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C Guillot, C Le Reun, H Behal, J Labreuche, M Recher, A Duhamel, S Leteurtre
BACKGROUND: Viral bronchiolitis is the leading cause of hospitalization in children during the first 12 months of life. There is evidence to support the use of noninvasive ventilation in bronchiolitis. A recent respiratory management of bronchiolitis is the use of high-flow nasal cannula (HFNC) therapy. The primary objective of this study was to evaluate the use of HFNC as the first-line treatment for children with severe bronchiolitis and the secondary objective was to identify factors for HFNC therapy failure...
March 15, 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Mihir Sarkar, Rajasree Sinha, Satyabrata Roychowdhoury, Sobhanman Mukhopadhyay, Pramit Ghosh, Kalpana Dutta, Shibarjun Ghosh
Background: Early initiation of appropriate noninvasive respiratory support is utmost important intervention to avoid mechanical ventilation in severe bronchiolitis. Aim: This study aims to compare noninvasive continuous positive airway pressure (nCPAP) and hot humidified high-flow nasal cannulae (HHHFNC) as modes of respiratory support in infants with severe bronchiolitis. Methods: Prospective, randomized, open-label pilot study done in a tertiary-care hospital Pediatric Intensive Care Unit (PICU)...
February 2018: Indian Journal of Critical Care Medicine
Hilde Brenne, Kristine Hermansen Grunewaldt, Turid Follestad, Håkon Bergseng
AIM: We measured electrical activity of the diaphragm (Edi) to compare the breathing effort in preterm infants during weaning from respiratory support with high-flow nasal cannulae (HFNC) or nasal continuous positive airway pressure (nCPAP). METHODS: This randomised cross-over study was carried out at St Olav's University Hospital, Trondheim, Norway from December 2013 to June 2015. We gave 21 preterm infants weighing at least 1,000 grams HFNC 6 l/min for four hours and nCPAP 3 cmH2 O for four hours with a one-hour wash-out period...
March 5, 2018: Acta Paediatrica
Jennifer M Guay, Dru Carvi, Deborah A Raines, Wendy A Luce
Respiratory distress continues to be a major cause of neonatal morbidity. Current neonatal practice recommends the use of nasal continuous positive airway pressure (nCPAP) in the immediate resuscitation and continued support of neonates of all gestations with clinical manifestations of respiratory distress. Despite the many short- and long-term benefits of nCPAP, many neonatal care units have met resistance in its routine use. Although there have been numerous recent publications investigating the use and outcomes of various modes of nCPAP delivery, surfactant administration, mechanical ventilation, and other forms of noninvasive respiratory support (high-flow nasal cannula, nasal intermittent positive pressure ventilation), there has been a relative lack of publications addressing the practical bedside care of infants managed on nCPAP...
January 1, 2018: Neonatal Network: NN
Srinivas Murki, Jayesh Singh, Chiragkumar Khant, Swarup Kumar Dash, Tejo Pratap Oleti, Percy Joy, Nandkishor S Kabra
BACKGROUND: Nasal continuous positive airway pressure (nCPAP) is the standard noninvasive respiratory support for newborns with respiratory distress. Evidence for high-flow nasal cannula (HFNC) as an alternative mode of respiratory support is inconclusive. OBJECTIVE: The aim of this work was to evaluate whether HFNC is not inferior to nCPAP in reducing the need for higher respiratory support in the first 72 h of life when applied as a noninvasive respiratory support mode for preterm neonates with respiratory distress...
January 23, 2018: Neonatology
Carmen Rey-Santano, Victoria E Mielgo, Miguel Angel Gomez-Solaetxe, Francesca Ricci, Federico Bianco, Fabrizio Salomone, Begoña Loureiro, Jon López de Heredia Y Goya
BACKGROUND: Nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV), forms of non-invasive ventilation (NIV) for respiratory support, are increasingly being chosen as the initial treatment for neonates with surfactant (SF) deficiency. Our objective was to compare NCPAP with NIPPV with or without SF administration as a primary mode of ventilation. METHODS: Twenty-four newborn piglets with SF-deficient lung injury produced by repetitive bronchoalveolar lavages were randomly assigned to NCPAP or NIPPV, with or without SF administration (InSurE method)...
