American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Mar 2016
Early High Frequency Oscillatory Ventilation in Pediatric Acute Respiratory Failure: A Propensity Score Analysis.
The use of high-frequency oscillatory ventilation (HFOV) for acute respiratory failure in children is prevalent despite the lack of efficacy data. ⋯ In adjusted models including important oxygenation variables, early HFOV was associated with a longer duration of mechanical ventilation. These analyses make supporting the current approach to HFOV less convincing.
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Am. J. Respir. Crit. Care Med. · Mar 2016
The Role of Nicotine in the Effects of Maternal Smoking During Pregnancy on Lung Development and Childhood Respiratory Disease: Implications for Dangers of E-Cigarettes.
Use of e-cigarettes, especially among the young, is increasing at near-exponential rates. This is coupled with a perception that e-cigarettes are safe and with unlimited advertising geared toward vulnerable populations, the groups most likely to smoke or vape during pregnancy. There is now wide appreciation of the dangers of maternal smoking during pregnancy and the lifelong consequences this has on offspring lung function, including the increased risk of childhood wheezing and subsequent asthma. ⋯ In fact, the evidence for nicotine being the mediator of harm of conventional cigarettes may be most compelling for its effects on lung development. This raises concerns about both the combined use of e-cigarettes plus conventional cigarettes by smokers during pregnancy as well as the use of e-cigarettes by e-cigarette-only users who think them safe or by those sufficiently addicted to nicotine to not be able to quit e-cigarette usage during pregnancy. Thus, it is important for health professionals to be aware of the risks of e-cigarette usage during pregnancy, particularly as it pertains to offspring respiratory health.
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Am. J. Respir. Crit. Care Med. · Mar 2016
Observational StudySleep Disordered Breathing and Incident Heart Failure in Older Men.
The directionality of the relationship between sleep-disordered breathing and heart failure is controversial. ⋯ An elevated CAI/Cheyne-Stokes breathing, but not an elevated obstructive AHI, is significantly associated with increased risk of decompensated heart failure and/or development of clinical heart failure in a community-based cohort of older men.
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Am. J. Respir. Crit. Care Med. · Mar 2016
Development of the Nasopharyngeal Microbiota in Infants with Cystic Fibrosis.
Cystic fibrosis (CF) is characterized by early structural lung disease caused by pulmonary infections. The nasopharynx of infants is a major ecological reservoir of potential respiratory pathogens. ⋯ From diagnosis onward, we observed distinct patterns of nasopharyngeal microbiota development in infants with CF under 6 months of age compared with control subjects and a marked effect of antibiotic therapy leading toward a gram-negative microbial composition.