Pediatric pulmonology
-
Pediatric pulmonology · Dec 2015
Observational StudyTonic diaphragmatic activity in critically ill children with and without ventilatory support.
Infants have to actively maintain their end expiratory lung volume (EELV). In mechanically ventilated infants, the diaphragm stays activated until the end of expiration (tonic activity), contributing to EELV maintenance. It is unclear whether tonic activity compensates for the lack of laryngeal braking due to intubation or if it is normally present. ⋯ In infants, tonic EAdi remains involved in ventilatory control after extubation and restoration of laryngeal braking. Tonic EAdi may play a pathophysiological role in bronchiolitis and it can be reactivated in older patients. The interest of tonic EAdi as a tool to titrate mechanical ventilation warrants further evaluation.
-
Pediatric pulmonology · Dec 2015
Case ReportsTreatment of dyskeratosis congenita-associated pulmonary fibrosis with danazol.
Individuals with Dyskeratosis Congenita (DC) are at increased risk for complications in variety of systems including pulmonary fibrosis. Idiopathic and DC-associated pulmonary fibrosis are progressive and fatal disorders without known treatment. Here we describe, for the first time, marked improvement in the clinical and laboratory parameters of the pulmonary disease of a child who suffered from TINF2-associated DC and severe pulmonary fibrosis after initiation of therapy with Danazol. We recommend that the clinical efficacy of Danazol in slowing down the progression of pulmonary fibrosis in patients with telomere-related disorders is evaluated in prospective studies.
-
Pediatric pulmonology · Dec 2015
Neurally adjusted ventilator assist (NAVA) reduces asynchrony during non-invasive ventilation for severe bronchiolitis.
To determine the prevalence of main inspiratory asynchrony events during non-invasive intermittent positive-pressure ventilation (NIV) for severe bronchiolitis. Ventilator response time and asynchrony were compared in neurally adjusted ventilator assist (NAVA) and in pressure assist/control (PAC) modes. ⋯ Patient-ventilator inspiratory asynchronies and trigger delay were dramatically lower in NAVA mode than in PAC mode during NIV in infants with severe bronchiolitis.