Pediatric pulmonology
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Pediatric pulmonology · Aug 1996
Comparative StudyA new microtransducer catheter for measuring esophageal pressure in infants.
Measurement of esophageal pressure, as a reflection of pleural pressure, is essential for assessment of dynamic lung mechanics in neonates and infants. Conventionally, an esophageal balloon or a fluid-filled catheter is used, but considerable skill is required to obtain accurate results. Both devices have problems, and failure to achieve valid occlusion tests have been reported, particularly in small infants with lung disease. ⋯ Positioning of the catheter was well tolerated by all infants. The ratio of esophageal to airway opening pressure changes (delta Pes:delta Pao) ranged from 0.94 to 1.09 [mean (SD) 1.013 (0.03)] for the spontaneously breathing infants and from 0.98 to 1.06 [mean (SD) 1.003 (0.02)] In the ventilated infants with no significant difference in this ratio between the two groups (p = 0.16). This new generation of catheter tip pressure transducers may provide a simpler and more reliable tool for assessing transpulmonary pressure changes in infants than has previously been available.
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Pediatric pulmonology · Aug 1996
Randomized Controlled Trial Multicenter Study Clinical TrialDose response to inhaled terbutaline powder and peak inspiratory flow through Turbuhaler in children with mild to moderate asthma.
The purpose of this study was to investigate the relative effectiveness of 0.25 mg, 0.5 mg, and 1.0 mg of terbutaline, administered via Turbuhaler, in children with mild to moderate asthma, and to register peak inspiratory flow rates through Turbuhaler (PIFTBH). Thirty-seven children in Portugal (one center) and 45 children in Sweden (one center) aged 3-10 years participated in two separate, double-blind, placebo-controlled, crossover, and randomized studies of the same design. Because of differences in other therapies for asthma and climate, combination of the two studies into one metanalysis did not appear appropriate. ⋯ In the 7-10 year group the mean PIFTBH was 72 L/min (n = 22) in Portugal, and 68 L/min (n = 22) in Sweden. We conclude that inhalation of terbutaline sulfate via Turbuhaler at a small dose of 0.25 mg resulted in good bronchodilation and was comparable to inhalations of 0.5 mg and 1.0 mg in children aged 3-10 years with mild to moderate asthma. PIFTBH were comparable to values previously recorded in healthy 6-year-old and older children and in adult asthmatic patients.
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Pediatric pulmonology · Aug 1996
Humidification of oxygen with unheated humidifiers in tropical climates.
In developing countries, oxygen therapy in hospitals is frequently humidified with unheated bubble-through humidifiers. We assessed the efficacy of humidification under such circumstances. The water temperature in the humidifier and the ambient air temperature were measured and compared to the oxygen flow rate. ⋯ Using the average temperatures on the hospital ward in January and August, and the WHO-recommended flow rates of 0.5 l/min and 1 l/min, the relative humidity of the oxygen delivered to a child was estimated to be between 34% and 56%. We conclude that unheated bubble-through humidifiers achieve low humidity in oxygen in tropical climates. Some of the complications associated with the use of nasopharyngeal catheters for the delivery of oxygen might be explained by this, as oxygen of low humidity and temperature is delivered directly into the posterior nasopharynx.
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Pediatric pulmonology · Aug 1996
Polysomnographic studies in children with adenotonsillar hypertrophy and suspected obstructive sleep apnea.
Upper airway obstruction causes many sleep-related respiratory disorders that can culminate in obstructive sleep apnea syndrome (OSAS). Polysomnography is routinely used to define OSAS in adults, but problems remain in diagnosing children by this method. The current study was designed to analyze the polysomnographic patterns in children with symptomatic adenotonsillar hypertrophy and to determine whether obstructive respiratory events shorter than 10 sec could have pathophysiological significance. ⋯ When considering all obstructive episodes > or = 5 sec, the number of desaturations did not exceed the number of respiratory events. The correlation between the desaturation index and spontaneous or respiratory event associated desaturations was similar. The occurrence of short AH episodes that lead to hemoglobin desaturation are important in the evaluation of OSAS in children.