Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2011
Effects of flow rate and airleak at the nares and mouth opening on positive distending pressure delivery using commercially available high-flow nasal cannula systems: a lung model study.
Use of high-flow humidified nasal cannulas to deliver continuous positive airway pressure in children is increasing. Data on the relationship between the flow values and the corresponding pressures are limited. The purpose of this experiment was to evaluate the relationship between the device, intraprong, and proximal airway pressures and the flow values in a neonatal/pediatric test lung model, using the Vapotherm 2000i and Fisher-Paykel humidified nasal cannulas devices. ⋯ High flow humidified nasal cannulas systems may deliver uncontrolled continuous positive airway pressure to infants. This, along with the potentially large nares and mouth leak effects on any form of continuous positive airway pressure, renders the effective humidified nasal cannulas delivered continuous positive airway pressure particularly unpredictable.
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Pediatr Crit Care Me · Jan 2011
Changes in lung volume during spells in children with Tetralogy of Fallot under general anesthesia.
To describe the changes in end-expiratory lung volume and ventilation inhomogeneities during spells in three children with Tetralogy of Fallot. ⋯ These data show the deleterious effect of a spell on respiratory function, which may worsen hypoxemia. The loss in lung volume can have a deleterious additive effect in the presence of a spell, particularly because of the slow improvement after treatment.
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To outline the journey of a mother of a critically ill child in her quest for care for her infant. This article outlines the barriers faced, disappointments, and the indignity of poverty. Questions and commentary relating to the care of the critically ill in resource-limited environments underline the issues she faces. Critical illness is very common in the developing world with most childhood deaths occurring in Asia and sub-Saharan Africa. These areas are handicapped by limited access to critical care and intensive care facilities. This paper is not intended to review preventive strategies and simple inexpensive treatments that may prevent diseases and diminish critical illnesses. ⋯ Critical illness is common in areas of the world plagued with minimal resources to deal with its ravages. Parents try to do what is best for their critically ill children, but navigation of systems and lack of resources are daunting propositions. On any given day, this story or versions of it occurs in many parts of Africa and in low income countries in general. I saw similar scenes several times daily in Uganda and Kenya and, although the issues are slightly different in South Africa, failures of healthcare processes resulted in similar adverse outcomes in all areas. This is a mother's story.
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Pediatr Crit Care Me · Jan 2011
Editorial CommentAre we there yet? Improved patient survival with mock codes.