onset cases have been reported. In 2003, it was discovered that mutations in the PHOX2B gene were responsible for CCHS. ⋯ The goal of treatment for CCHS is to ensure adequate ventilation during wakefulness and sleep. A variety of ventilation modalities are available including positive pressure ventilation via tracheostomy, non-invasive ventilation via nasal mask, and diaphragmatic pacing. With close monitoring and support, children with CCHS can be expected to function well in society and have a good quality of life.