Open Respiratory Medicine Journal最新文献

{"title":"Validation of a Clinical Instrument for Measuring the Severity of Acute Bronchitis in Children - The BSS-ped.","authors":"Siegfried Lehrl,&nbsp;Peter Kardos,&nbsp;Heinrich Matthys,&nbsp;Wolfgang Kamin","doi":"10.2174/1874306401812010050","DOIUrl":"https://doi.org/10.2174/1874306401812010050","url":null,"abstract":"<p><strong>Background: </strong>There are no validated standardised clinical procedures for severity measurement of acute bronchitis in children. The \"BSS-ped\", a short version of the physician-rated assessment scale BSS (Bronchitis Severity Scale), can fill this gap, if it is valid.</p><p><strong>Objective: </strong>To examine the scale´s validity.</p><p><strong>Methods: </strong>Investigations were planned according to classical clinical-psychometric validity criteria including a formal competence evaluation of the scale´s authors and statistical analyses of data from 78 patients aged 1-6 and diagnosed with \"acute bronchitis\". Cross-validation was provided by analysis of data from 70 children with matching age, sex and diagnosis. All children were examined three times (day 0, 3-5 and 7) using the BSS-ped in addition to other clinical and psychometric monitoring procedures.</p><p><strong>Results: </strong>The evidently high level of expertise of the scale's authors substantiates pronounced content validity and relevance of the BSS-ped and its items. The validity criterion, <i>i.e</i>. to reflect the unidimensional severity of acute bronchitis and its change using the BSS-ped score, was fulfilled. There were substantial correlations with other scales measuring the current health-related quality of life, as well as satisfaction and success of treatment. Severity change prognoses for acute bronchitis under placebo and an active substance were correct. The BSS-ped was found to be a feasible instrument because it can be repeated at short intervals (minute range) without any special technical aids or extended training.</p><p><strong>Conclusion: </strong>The BSS-ped is a valid procedure for measuring the severity of acute bronchitis in children.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"12 ","pages":"50-66"},"PeriodicalIF":0.0,"publicationDate":"2018-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874306401812010050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36728478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spirometric Values of Greek People and Comparison with ECSC and GLI Values in COPD People.","authors":"Nikolaos Tatsis,&nbsp;Sotirios Kakavas,&nbsp;Evgenios Metaxas,&nbsp;Evangelos Balis,&nbsp;George Tatsis,&nbsp;Nikolaos Pantazis,&nbsp;Petros Bakakos,&nbsp;Nikolaos Koulouris,&nbsp;Κostantinos Hadjistavrou","doi":"10.2174/1874306401812010029","DOIUrl":"https://doi.org/10.2174/1874306401812010029","url":null,"abstract":"<p><strong>Background: </strong>During the past few years, the use of criteria introduced by Global Initiative for Chronic Obstructive Lung Disease (GOLD) is recommended for the diagnosis and classification of Chronic Obstructive Pulmonary Disease(COPD),taking into account the values of a Forced Expiratory Volume In 1 second (FEV1) and a Forced Expiratory Volume In 1 second (FEV1) to Forced Vital Capacity (FVC) ratio. In Europe, the reference values of the European Coal and Steel Community (ECSC), that were originally developed in 1993 are still used.</p><p><strong>Aim of the study: </strong>The study aimed to carry out measurement of spirometric values in a healthy, non smoking Greek population, development of local equations and comparison with ECSC and Global Lung Initiative(GLI) equations, in order to see if there is a need for separate ones in everyday use.</p><p><strong>Methods: </strong>Normal predicted values for FEV1 and FEV1/FVC% were obtained from a group of 500 healthy subjects, aged 18-89 years. In addition, a group of 124 COPD patients, with no other comorbidities was studied. Patients were classified according to GOLD criteria in four groups with ECSC, GLI predicted values or with our own predicted values.