Paediatric respiratory reviews
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The ideal care of the critically ill infant or child should demonstrate a seamless service starting with recognition of potential critical illness and initiation of early resuscitative interventions, escalating to advanced life support and skilled transfer to an appropriate location where intensive care can be continued. This article discusses advances in the package of respiratory care commencing with the decision to provide respiratory support, which includes the decision whether or not to intubate, leading to the choice of mechanical ventilatory support mode in the critically ill child. ⋯ Non-invasive respiratory support includes continuous positive airway pressure, biphasic positive airway pressure, or negative extrathoracic pressure. Recent advances in understanding and management of acute lung injury, such as appropriate use of positive end-expiratory airway pressure, alveolar recruitment manoeuvres, high frequency ventilation and use of inhaled nitric oxide, will be discussed in the light of recent randomised controlled trials providing evidence of benefit.
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Paediatr Respir Rev · Jun 2001
Review Comparative StudyChildhood tuberculosis: treatment strategies and recent advances.
Over the past 20 years, several major studies have shown that 6-month therapy, initially using isoniazid, rifampin and pyrazinamide, is highly effective and extremely safe for the treatment of most forms of childhood tuberculosis. The various drug schedules and frequency of administration will be reviewed. ⋯ As the rates of drug-resistant tuberculosis increase around the world, special aspects of paediatric tuberculosis will have to be considered when designing treatment regimens for children. Finally, the next frontier of antituberculosis therapy may be the manipulation of the host immune system.
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Paediatr Respir Rev · Jun 2001
Review Comparative StudyClinical applications of infant lung function testing: does it contribute to clinical decision making?
Infant lung function testing is important in clinical research and recent standardisation efforts have enabled measurements to be made in infants in different laboratories throughout the world. Thus, the theoretical conditions are now fulfilled for use of these techniques in clinical practice. This review discusses the usefulness of various infant lung function techniques in a clinical setting and their potential present or future clinical application. It will focus on the role of infant lung function in the clinical management of infants with respiratory disease.