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Pediatric non invasive ventilation

Traci M Kazmerski, Daniel J Weiner, Janice Matisko, Diane Schachner, Whitney Lerch, Carol May, Scott H Maurer
INTRODUCTION: Advance care planning (ACP), though recommended, has not been studied in adolescents with cystic fibrosis (CF). This quality improvement project engaged adolescents with advanced CF disease in ACP and assessed patient and CF provider attitudes and preferences regarding ACP discussions and tools. MATERIALS AND METHODS: Patients ≤22 years with advanced CF (FEV1 ≤40% predicted, >2 pulmonary exacerbations requiring IV antibiotics in 1 year, and/or use of home oxygen or non-invasive ventilation) were referred to the pediatric palliative care team (PC)...
October 17, 2016: Pediatric Pulmonology
Başak Yıldız-Atıkan, Bülent Karapınar, Şöhret Aydemir, Fadıl Vardar
Ventilator-associated pneumonia (VAP) is defined as pneumonia occuring in any period of mechanical ventilation. There is no optimal diagnostic method in current use and in this study we aimed to compare two non-invasive diagnostic methods used in diagnosis of VAP in children. This prospective study was conducted in 8 bedded Pediatric Intensive Care Unit at Ege University Children´s Hospital. Endotracheal aspiration (ETA) and non-bronchoscopic bronchoalveolar lavage (BAL) were performed in case of developing VIP after 48 hours of ventilation...
November 2015: Turkish Journal of Pediatrics
Camilla R S Silva, Lívia B Andrade, Danielle A S X Maux, Andreza L Bezerra, Maria C M B Duarte
Objective: To evaluate the effectiveness of prophylactic, non-invasive ventilation (NIV) on respiratory function in seven- to 16-year-old children in the post-operative phase of cardiac surgery. Method: A randomized, controlled trial with 50 children who had undergone cardiac surgery with median sternotomy. After extubation, patients were randomly assigned to one of two groups: control group (n=26), which received instructions regarding posture, early ambulation, and cough stimulation, and CPAP group (continuous positive airway pressure; n=24), which received the same instructions as the control group and CPAP=10 cmH20 twice daily for 30 minutes from the 1st to the 5th post-operative day (POD)...
September 29, 2016: Brazilian Journal of Physical Therapy
Smeeta Sardesai, Manoj Biniwale, Fiona Wertheimer, Arlene Garingo, Rangasamy Ramanathan
Respiratory distress syndrome (RDS) due to surfactant deficiency is the most common cause of respiratory failure in preterm infants. Tremendous progress has been made since the original description that surfactant deficiency is the major cause of RDS. Surfactant therapy has been extensively studied in preterm infants and has been shown to significantly decrease air leaks and neonatal and infant mortality. Synthetic and animal-derived surfactants from bovine as well as porcine origin have been evaluated in randomized controlled trials...
October 5, 2016: Pediatric Research
Maryam Oskoui, Pamela Ng, Stephen Liben, David Zielinski
BACKGROUND: Increasing numbers of families are requesting active supportive management for their child with spinal muscular atrophy type 1 (SMA1), leading to longer survival and greater prevalence of affected children. Strong opinions exist among physicians for and against the provision of care measures prolonging life. OBJECTIVE: To describe current practice in the care of SMA1 in Canada, and explore the factors underlying inter-physician variability. METHODS: A cross-sectional survey of Canadian hospital-based pediatric neurologists and pediatric respirologists was performed in 2015...
September 29, 2016: Pediatric Pulmonology
Marcus A Mall, Mirjam Stahl, Simon Y Graeber, Olaf Sommerburg, Hans-Ulrich Kauczor, Mark O Wielpütz
Recent imaging studies using chest computed tomography (CT) in presymptomatic infants and young children with cystic fibrosis (CF) diagnosed by newborn screening presented compelling evidence of early onset and progression of structural lung damage in CF. These data argue persuasively that non-invasive outcome measures for early detection and sensitive monitoring of lung disease applicable in the clinical setting will be instrumental for further improvement of clinical care and the development of early intervention therapies that have the potential to prevent irreversible lung damage...
October 2016: Pediatric Pulmonology
Deepak Sharma, Sweta Shastri, Pradeep Sharma
BACKGROUND: Lactoferrin (LF) is present in breast milk and have numerous properties including antimicrobial, antiviral, anti-fungal, and anti-cancer. Recent studies have emphasized the role of LF in neonatal care Aims and objective: To evaluate the various roles of Lactoferrin in Neonatal care in preterm infants. SEARCH METHODS: The literature search was done for this systematic review by searching the electronic data base namely Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, Scopus, Index Copernicus, African Index Medicus (AIM), Thomson Reuters (ESCI), Chemical Abstracts Service (CAS), SCIWIN (Scientific World Index), Google Scholar, Latin American and Caribbean Health Sciences Information System (LILACS), Index Medicus for the Eastern Mediterranean Region (IMEMR), Index Medicus for the South-East Asian Region (IMSEAR), Western Pacific Region Index Medicus (WPRIM), various sites for ongoing trials namely clinical trial registry ( www...