</p><p><strong>Results: </strong>The statistical analysis has revealed that there is no significant difference among the three sets of predicted values and no statistical difference was detected among the classification of COPD patients.</p><p><strong>Conclusion: </strong>It is shown that the 3 sets of predicted values are almost identical, despite the fact that they have been collected from different study populations.Αccording to the study, there is no need in recalculating values for Greek population.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"12 ","pages":"29-38"},"PeriodicalIF":0.0,"publicationDate":"2018-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6080060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36443370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Comprehensive Medical Care on the Long-Term Outcomes of Children Discharged from the NICU with Tracheostomy.","authors":"Wilfredo De Jesus-Rojas,&nbsp;Ricardo A Mosquera,&nbsp;Cheryl Samuels,&nbsp;Julie Eapen,&nbsp;Traci Gonzales,&nbsp;Tomika Harris,&nbsp;Sandra McKay,&nbsp;Fatima Boricha,&nbsp;Claudia Pedroza,&nbsp;Chiamaka Aneji,&nbsp;Amir Khan,&nbsp;Cindy Jon,&nbsp;Katrina McBeth,&nbsp;James Stark,&nbsp;Aravind Yadav,&nbsp;Jon E Tyson","doi":"10.2174/1874306401812010039","DOIUrl":"https://doi.org/10.2174/1874306401812010039","url":null,"abstract":"<p><strong>Background: </strong>Survival of infants with complex care has led to a growing population of technology-dependent children. Medical technology introduces additional complexity to patient care. Outcomes after NICU discharge comparing Usual Care (UC) with Comprehensive Care (CC) remain elusive.</p><p><strong>Objective: </strong>To compare the outcomes of technology-dependent infants discharged from NICU with tracheostomy following UC versus CC.</p><p><strong>Methods: </strong>A single site retrospective study evaluated forty-three (N=43) technology-dependent infants discharged from NICU with tracheostomy over 5½ years (2011-2017). CC provided 24-hour accessible healthcare-providers using an enhanced medical home. Mortality, total hospital admissions, 30-days readmission rate, time-to-mechanical ventilation liberation, and time-to-decannulation were compared between groups.</p><p><strong>Results: </strong>CC group showed significantly lower mortality (3.4%) versus UC (35.7%), RR, 0.09 [95%CI, 0.12-0.75], P=0.025. CC reduced total hospital admissions to 78 per 100 child-years versus 162 for UC; RR, 0.48 [95% CI, 0.25-0.93], P=0.03. The 30-day readmission rate was 21% compared to 36% in UC; RR, 0.58 [95% CI, 0.21-1.58], P=0.29). In competing-risk regression analysis (treating death as a competing-risk), hazard of having mechanical ventilation removal in CC was two times higher than UC; SHR, 2.19 [95% CI, 0.70-6.84]. There was no difference in time-to-decannulation between groups; SHR, 1.09 [95% CI, 0.37-3.15].</p><p><strong>Conclusion: </strong>CC significantly decreased mortality, total number of hospital admissions and length of time-to-mechanical ventilation liberation.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"12 ","pages":"39-49"},"PeriodicalIF":0.0,"publicationDate":"2018-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36476678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and Outcomes of Children with Clinical History of Atopic <i>Versus</i> Non-atopic Asthma Admitted to a Tertiary Pediatric Intensive Care Unit.","authors":"Jamie Causey,&nbsp;Traci Gonzales,&nbsp;Aravind Yadav,&nbsp;Syed Hashmi,&nbsp;Wilfredo De Jesus-Rojas,&nbsp;Cindy Jon,&nbsp;Ikram Haque,&nbsp;Richard Johnston,&nbsp;James Stark,&nbsp;Katrina McBeth,&nbsp;Giuseppe Colasurdo,&nbsp;Ricardo Mosquera","doi":"10.2174/1874306401812010021","DOIUrl":"https://doi.org/10.2174/1874306401812010021","url":null,"abstract":"<p><strong>Background: </strong>Children admitted to the Pediatric Intensive Care Unit (PICU) with status asthmaticus have variable clinical courses, and predicting their outcomes is challenging. Identifying characteristics in these patients that may require more intense intervention is important for clinical decision-making.