Pediatric pulmonology
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Pediatric pulmonology · Jul 2018
The effectiveness of magnesium sulfate for status asthmaticus outside the intensive care setting.
Magnesium is an adjunctive therapy used in patients with status asthmaticus who do not respond to conventional therapy. The optimal time from initiation of therapy, to determination of response and administration of magnesium has not yet been resolved. Our objective was to determine if magnesium administered in the non-intensive care setting can decrease duration of continuous albuterol and hospital length of stay. ⋯ Children requiring continuous albuterol for status asthmaticus can be administered magnesium sulfate outside the PICU with a low incidence of adverse events; however, among a RAS matched cohort, those who received magnesium did not experience shorter time on continuous albuterol, or hospital length of stay.
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Pediatric pulmonology · Jul 2018
Neutrophil elastase correlates with increased sphingolipid content in cystic fibrosis sputum.
Sphingolipids are associated with the regulation of pulmonary inflammation. Although sphingolipids have been investigated in the context of cystic fibrosis (CF), the focus has been on loss of CF transmembrane conductance regulator (CFTR) function in mice, and in CF human lung epithelial cell lines. The sphingolipid content of CF sputum and the potential link between ceramide and airway inflammation in CF remain relatively unexplored. ⋯ These data suggest that NE may increase pro-inflammatory sphingolipid signaling, and the association is strengthened in female patients and patients with MRSA.
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Pediatric pulmonology · Jul 2018
Observational StudyPediatric acute respiratory distress syndrome associated with human metapneumovirus and respiratory syncytial virus.
To study the incidence, risk factors, clinical course, and outcome of ARDS in children with HMP and RSV. ⋯ About 1/3 of children with HMP or RSV and acute (or acute-on-chronic) respiratory failure developed PARDS. Children with either virus and a neurologic comorbidity or an increased PIM 3 probability of mortality were at increased risk for PARDS.
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Pediatric pulmonology · Jul 2018
Accuracy of oscillatory pressure measured by mechanical ventilators during high frequency oscillatory ventilation in newborns.
Oscillatory pressure (ΔP) measurement during high frequency oscillatory ventilation (HFOV) is technically challenging and influenced by all the components of the measurement system. ⋯ The ventilator model, the breathing circuit, the flowmeter, and the patient condition severely impacts ΔP measurement accuracy during HFOV, leading to highly variable performances. This prevents the possibility of using the ΔP required to normalize gas exchange as an indicator of patients' condition, complicates comparison of ventilators performances, and adds a significant element of complexity in clinical management of HFOV.