January 10, 2018: Pediatric Research
Liang Ye, Yingying Qian, Qian Li, Surong Fang, Zhenhua Yang, Yan Tan, Wei Gu
PURPOSE: We aim to evaluate reactive oxygen species modulator 1 (Romo1) levels in obstructive sleep apnea syndrome (OSAS) and analyze its possible relationships to OSAS severity, reactive oxygen species (ROS), and C-reactive protein (CRP). Additionally, we also investigated the effects of nasal continuous positive airway pressure (nCPAP) on serum Romo1. METHODS: One hundred and five patients diagnosed with OSAS were classified into the OSAS group, and 41 subjects without OSAS were recruited for the control group...
January 4, 2018: Sleep & Breathing, Schlaf & Atmung
Dong-Mei Zhang, Rong Huang, Yi Xiao, Feng-Ying Gong, Xu Zhong, Jin-Mei Luo
Objective Obstructive sleep apnea (OSA) is closely related to obesity, insulin resistance and inflammation. Secreted frizzled-related protein 5 (SFRP5) is a recently discovered adipokine. It is involved in insulin resistance and inflammation in obesity. This study aimed at evaluating the association between SFRP5 and sleeping characteristics as well as biochemical parameters of OSA patients. Methods This was a prospective case control study. Nondiabetic OSA patients and controls were consecutively recruited and divided into three groups: OSA group, apnea-hypopnea Index (AHI)≥5/h; healthy controls with normal body mass index (BMI); obese controls without OSA, and BMI > 24...
December 30, 2017: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
W Muhsen, R Roy
INTRODUCTION: Despite recent advances in respiratory support, the wide use of antenatal steroids and surfactant replacement therapy, respiratory problems continue to represent the leading cause of mortality in premature infants during the neonatal period. In the last few years, HHHFNC has been widely adopted as a mode of noninvasive respiratory support for infants with respiratory difficulties. However, data of the safety and efficacy of HHHFNC use in extremely premature infants are scarce...
December 27, 2017: Journal of Maternal-fetal & Neonatal Medicine
Zhi-Cheng Zhu, Jian-Guo Zhou, Chao Chen
Nasal intermittent positive pressure ventilation (NIPPV) can augment nasal continuous positive airway pressure (nCPAP) by delivering intermittent positive pressure ventilation in a noninvasive way and can provide a new option for neonatal noninvasive respiratory support. NIPPV has an advantage over nCPAP in primary and post-extubation respiratory support. Moreover, it can reduce severe apnea of prematurity. Synchronized NIPPV has promising application prospects. This review article summarizes the advances in the application of NIPPV in neonatal respiratory support to promote the understanding and standardization of this technique...
December 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Aakash Pandita, Srinivas Murki, Tejo Pratap Oleti, Baswaraj Tandur, Sai Kiran, Sachin Narkhede, Amrut Prajapati
Importance: Nasal continuous positive airway pressure (NCPAP) as a primary respiratory therapy in meconium aspiration syndrome (MAS) has not been studied extensively. Nasal continuous positive airway pressure, when applied in newborns with MAS, may resolve atelectasis by sufficiently expanding partially obstructed small airways and stabilizing the collapsing terminal airways to enhance oxygen exchange. Objective: To compare NCPAP vs standard care in neonates with moderate to severe respiratory failure due to MAS in reducing the need for invasive ventilation...
February 1, 2018: JAMA Pediatrics
Kihyuck Choi, Stephen M Marek
Phoma medicaginis (syn. Ascochyta medicaginicola Qchen & L. Cai) causes spring black stem and leaf spot, an important disease of alfalfa and annual medics. P. medicaginis forms uninucleate conidia in melanized pycnidia and is genetically tractable using Agrobacterium mediated transformation (ATMT), resulting in random integration of T-DNA that occasionally generates pycnidial mutants. The T-DNA tagged mutant, P265 displayed smaller pycnidia and more aerial hyphae than the wild type. A single T-DNA disrupted a putative noncanonical poly(A) RNA polymerase gene, Pmncpap1, which in yeast interacts with ribonucleotide reductase (RNR)...
February 2018: Fungal Genetics and Biology: FG & B
N Eze, D Murphy, V Dhar, V K Rehan
OBJECTIVE: Though nasal continuous positive airway pressure (NCPAP) is commonly used for non-invasive neonatal respiratory support, the optimal method of weaning NCPAP is not established. In this prospective, two-center randomized control trial we hypothesize that gradually increasing spontaneous breathing time off NCPAP increases successful weaning from NCPAP in infants born <31 weeks gestational age. STUDY DESIGN: Infants were randomized to one of the two NCPAP weaning protocols, a sprinting, that is, gradually increasing spontaneous breathing time off CPAP, protocol vs a non-sprinting (weaning pressure down) protocol...