</p><p><strong>Objective: </strong>This study sought to determine the characteristics and outcomes, specifically length of stay and mortality, of atopic <i>versus</i> non-atopic asthmatics admitted to a PICU with status asthmaticus.</p><p><strong>Methods: </strong>A retrospective study was conducted at a children's hospital from November 1, 2008 to October 31, 2013. A total of 90 children admitted to the PICU were included in the analysis. Patients were divided into two groups based on the presence of specific historical data indicative of a clinical history of atopy. Children were considered to be atopic if they had a parental history of asthma, a personal history of eczema, or a combined history of wheezing (apart from colds) and allergic rhinitis (diagnosed by a medical provider). The median hospital Length Of Stay (LOS), PICU LOS, cardiopulmonary arrest, and mortality were compared between atopic and non-atopic asthma groups. Regression models were used to estimate the LOS stratified by atopic or non-atopic and by history of intubation in present hospitalization.</p><p><strong>Results: </strong>Median hospital LOS for atopic children was 5.9 days (IQR of 3.8-8.7) and 3.5 days (IQR of 2.2-5.5) for non-atopic asthmatics (z = 2.9, <i>p</i> = 0.0042). The median PICU LOS was 2.5 days (IQR 1.4-6.1) for atopic asthmatics and 1.6 days (IQR 1.1-2.4) for non-atopic asthmatics (z = 2.5, <i>p</i> = 0.0141). The median LOS was significantly higher for atopic intubated patients compared to non-atopic intubated patients (p=0.021). Although there was an increased tendency towards intubation in the atopic group, the difference was not significant. There was no significant difference in cardiopulmonary arrest or mortality.</p><p><strong>Conclusion: </strong>A clinical history of atopic asthma in children admitted to the PICU with status asthmaticus was associated with longer length of stays The longest LOS was observed when atopic patients required intubation.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"12 ","pages":"21-28"},"PeriodicalIF":0.0,"publicationDate":"2018-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36311518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central Venous Oxygen Saturation as a Predictor of a Successful Spontaneous Breathing Trial from Mechanical Ventilation: A Prospective, Nested Case-Control Study.","authors":"Ioannis Georgakas,&nbsp;Afroditi K Boutou,&nbsp;Georgia Pitsiou,&nbsp;Ioannis Kioumis,&nbsp;Milly Bitzani,&nbsp;Kristina Matei,&nbsp;Paraskevi Argyropoulou,&nbsp;Ioannis Stanopoulos","doi":"10.2174/1874306401812010011","DOIUrl":"https://doi.org/10.2174/1874306401812010011","url":null,"abstract":"<p><strong>Background: </strong>Weaning from mechanical ventilation is a key element in the care of critically ill patients, and Spontaneous Breathing Trial (SBT) is a crucial step in this procedure. This nested case-control study aimed to evaluate whether central oxygen saturation (ScvO₂) values and their changes could independently predict the SBT outcome among mechanically ventilated patients.</p><p><strong>Methods: </strong>A prospective cohort of patients who were mechanically ventilated for at least 48hours and fulfilled the criteria of readiness to wean constituted the study population. All patients attempted a SBT and were then categorized in SBT success group and SBT failure group, based on a combination of criteria which indicated whether SBT was successful or not. Multivariate binary logistic regression analysis was utilized to indicate the independent predictors of SBT success, while the Receiver Operating Characteristic (ROC) curves were used to demonstrate the diagnostic accuracy of these independent predictors.</p><p><strong>Results: </strong>Seventy-seven patients 69(18-86) years old; 62.3% male) constituted the study population. SBT was successful among 63.6% of them. A decrease in ScvO₂ values (ΔScvO₂) < 4% between the beginning and the end of the trial independently predicted the successful outcome (OR=18.278; 95% CI=4.017-83.163), along with age, Hemoglobin concentration (Hb) and arterial oxygen saturation (SaO₂). Diagnostic accuracy for ΔScvO₂ alone (ROC area=0.715) was slightly superior to that of either SaO₂ (0.625) or Hb (0.685) to predict SBT success.