September 4, 2016: Journal of Maternal-fetal & Neonatal Medicine
Daniel Klotz, Christoph Schaefer, Dimitra Stavropoulou, Hans Fuchs, Stefan Schumann
OBJECTIVE: Nasal high frequency oscillatory ventilation (nHFOV) is a promising mode of non-invasive neonatal respiratory support. To combine the effects of nasal continuous positive airway pressure (nCPAP) and high frequency oscillatory ventilation, an oscillatory pressure waveform is superposed to a nCPAP via a nasal or nasopharyngeal interface. nHFOV has been described to facilitate carbon dioxide (CO2 ) elimination compared to nCPAP. The influence of unintended leakage on CO2 elimination has not been investigated in nHFOV before...
August 15, 2016: Pediatric Pulmonology
Lisa A Joss-Moore, Synneva J Hagen-Lillevik, Calan Yost, Jennifer Jewell, Robert D Wilkinson, Sydney Bowen, Mar Janna Dahl, Li Dong, Zhengming Wang, Angela P Presson, Chong Zhang, Donald M Null, Bradley A Yoder, Kurt H Albertine
BACKGROUND: Preterm birth and respiratory support with invasive mechanical ventilation frequently leads to bronchopulmonary dysplasia (BPD). A hallmark feature of BPD is alveolar simplification. For our preterm lamb model of BPD, invasive mechanical ventilation is associated with postnatal feeding intolerance (reduced nutrition) and sedation. In contrast, preterm lambs managed by non-invasive support (NIS) have normal alveolar formation, appropriate postnatal nutrition, and require little sedation...
July 18, 2016: Pediatric Research
John J Hawkshead, Russell B Van Dyke, Susan E Hassig, Larry S Webber, Rodolfo E Begue
BACKGROUND: Pediatric Candida infections are associated with worse clinical outcomes and increased costs. Yet, it is not definitively known if particular species are associated with more severe illness. Differential risk factor exposures among the species group may also exist. We aimed to determine whether certain Candida species are more strongly associated with worse outcomes, and whether certain risk factors more strongly predispose patients to infection with certain species. METHODS: Microbiology lab records from patients seen from 2003 to 2010 at an urban children's hospital were reviewed for invasive or disseminated Candida infections...
2016: Infection and Drug Resistance
Brittany Pardue Jones, Geoffrey M Fleming, Jaime Kaye Otillio, Ishan Asokan, Donald H Arnold
OBJECTIVE: The goal of this report is to review available modalities for assessing and managing acute asthma exacerbations in pediatric patients, including some that are not included in current expert panel guidelines. While it is not our purpose to provide a comprehensive review of the National Asthma Education and Prevention Program (NAEPP) guidelines, we review NAEPP-recommended treatments to provide the full range of treatments available for managing exacerbations with an emphasis on the continuum of care between the ER and ICU...
August 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Sander Roosens, Frank Derriks, Filip Cools
Diaphragmatic paralysis is a rare cause of respiratory distress in the newborn. In this paper, a patient with unilateral phrenic nerve injury after traumatic delivery is presented. The child inadequately responded to standard respiratory supportive measures. Non-invasive neurally adjusted ventilatory assist (NIV-NAVA®), providing an optimally synchronized respiratory support proportional to the effort of the patient, resulted in prompt clinical and biological improvement of the patient's respiratory condition...
April 19, 2016: Pediatric Pulmonology
Peter Schenk, Ernst Eber, Georg-Christian Funk, Wilfried Fritz, Sylvia Hartl, Peter Heininger, Eveline Kink, Gernot Kühteubl, Beatrice Oberwaldner, Ulrike Pachernigg, Andreas Pfleger, Petra Schandl, Ingrid Schmidt, Markus Stein
The current consensus report was compiled under the patronage of the Austrian Society of Pneumology (Österreichischen Gesellschaft für Pneumologie, ÖGP) with the intention of providing practical guidelines for out-of-hospital ventilation that are in accordance with specific Austrian framework parameters and legal foundations. The guidelines are oriented toward a 2004 consensus ÖGP recommendation concerning the setup of long-term ventilated patients and the 2010 German Respiratory Society S2 guidelines on noninvasive and invasive ventilation of chronic respiratory insufficiency, adapted to national experiences and updated according to recent literature...
