Paediatric respiratory reviews
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Paediatr Respir Rev · Jun 2009
ReviewRole of ventilation in RSV disease: CPAP, ventilation, HFO, ECMO.
Respiratory syncytial virus (RSV) lower respiratory tract disease may present as bronchiolitis, an obstructive lung disease with hyperinflation, or pneumonitis, a restrictive parenchymal disease with diffuse consolidation, a large intrapulmonary shunt and acute respiratory distress syndrome (ARDS). Although a significant proportion of those admitted to hospital will require some form of respiratory support, there have been few randomised studies to determine which is the most beneficial. ⋯ Current practice regarding ventilator support is largely based on clinical judgment and case reports. Multicentre randomised trials with long-term follow-ups are urgently required.
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Paediatr Respir Rev · Jun 2009
Sublingual immunotherapy for children: Are we there yet? Defining its role in clinical practice.
Immunotherapy in various forms has been used to treat allergic disorders since the early 19th century. Subcutaneous immunotherapy is now well established for the treatment of insect anaphylaxis and allergic rhinitis. ⋯ Several trials have also shown a potential immunomodulatory effect of sublingual immunotherapy, with evidence of a reduction in the progression from allergic rhinitis to asthma and reduced new aeroallergen sensitisation. This review will give an overview of the current evidence for sublingual immunotherapy in the paediatric population.
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Paediatr Respir Rev · Dec 2008
ReviewVentilatory strategies in the neonatal and paediatric intensive care units.
Mechanical ventilation is a common form of support in the modern day intensive care unit (ICU). In order for the clinician better to understand and apply mechanical ventilation, it is important that they understand the physiological principles of ventilation. This review describes these basic concepts; parameters of mechanical ventilation, high frequency ventilation and non-invasive ventilation. An overview of ventilatory strategies for four common diseases seen in paediatric and neonatal ICUs will be discussed.
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Paediatr Respir Rev · Sep 2008
ReviewEarly detection of lung disease in children with cystic fibrosis using lung function.
Measurement of lung function is routine in older children and adults with cystic fibrosis (CF) but not in infants and preschool children. Pulmonary infection, neutrophil-dominated inflammation and clinical exacerbations in young children similar to those seen in older subjects have been identified and highlight the urgent need to evaluate lung function in early life. ⋯ In addition, the majority of studies in young children with CF have not reported longitudinal data and therefore the prognostic potential of existing lung function methods to track disease progression is poorly understood. This review aims to describe recent research findings in infants and preschool children and to outline currently available lung function techniques, issues around their standardization and their relative advantages and disadvantages in young children with CF.
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Human parasitosis is still prevalent worldwide and causes significant morbidity and mortality in developing countries. The involvement of the lung is variable depending on the characteristics of the parasites and hosts. In malnourished and immunodeficient children, the consequences of lung parasitosis may result in significant morbidity and mortality.