</p><p><strong>Conclusion: </strong>ScvO₂ is an independent predictor of the weaning outcome and its evaluation may further facilitate the accurate categorization among those patients who pass or fail the SBT.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"12 ","pages":"11-20"},"PeriodicalIF":0.0,"publicationDate":"2018-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5876926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36000184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric Aspiration and Its Role in Airway Inflammation.","authors":"E B Hunt,&nbsp;A Sullivan,&nbsp;J Galvin,&nbsp;J MacSharry,&nbsp;D M Murphy","doi":"10.2174/1874306401812010001","DOIUrl":"https://doi.org/10.2174/1874306401812010001","url":null,"abstract":"<p><p>Gastro-Oesophageal Reflux (GOR) has been associated with chronic airway diseases while the passage of foreign matter into airways and lungs through aspiration has the potential to initiate a wide spectrum of pulmonary disorders. The clinical syndrome resulting from such aspiration will depend both on the quantity and nature of the aspirate as well as the individual host response. Aspiration of gastric fluids may cause damage to airway epithelium, not only because acidity is toxic to bronchial epithelial cells but also due to the effect of digestive enzymes such as pepsin and bile salts. Experimental models have shown that direct instillation of these factors to airways epithelia cause damage with a consequential inflammatory response. The pathophysiology of these responses is gradually being dissected, with better understanding of acute gastric aspiration injury, a major cause of acute lung injury, providing opportunities for therapeutic intervention and potentially, ultimately, improved understanding of the chronic airway response to aspiration. Ultimately, clarification of the inflammatory pathways which are related to micro-aspiration <i>via</i> pepsin and bile acid salts may eventually progress to pharmacological intervention and surgical studies to assess the clinical benefits of such therapies in driving symptom improvement or reducing disease progression.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"12 ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2018-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874306401812010001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35842624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Breath-Holding Test in Assessment of Peripheral Chemoreflex Sensitivity in Patients with Chronic Heart Failure.","authors":"Nikita Trembach,&nbsp;Igor Zabolotskikh","doi":"10.2174/1874306401711010067","DOIUrl":"https://doi.org/10.2174/1874306401711010067","url":null,"abstract":"<p><strong>Background: </strong>The sensitivity of peripheral chemoreflex is a marker of the severity of heart failure and the prognosis of the outcome in these patients. The assessment of chemosensitivity in these patients remains an actual problem.</p><p><strong>Objective: </strong>The aim of the study was to explore the relationship between a Breath-Holding Test (BHT) and single-breath carbon dioxide test and to evaluate the reliability of both tests in patients with Heart Failure (HF).</p><p><strong>Method: </strong>The study was performed in 43 patients with chronic heart failure. All subjects underwent BHT and single-breath carbon dioxide (CB-CO₂), the evaluation of both tests was repeated a month later. Relationship of two test was evaluated by correlation analysis. Reliability was assessed with calculation of Standard Error of Measurement (SEM), Coefficient of Variation (CV) and Intraclass Correlation Coefficient (ICC).</p><p><strong>Results: </strong>The duration of the breath-holding was inversely correlated to the result of CB-CO₂ test (r = -0.86 at first measurement and r = -0.79 after a month) The ICC was 0.87 (95%CI: 0.78-0.93) for SB-CO₂ test and 0,93 (95%CI: 0.88-0.96) for BHT, the CV was 24% for SB-CO₂ and 13% for BHT. SEM for SB-CO₂ test was 0.04 L / min / mmHg and limits of variation was 0.11 L / min / mmHg; SEM for BHT was 3.6 sec and limits of variation was10 sec.