October 26, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
Mark S Ferguson, Jennifer Claire Magill, Bhik T Kotecha
Snoring and obstructive sleep apnoea (OSA) are increasingly common conditions, and confer a significant health and socioeconomic burden. Furthermore, untreated OSA represents a significant mortality risk. Patients require careful assessment, including detailed clinical history and examination, sleep study and drug-induced sleep endoscopy (DISE). Although nasal continuous positive airway pressure (nCPAP) is the gold standard treatment for moderate and severe OSA, multidisciplinary team assessment is often required to develop the best treatment plan for an individual, especially when nasal CPAP is poorly tolerated...
November 2017: Therapeutic Advances in Respiratory Disease
Sandeep Narayan Lal, Jaspreet Kaur, Pooja Anthwal, Pinky Bahl, Jacob M Puliyel
OBJECTIVE: To evaluate the efficacy of nasal continuous positive airway pressure (nCPAP) in decreasing respiratory distress in bronchiolitis. DESIGN: Randomized controlled trial. SETTING: Tertiary-care hospital in New Delhi, India. PARTICIPANTS: 72 infants (age <1y) hospitalized with a clinical diagnosis of bronchiolitis were randomized to receive standard care, or nCPAP in addition to standard care, in the first hour after admission...
September 26, 2017: Indian Pediatrics
Florian Schmid, Dirk Manfred Olbertz, Manfred Ballmann
BACKGROUND: High-flow nasal cannula (HFNC)1 is a technique of oxygen supply, initially being used as a potentially less-invasive alternative to nasal continuous positive airway pressure (nCPAP)2 for premature infants/neonates, which nowadays crosses the border of neonatal care. HFNC builds up a positive end-expiratory pressure (PEEP)3 but lacks the opportunity for continuous monitoring. Therefore, pressure-depending complications are a risk. Our goal was to evaluate the current use of HFNC in Germany regarding indications, techniques of application and complications experienced...
October 2017: Respiratory Medicine
Chang-Yo Yang, Mei-Chin Yang, Shih-Ming Chu, Ming-Chou Chiang, Reyin Lien
BACKGROUND: There is a lack of evidence to guide step-wise weaning of positive pressure respiratory support for premature infants. This study sought to compare the efficacy of three weaning protocols we designed to facilitate weaning of very low birth weight (VLBW, less than 1500 g) preterm infants from nasal continuous positive airway pressure (NCPAP) support. METHODS: This was a prospective, randomized, controlled trial of VLBW preterm infants who received positive pressure ventilatory support in our neonatal intensive care unit (NICU) from April 2008 through March 2009...
September 6, 2017: Pediatrics and Neonatology
Catherine S Chang, Jordan W Swanson, Anthony Wilson, David W Low, Scott P Bartlett
Nasal continuous positive airway pressure is used increasingly to treat pulmonary immaturity in premature neonates. Nasal injury is common with nasal continuous positive airway pressure use, with full-thickness tissue loss at the columella among the most devastating complications. Columellar necrosis often imparts a full-thickness injury to the overlying columellar skin, the medial crura of the lower lateral nasal cartilages, the anteromedial inner nasal mucosal lining, and potentially the anterior septal cartilage...
January 2018: Plastic and Reconstructive Surgery
William J Coles, Susanne Elliott, Jonathan Davis
No abstract text is available yet for this article.
September 18, 2017: Archives of Disease in Childhood. Education and Practice Edition
Daniel Klotz, Hendryk Schneider, Stefan Schumann, Benjamin Mayer, Hans Fuchs
OBJECTIVE: Non-invasive high-frequency oscillatory ventilation (nHFOV) has recently been described as a novel mode of respiratory support for premature infants. This study was designed to determine whether nHFOV decreases CO2 partial pressure (pCO2 ) in premature infants more effectively than non-invasive continuous positive airway pressure (nCPAP). DESIGN: Non-blinded prospective randomised controlled cross-over study. SETTING: University Medical Center tertiary neonatal intensive care unit...
September 16, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
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