Paediatric respiratory reviews
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Paediatr Respir Rev · Mar 2002
ReviewDiagnostic techniques for obstructive sleep apnoea: is polysomnography necessary?
Obstructive sleep apnoea (OSA) is a common condition of childhood with significant associated morbidity. The comprehensive evaluation of children who present with suggestive symptoms involves the overnight recording and assessment of both sleep and respiration by polysomnography in a sleep laboratory. These studies require resources and facilities that are not widely available and thus simpler, more available and less expensive alternatives have been sought. This review discusses the available alternatives to polysomnography for the evaluation of the child with suspected obstructive sleep apnoea.
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Paediatr Respir Rev · Sep 2001
ReviewParental smoking: asthma and wheezing illnesses in infants and children.
Parental smoking has an important impact on asthma and wheezing illnesses in infants and children. In utero exposure is associated with impaired lung growth and wheezing illnesses, particularly in preschool children. ⋯ There are no consistent data to confirm an effect of in utero or postnatal cigarette smoke exposure on the prevalence of asthma but there is evidence of increased severity of symptoms. The detrimental effects of parental smoking on lung growth will have an impact on respiratory health throughout life.
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Paediatr Respir Rev · Jun 2001
Review Comparative StudyChildhood tuberculosis: treatment strategies and recent advances.
Over the past 20 years, several major studies have shown that 6-month therapy, initially using isoniazid, rifampin and pyrazinamide, is highly effective and extremely safe for the treatment of most forms of childhood tuberculosis. The various drug schedules and frequency of administration will be reviewed. ⋯ As the rates of drug-resistant tuberculosis increase around the world, special aspects of paediatric tuberculosis will have to be considered when designing treatment regimens for children. Finally, the next frontier of antituberculosis therapy may be the manipulation of the host immune system.
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The ideal care of the critically ill infant or child should demonstrate a seamless service starting with recognition of potential critical illness and initiation of early resuscitative interventions, escalating to advanced life support and skilled transfer to an appropriate location where intensive care can be continued. This article discusses advances in the package of respiratory care commencing with the decision to provide respiratory support, which includes the decision whether or not to intubate, leading to the choice of mechanical ventilatory support mode in the critically ill child. ⋯ Non-invasive respiratory support includes continuous positive airway pressure, biphasic positive airway pressure, or negative extrathoracic pressure. Recent advances in understanding and management of acute lung injury, such as appropriate use of positive end-expiratory airway pressure, alveolar recruitment manoeuvres, high frequency ventilation and use of inhaled nitric oxide, will be discussed in the light of recent randomised controlled trials providing evidence of benefit.
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Paediatr Respir Rev · Jun 2001
Review Comparative StudyClinical applications of infant lung function testing: does it contribute to clinical decision making?
Infant lung function testing is important in clinical research and recent standardisation efforts have enabled measurements to be made in infants in different laboratories throughout the world. Thus, the theoretical conditions are now fulfilled for use of these techniques in clinical practice. This review discusses the usefulness of various infant lung function techniques in a clinical setting and their potential present or future clinical application. It will focus on the role of infant lung function in the clinical management of infants with respiratory disease.