</p><p><strong>Conclusion: </strong>Breath-holding test is a reliable and safe method for assessing the sensitivity of peripheral chemoreflex to carbon dioxide in patients with heart failure.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"11 ","pages":"67-74"},"PeriodicalIF":0.0,"publicationDate":"2017-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5750724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35781221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchodilator Response Assessment of the Small Airways Obstructive Pattern.","authors":"Plamen Bokov,&nbsp;Clémence Martin,&nbsp;Sémia Graba,&nbsp;Karine Gillet-Juvin,&nbsp;Mohamed Essalhi,&nbsp;Christophe Delclaux","doi":"10.2174/1874306401711010047","DOIUrl":"https://doi.org/10.2174/1874306401711010047","url":null,"abstract":"<p><strong>Background: </strong>A concomitant decrease in FEV₁ and FVC with normal FEV₁/FVC ratio and TLC defines small airways obstructive pattern (SAOP) and constitutes a classic pitfall of pulmonary-function-tests interpretation.</p><p><strong>Objective: </strong>To evaluate the prevalence of flow- (FEV₁ increase≥12% and 200 mL), volume- (FVC or inspiratory capacity [IC] increase≥12% and 200 mL), flow and volume-, and non-response to bronchodilation in patients with SAOP. An additional objective was to assess whether impulse oscillometry (IOS) parameters allow the diagnosis of SAOP and its reversibility.</p><p><strong>Methods: </strong>Fifty consecutive adult patients with SAOP (FEV₁ and FVC < lower limit of normal, FEV₁/FVC and TLC > lower limit of normal) diagnosed on spirometry and plethysmography underwent the assessment of reversibility (400 µg salbutamol) on FEV₁, FVC, IC and IOS parameters.</p><p><strong>Results: </strong>The diseases most frequently associated with SAOP were COPD and asthma (26 and 15 patients, respectively). Six patients were flow-responders, 20 were volume-responders, 9 were flow and volume-responders and 15 patients were non-responders. Overall, 26 patients had a significant improvement of IC, and 35 / 50 (70%, 95%CI: 57-83) exhibited a significant bronchodilator response. The difference between Rrs_5Hz and Rrs_20Hz was increased in 28/50 patients (56%, 95%CI: 42-70 with value higher than upper limit of normal) and its decrease after bronchodilator significantly correlated to FEV₁ increase only, suggesting proximal airway assessment.</p><p><strong>Conclusion: </strong>A significant reversibility, mainly assessed on IC increase, is frequent in Small Airways Obstructive Pattern. Impulse oscillometry is of limited value in this context because of its low sensitivity.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"11 ","pages":"47-53"},"PeriodicalIF":0.0,"publicationDate":"2017-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5543622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35444190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Nasal Non-Invasive Ventilation with a RAM Cannula in the Outpatient Home Setting.","authors":"Wilfredo De Jesus Rojas,&nbsp;Cheryl L Samuels,&nbsp;Traci R Gonzales,&nbsp;Katrina E McBeth,&nbsp;Aravind Yadav,&nbsp;James M Stark,&nbsp;Cindy Jon,&nbsp;Ricardo A Mosquera","doi":"10.2174/1874306401711010041","DOIUrl":"https://doi.org/10.2174/1874306401711010041","url":null,"abstract":"<p><strong>Background: </strong>Nasal non-invasive-ventilation (Nasal NIV) is a mode of ventilatory support providing positive pressure to patients via a nasal interface. The RAM Cannula is an oxygen delivery device that can be used as an alternative approach to deliver positive pressure. Together they have been successfully used to provide respiratory support in neonatal in-patient settings.</p><p><strong>Objective: </strong>To describe the outpatient use of Nasal NIV/RAM Cannula as a feasible alternative for home respiratory support in children with chronic respiratory failure.