Articles: respiratory-distress-syndrome.
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Paediatric anaesthesia · Mar 2022
Observational StudyRecovery characteristics and parental satisfaction in pediatric procedural sedation.
Despite being a standard of care for children undergoing stressful procedures, little data exist on parental perception of pediatric sedation. ⋯ In this study, caregivers' satisfaction with pediatric sedation was high, regardless of the regimen used. Lower parental satisfaction was associated with younger age, irritability after sedation, prolonged sleepiness, hyperactivity, unsteadiness, hallucinations, emesis, and respiratory distress.
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Pediatr Crit Care Me · Mar 2022
Observational StudyAgreement Between Peak Inspiratory Pressure in Decelerating-Flow Ventilation and Plateau Pressure in Square-Flow Ventilation in Pediatric Acute Respiratory Distress Syndrome.
Acute respiratory distress syndrome guidelines suggest limiting plateau pressures to 28-30 cm H2O. Plateau pressure is most accurately measured in square-flow modes, such as volume control. In children, decelerating-flow modes, such as pressure-regulated volume control and pressure control, are more common. Consequently, plateau pressures are rarely obtained, and pressure limits are instead provided for peak inspiratory pressure. The degree to which peak inspiratory pressure in decelerating-flow overestimates plateau pressure is unknown. Therefore, we assessed the correlation and accuracy of peak inspiratory pressure in decelerating-flow ventilation for approximating plateau pressure during square-flow ventilation. ⋯ Peak inspiratory pressure measured during decelerating-flow ventilation may be an adequate surrogate of plateau pressure in pediatric acute respiratory distress syndrome when inspiratory flow approaches zero. Practitioners should be aware that peak inspiratory pressures in decelerating-flow may not be substantially higher than plateau pressures.
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Critical care medicine · Mar 2022
Electrical Impedance Tomography Monitoring of Bronchoalveolar Lavage in Patients With Acute Respiratory Distress Syndrome.
The impact of bronchoalveolar lavage on regional ventilation in mechanically ventilated patients with acute respiratory distress syndrome has rarely been described. Our objectives were use electrical impedance tomography to describe lung impedance variation post bronchoalveolar lavage and identify morphologic patterns according to respiratory failure severity. ⋯ The negative impact of bronchoalveolar lavage on regional ventilation, which persisted at least 6 hours, appeared to be more profound in patients with normal lung function or mild acute respiratory distress syndrome. In contrast, regional ventilation, lung recruitment, respiratory mechanics, and gas exchanges were modestly impacted by the bronchoalveolar lavage in patients with severe or moderate acute respiratory distress syndrome. That finding is reassuring and supports not summarily proscribing bronchoalveolar lavage for the most severely ill with acute respiratory distress syndrome.
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Pediatr Crit Care Me · Mar 2022
Driving Pressure Is Associated With Outcome in Pediatric Acute Respiratory Failure.
Driving pressure (ratio of tidal volume over respiratory system compliance) is associated with mortality in acute respiratory distress syndrome. We sought to evaluate if such association could be identified in critically ill children. ⋯ Higher driving pressure was independently associated with increased time to extubation in mechanically ventilated children. Dynamic assessments of driving pressure should be cautiously interpreted.