February 2016: Wiener Klinische Wochenschrift
S Weiss, A Van Egmond-Fröhlich, N Hofer, A Pfleger, R Rath, R Schwarz, H Kurz, V Waibel, H Kenzian, E Kommer, F Wadlegger, W Stelzl, B Keck, I Grigorow, R Kerbl, W Sauseng, T Frischer, E Eber, G Bernert
BACKGROUND: Population-based data on pediatric patients on long-term respiratory support (LTRS) in Austria are lacking. This study aimed to record the pediatric departments active in this field, as well as number and characteristics of patients on LTRS. METHODS: A national cross-sectional study was carried out by means of questionnaires sent to all pediatric departments in Austria. RESULTS: All departments answered to the questionnaires. On June 1st, 2013, the reference day for this study, 12 of the 41 pediatric departments in Austria were active in the field...
January 2016: Klinische Pädiatrie
Nora Hofer, Katharina Jank, Volker Strenger, Jasmin Pansy, Bernhard Resch
INTRODUCTION: Meconium aspiration syndrome (MAS) is linked to inflammation, but data on the patterns of hematological indices and C-reactive protein (CRP) in MAS are lacking. The aim of the study was to evaluate CRP, white blood cell count (WBC), absolute neutrophil count (ANC), and immature-to-total neutrophil ratio (IT-ratio) in MAS and to assess their association with disease severity. METHODS: Retrospective cross-sectional study including 239 consecutively admitted neonates with MAS to a level III NICU...
June 2016: Pediatric Pulmonology
M Westhoff, B Schönhofer, P Neumann, J Bickenbach, T Barchfeld, H Becker, R Dubb, H Fuchs, H J Heppner, U Janssens, T Jehser, O Karg, E Kilger, H-D Köhler, T Köhnlein, M Max, F J Meyer, W Müllges, C Putensen, D Schreiter, J H Storre, W Windisch
The non-invasive ventilation (NIV) is widespread in the clinical medicine and has attained meanwhile a high value in the clinical daily routine. The application of NIV reduces the length of ICU stay and hospitalization as well as mortality of patients with hypercapnic acute respiratory failure. Patients with acute respiratory failure in context of a cardiopulmonary edema should be treated in addition to necessary cardiological interventions with continuous positive airway pressure (CPAP) or NIV. In case of other forms of acute hypoxaemic respiratory failure it is recommended the application of NIV to be limited to mild forms of ARDS as the application of NIV in severe forms of ARDS is associated with higher rates of treatment failure and mortality...
December 2015: Pneumologie
Alberto García-Salido, Montserrat Nieto-Moro, María Isabel Iglesias-Bouzas, Marta González-Vicent, Ana Serrano-González, Juan Casado-Flores
OBJECTIVE: Primary objective, to describe the management and monitorization of critically ill pediatric hemato-oncology patient (CIPHO) in the Spanish pediatric intensive care units (PICU). Secondary objective, through a literature review, to identify possible areas of improvement. MATERIAL AND METHODS: Observational transversal descriptive study. An anonymous web-based survey was sent to 324 Spanish pediatric intensivists from April 2011 to May 2011. None of them were pediatric residents...
August 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Kusum Menon, Belinda Dundon, Betty-Lou Twolan, Salman AlShammari
UNLABELLED: An unplanned extubation is defined as an extubation that occurs at a time other than that planned for the procedure. It may result in life-threatening complications such as laryngospasm, pulmonary or cardiac failure. Quality improvement initiatives have targeted an unplanned extubation rate of 0% in pediatric intensive care units. OBJECTIVE: To determine if a targeted approach specific to local practices and unit culture could decrease the incidence of and, ultimately, eliminate unplanned extubations in our tertiary care PICU...
2015: Canadian Journal of Critical Care Nursing
Gennie Jing Wang, Emilie Belley-Coté, Lisa Burry, Mark Duffett, Timothy Karachi, Dan Perri, Waleed Alhazzani, Frederick D'Aragon, Hannah Wunsch, Bram Rochwerg
BACKGROUND: Management and choice of sedation is important during critical illness in order to reduce patient suffering and to facilitate the delivery of care. Unfortunately, medications traditionally used for sedation in the intensive care unit (ICU) such as benzodiazepines and propofol are associated with significant unwanted effects. Clonidine is an alpha-2 selective adrenergic agonist that may have a role in optimizing current sedation practices in the pediatric and adult critically ill populations by potentially minimizing exposure to other sedative agents...
2015: Systematic Reviews
Regina Rath-Wacenovsky
Out-of-hospital ventilation represents only a marginal area of paediatric therapeutic concepts. In Austria, the proportion of children to be supplied with invasive and non-invasive ventilation increases significantly, together with the challenges of caring for their long-term demands. Neuromuscular diseases accounted for almost the sole indication group. Premature and newborn infants with persistent respiratory failures are an increasing group, needing more extensive care due to additional comorbidities. Children with congenital disorder have often been tracheotomised in order to secure their airway, and non-invasive ventilation as a bridge- or long-term therapy gains in importance more and more...
September 2015: Wiener Medizinische Wochenschrift
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