Abstract:
:Background The prevalence of respiratory-technology dependent children is increasing although for most children the goal is liberation from technology. Liberation from home mechanical ventilation (HMV) and decannulation strategies vary due to the lack of clinical practice standards. The primary objective of this study was to describe our practice utilizing a polysomnography (PSG) in the liberation from respiratory-technology process. Methods Retrospective study of tracheostomized children with and without HMV who underwent an evaluation for decannulation between January 2006 and June 2016. Patient demographics, indication for tracheostomy, indication for PSG, PSG results and interventions performed after the PSG were collected. RESULTS: We identified 153 decannulation attempts in 148 children. Ninety-nine children had a tracheostomy only and 49 children had a tracheostomy with HMV. There were 190 PSGs performed. Almost two-thirds of the children (N = 92) had at least one PSG, 37 children (25%) had two and 19 children (13%) had more than 2 PSGs. Children with tracheostomy and HMV had more PSGs compared to children with tracheostomy only. PSGs were performed at four points: (1) prior to tracheostomy placement (N = 23); (2) to titrate HMV (N = 19); (3) off-HMV support (N = 43); and with a capped tracheostomy (N = 101). Most of the off-HMV PSGs (N = 39) were favorable for discontinuing HMV. About two-thirds of the capped PSGs (N = 73) were favorable for decannulation; of the unfavorable capped PSGs (N = 28), thirteen required airway surgeries following the unfavorable PSG. CONCLUSION: : Overnight PSG provides useful information to the liberation process, particularly when determining readiness for discontinuing HMV and decannulation.
journal_name
Pediatr Pulmonoljournal_title
Pediatric pulmonologyauthors
Bashir A,Henningfeld JK,Thompson NE,D'Andrea LAdoi
10.1002/ppul.24164subject
Has Abstractpub_date
2018-11-01 00:00:00pages
1549-1558issue
11eissn
8755-6863issn
1099-0496journal_volume
53pub_type
杂志文章abstract:OBJECTIVE:To examine cystic fibrosis (CF) physician adherence to the 2007 CF Foundation (CFF) Pulmonary Guidelines for Chronic Medications. Specifically adherence and barriers to prescribing level A medication recommendations (i.e., inhaled tobramycin and dornase alfa) and level B medication recommendations (i.e., macr...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.21573
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:To determine if fetal growth restriction (FGR) in the setting of sterile intra-uterine milieu would be associated with a decrease in respiratory distress syndrome (RDS) of preterm-neonates. METHODS:The relationship between FGR and neonatal RDS was examined in 92 singleton preterm-neonates (gestational age [G...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.23369
更新日期:2016-08-01 00:00:00
abstract::During the final prenatal period of fetal lung development in humans, important maturational processes occur, including the production of surfactant necessary to decrease surface tension at the air-liquid interface of the alveoli. During early gestation, the glucocorticoid receptor is expressed in the fetal lung, and ...
journal_title:Pediatric pulmonology
pub_type: 杂志文章,评审
doi:10.1002/ppul.1092
更新日期:2001-07-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章,评审
doi:10.1002/ppul.24442
更新日期:2019-10-01 00:00:00
abstract::The purpose of this report is to describe the College of American Pathologists sweat testing (SW) proficiency testing program for cystic fibrosis, to evaluate its impact on test performance, and to describe the current practice of sweat testing in North America. The study analyzed participant summary reports of the SW...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/1099-0496(200012)30:6<476::aid-ppul7>3.0.c
更新日期:2000-12-01 00:00:00
abstract::Ten infants with evidence of impending respiratory failure from severe bronchiolitis were successfully treated with continuous positive airway pressure (NCPAP) with double nasal prongs. Their mean (SD) age was 6.7 (3.8) months and mean (SD) body weight was 7.1 (2.1) kg. Respiratory assessments were made immediately be...
journal_title:Pediatric pulmonology
pub_type: 临床试验,杂志文章
doi:10.1002/ppul.1950160305
更新日期:1993-09-01 00:00:00
abstract::Nine young asthmatic children aged 2-5 years underwent methacholine challenge after placebo or albuterol administered by metered dose inhaler through a spacer device (Babyhaler) with a face mask in a double-blind, cross-over, randomized study. The methacholine challenge was performed using chest auscultation to define...
journal_title:Pediatric pulmonology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/ppul.1950170503
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE:Alveolar concentration (C(A)NO) and bronchial flux (J(aw)NO) of nitric oxide (NO) characterize the contributions of peripheral and proximal airways to exhaled NO. Both parameters can be estimated using a two-compartment model if the fraction of NO in orally exhaled air (FE(NO)) is measured at multiple constan...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.22550
更新日期:2012-11-01 00:00:00
abstract::A neonate with severe neonatal asphyxia was treated with therapeutic hypothermia. He developed hypothermia-induced respiratory deterioration, after which congenital tracheal stenosis and pulmonary artery sling were diagnosed. Even low-grade hypothermia is likely to induce bronchial narrowing in neonates, especially in...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.23538
更新日期:2017-03-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章,评审
doi:10.1002/ppul.20943
更新日期:2008-12-01 00:00:00
abstract::To evaluate the long-term effect of prematurity and/or hyaline membrane disease (HMD) on pulmonary function and airway reactivity, we studied 49 prematurely born children aged 10 to 13 years. They were divided into three groups according to birth weight and HMD status: Groups I and II comprised the children weighing l...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.1950070412
更新日期:1989-01-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24549
更新日期:2020-02-01 00:00:00
abstract::We determined the effects of an immediately antecedent viral lower respiratory tract infection (LRI) on the severity of clinical illness, changes in lung function and airway histamine responsiveness produced by a subsequent LRI in 9-12 week old beagle puppies inoculated with canine adenovirus 2, followed in 2 weeks by...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.1950100403
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Chest computerized tomography (CT) scores are associated with the frequency of future pulmonary exacerbations in people with cystic fibrosis (CF). However, cut-off values to identify children with mild lung disease with different risks for frequent future pulmonary exacerbations have not been identified. ME...
