Paediatric respiratory reviews
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Many situations exist imposing the use of bronchoscopy in intensive care units (ICU). There are many diagnostic and therapeutic indications. ⋯ These situations seem quite frequent in paediatric ICU. This field has been developed with the availability of small endoscopes on the market and progress in instrumental and anaesthetic techniques.
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Paediatr Respir Rev · Jan 2004
ReviewSurfactant use for neonatal lung injury: beyond respiratory distress syndrome.
Surfactant has led to a significant reduction in neonatal mortality for premature infants with lung immaturity and respiratory distress. However, surfactant therapy has been shown to be effective in the treatment of a number of other neonatal respiratory disorders and the evidence for surfactant use in such circumstances is presented. Meconium aspiration is characterised by severe atelectasis, the influx of neutrophils, edema, and hyaline membranes, with decreased levels of SP-A and SP-B and the large aggregate fraction of lung surfactant, and altered surfactant surface morphology. ⋯ Case reports have reported a benefit of surfactant for infants with CDH. In the near-term infants with severe respiratory distress, surfactant is one of the therapies along with inhaled nitric oxide and high frequency ventilations, that have resulted in improved outcomes. Surfactant treatment may be of significant benefit in newborn infants with respiratory compromise secondary to a number of insults, and further prospective evidence of its efficacy in such disorders is needed.