Pediatric pulmonology
-
Pediatric pulmonology · Jul 2014
Comparative Study Clinical TrialSynchronized neonatal non-invasive ventilation-a pilot study: the graseby capsule with bi-level NCPAP.
(1) To evaluate the Graseby capsule (GC) as a respiratory detection device when compared to respiratory inductance plethysmography (RIP); (2) to evaluate the response to the Graseby signal of a commercially available bi-level nasal CPAP device (BNCPAP) designed for use with the GC; and (3) to assess the performance of the GC/BNCPAP device when fitted on preterm infants. ⋯ The GC is a sensitive respiratory detection device; however, the GC/BNCPAP interface requires a minimum Ti of 0.3 sec and an adequate respiratory effort to achieve the desired pressure and to synchronously trigger the BNCPAP.
-
Pediatric pulmonology · Jul 2014
Randomized Controlled TrialAnti-PcrV antibody in cystic fibrosis: a novel approach targeting Pseudomonas aeruginosa airway infection.
Pseudomonas aeruginosa (Pa) airway infection is associated with increased morbidity and mortality in cystic fibrosis (CF). The type III secretion system is one of the factors responsible for the increased virulence and pro-inflammatory effects of Pa. KB001 is a PEGylated, recombinant, anti-Pseudomonas-PcrV antibody Fab' fragment that blocks the function of Pa TTSS. ⋯ However, compared to baseline, at Day 28 there was a trend towards a dose-dependent reduction in sputum myeloperoxidase, IL-1, and IL-8, and there were significant overall differences in change in sputum neutrophil elastase and neutrophil counts favoring the KB001 10 mg/kg group versus placebo (-0.61 log(10) and -0.63 log(10) , respectively; P < 0.05). These results support targeting Pa TTSS with KB001 as a nonantibiotic strategy to reduce airway inflammation and damage in CF patients with chronic Pa infection. Repeat-dosing studies are necessary to evaluate the durability of the anti-inflammatory effects and how that may translate into clinical benefit. (NCT00638365).
-
Pediatric pulmonology · Jul 2014
Randomized Controlled Trial Comparative StudyA prospective, randomized, controlled study of NIPPV versus nCPAP in preterm and term infants with respiratory distress syndrome.
To evaluate whether nasal intermittent positive pressure ventilation (NIPPV) compared with nasal continuous positive airway pressure (nCPAP) decreases the requirement for endotracheal ventilation in preterm and term infants with respiratory distress syndrome (RDS). ⋯ Treatment with NIPPV compared with nCPAP decreased the need for endotracheal ventilation and increased favorable outcome in preterm and term infants with RDS.
-
Pediatric pulmonology · Jul 2014
Multicenter StudyAssessing the impact of national guidelines on the management of children hospitalized for acute bronchiolitis.
Acute bronchiolitis is a common illness accounting for $500 million annually in hospitalizations. Despite the frequency of bronchiolitis, its diagnosis and management is variable. To address this variability, the American Academy of Pediatrics (AAP) published an evidence-based practice management guideline for bronchiolitis in 2006. ⋯ A modest change in physician behavior in the inpatient management of bronchiolitis was seen post-guidelines. Additional health care provider training and education is warranted to reduce unnecessary interventions and healthcare resources use.
-
Pediatric pulmonology · Jul 2014
Comparative StudyHigh frequency oscillation and airway pressure release ventilation in pediatric respiratory failure.
Airway pressure release ventilation (APRV) and high frequency oscillatory ventilation (HFOV) are frequently used in acute lung injury (ALI) refractory to conventional ventilation. Our aim was to describe our experience with APRV and HFOV in refractory pediatric ALI, and to identify factors associated with survival. ⋯ In a heterogeneous PICU population with hypoxemia refractory to conventional ventilation transitioned to NCV, improvement in oxygenation at 24 hr was associated with survival. Immunocompromised status, number of vasopressor infusions, and the OI before transition to NCV were independently associated with survival.