</p><p><strong>Methods: </strong>We performed a retrospective case series of 18 children (4 months to 19 years old) using the Nasal NIV/RAM Cannula in the Pediatric Pulmonary Clinic at the McGovern Medical School, UTHealth (2014-16). Consideration for Nasal NIV/RAM Cannula utilization included: inability to wean-off in-patient respiratory support, comfort for dyspnea, intolerability of conventional mask interfaces and tracheostomy avoidance.</p><p><strong>Results: </strong>Average age was 7 years. 50% were Caucasian, 38% African-American and 11% Hispanics. Pulmonary disorders included: chest wall weakness (38%), central control abnormalities (33%), obstructive lung disease (16%) and restrictive lung disease (11%). Indications for Nasal NIV/RAM Cannula initiation included: CPAP/BPAP masks intolerability (11%), dyspnea secondary to chest wall weakness (38%) and tracheostomy avoidance (50%). Average length of use of Nasal NIV/RAM Cannula was 8.4 months. Successful implementation of Nasal NIV/Ram Cannula was 94%. One patient required a tracheostomy following the use of Nasal NIV/RAM Cannula. Significant decrease in arterial PaCO₂ pre and post Nasal NIV/RAM cannula initiation was notable (p=0.001).</p><p><strong>Conclusion: </strong>Outpatient use of Nasal NIV/RAM Cannula may prove to be a feasible and save treatment alternative for children with chronic respiratory failure, chest wall weakness, dyspnea and traditional nasal/face mask intolerance to avoid tracheostomy.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"11 ","pages":"41-46"},"PeriodicalIF":0.0,"publicationDate":"2017-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874306401711010041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35444189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"24-Hour Hypoxia and Pulmonary Hypertension in Patients with Idiopathic Pulmonary Fibrosis.","authors":"Marcelo P Rodrigues,&nbsp;Carolina M Vissoci,&nbsp;Samuel P Rosa,&nbsp;Sandra B C Negreiros","doi":"10.2174/1874306401711010010","DOIUrl":"https://doi.org/10.2174/1874306401711010010","url":null,"abstract":"<p><strong>Background: </strong>The quantification of hypoxia based on resting partial pressure of arterial oxygen (PaO₂) may underestimate hypoxia related to activities of daily living or sleep and thus not accurately reflect pulmonary hypertension (PH). The aim of the present study was to investigate the association of resting PaO₂ with percent time of SpO₂ below 90% (T90) and 88% (T88) in 24 hours. We also evaluated the capacity of hypoxia measures to predict PH in patients with idiopathic pulmonary fibrosis (IPF).</p><p><strong>Method: </strong>This cross-sectional study included 27 patients with IPF presenting PaO₂ ≥ 55 mmHg and not receiving home oxygen therapy. All were submitted to blood gas measurement, 24-h oximetry, and transthoracic Doppler echocardiography to estimate systolic pulmonary artery pressure (SPAP). Patients were divided into three groups according to resting PaO₂: 55-55.9 mmHg (A); 60-60.9 mmHg (B); ≥ 70 mmHg (C). PH was defined as \"likely\" if SPAP > 50 mmHg, and as possible for SPAP between 37 and 50 mmHg.</p><p><strong>Results: </strong>T90 and T88 in Groups A, B, and C were as follows: 59.9±29% and 44.1±34%; 49.3±34% and 29.9±31%; 17.1±25% and 8.8±18% respectively, with significant differences between the groups for both T90 (<i>p</i> ≤ 0.01) and T88 (<i>p</i> = 0.02). PaO₂ was inversely correlated with T90 (r = -0.398; <i>p</i> = 0.04) and T88 (r = -0.351; <i>p</i> = 0.07). Hypoxia variables did not correlate with SPAP, and were not able to predict PH.</p><p><strong>Conclusion: </strong>Percent time of SpO₂ below 90% and 88% in 24 hours revealed periods of severe hypoxia even in patients with borderline-normal resting PaO₂. However, none of the present hypoxia variables was capable of predicting PH.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"11 ","pages":"10-16"},"PeriodicalIF":0.0,"publicationDate":"2017-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5470069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35127303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}