journal_title:Pediatric pulmonology
pub_type: 杂志文章,随机对照试验
doi:10.1002/ppul.24144
更新日期:2018-10-01 00:00:00
abstract::The tidal flow volume (TFV) loop ratios of (1) time to peak flow (tPTEF) to total expiratory time (tE) [tPTEF/tE] and (2) volume to peak flow (VPTEF) to expired volume (VE) [VPTEF/VE] are reported to decrease with age in early life, and to decrease in subjects with obstructive airways disease (OAD). However, the mecha...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/(sici)1099-0496(199712)24:6<391::aid-ppul3
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:Child exposure to cigarette smoke is harmful. It should be reduced through parental smoking cessation interventions. The aim of our study was to determine the impact of simple advice provided by the pediatrician on the smoking habits of parents of children with cystic fibrosis (CF), diabetes mellitus (DM) an...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.25277
更新日期:2021-01-22 00:00:00
abstract:OBJECTIVES:To determine B-type natriuretic peptide (BNP) levels in infants and children with acute lung injury (ALI), and to investigate associations between BNP levels and clinical outcome. DESIGN:Prospective observational study. SUBJECTS:After informed consent, plasma was collected from 48 pediatric patients on day...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.21111
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Socioeconomic status (SES) is a strong predictor of outcomes in cystic fibrosis (CF); however, there are no published studies evaluating this relationship in Canadians with CF. The objective of this study was to assess the effect of SES on annual hospitalization rates in a large cohort of pediatric and adult...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.21368
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVES:To investigate the adherence and the self-reported barriers to general and respiratory exercises reported by individuals with cystic fibrosis (CF). STUDY DESIGN:An exploratory, experimental study. METHODS:Community-dwelling individuals aged 16 years and over, diagnosed with CF, who were accompanied in refe...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24912
更新日期:2020-10-01 00:00:00
abstract::The purpose of the study was to analyze the respiratory-dependent intraarterial blood pressure variations (pulsus paradoxus, PP) in intensive care unit patients with obstructive and restrictive pulmonary disease, and to evaluate the usefulness of PP for assessment of disease severity. One-minute paper recordings of ar...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/1099-0496(200102)31:2<138::aid-ppul1022>3.
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:Disease burden in cystic fibrosis (CF) impacts quality of life, distress, and treatment adherence. The promoting resilience in stress management (PRISM), is a brief patient-focused intervention to promote resilience in adolescents and young adults (AYAs), which may mitigate the negative outcomes, and is prov...
journal_title:Pediatric pulmonology
pub_type: 临床试验,杂志文章
doi:10.1002/ppul.24574
更新日期:2020-03-01 00:00:00
abstract::Patients with cystic fibrosis (CF) can be discriminated from healthy subjects by measurement of the nasal potential difference, which has become a useful outcome measure for therapies directed toward correcting defective electrolyte transport in CF. A standard operating procedure was developed by a CF Foundation clini...
journal_title:Pediatric pulmonology
pub_type: 杂志文章,多中心研究
doi:10.1002/ppul.10448
更新日期:2004-05-01 00:00:00
abstract::Home mattresses of 24 asthmatic children with house dust mite allergy were sprayed with either benzyl-benzoate foam or placebo in a double blind fashion, 10 days before the children left the residential house for asthmatic children Istituto Pio XII (located in the Italian Alps in an environment free of mites) and went...
journal_title:Pediatric pulmonology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/ppul.1950180405
更新日期:1994-10-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.20022
更新日期:2004-05-01 00:00:00
abstract::Phrenic nerve paralysis is a condition typically occurring after invasive procedures in the chest and neck. Here we describe a case of transient unilateral diaphragmatic paralysis in a child with status asthmaticus complicated by complete right lung atelectasis. Common causes of this disorder and possible implications...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.20040
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:Newborns exhibit the lowest immediate respiratory morbidity rates when born following 39 completed weeks of gestation. We sought to determine whether early-term delivery (37-38 + 6 weeks' gestation) impacts on long-term pediatric respiratory morbidity. STUDY DESIGN:In this population-based prospective cohort...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.23529
更新日期:2017-02-01 00:00:00
abstract::Fetal lung hypoplasia is a common finding in several fetal conditions such as congenital diaphragmatic hernia (CDH). Interestingly, previous studies have demonstrated that hypoplastic lungs have the ability to recover to normal size, when relieved from mechanical factors. However, the underlying mechanisms remain larg...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.20840
更新日期:2008-07-01 00:00:00
abstract::Since persistent pulmonary hypertension of the newborn (PPHN) often occurs as a life-threatening illness, it would be advantageous to identify the highest-risk infants within the first 24 hours of life so that transfer to centers with extracorporeal membrane oxygenation (ECMO) or high-frequency ventilation can be faci...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.1950050103
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Different modalities of noninvasive respiratory support have been recommended for the management of acute bronchiolitis in the pediatric intensive care unit (PICU). High-flow nasal cannula (HFNC) is among the new modalities that have been widely used in the last decade. METHODS:This is a retrospective study...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24553
更新日期:2020-02-01 00:00:00
abstract::Two patients with intractable chronic cough were found to have tonsillar tissue impinging on their epiglottis. In both case, tonsillectomy was curative. The observations in these patients are consistent with a previous report indicating chronic cough from the uvula in contact with the epiglottis with cough cessation f...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.20919
更新日期:2008-11-01 00:00:00