Work of breathing and different levels of volume-targeted ventilation.

Abstract:

OBJECTIVES:The objectives of this study were to determine the impact of different volume-targeted levels on the work of breathing and to investigate whether a level that reduced the work of breathing below that experienced during ventilatory support without volume targeting could be determined. METHODS:The transdiaphragmatic pressure-time product, as an estimate of the work of breathing, was measured for 20 infants (median gestational age: 28 weeks) who were being weaned from respiratory support by using patient-triggered ventilation (either assist-control ventilation or synchronous intermittent mandatory ventilation). The transdiaphragmatic pressure-time product was measured first without volume targeting (baseline) and then at volume-targeted levels of 4, 5, and 6 mL/kg, delivered in random order. After each volume-targeted level, the infants were returned to baseline. Each step was maintained for 20 minutes. RESULTS:The mean transdiaphragmatic pressure-time product was higher with volume targeting at 4 mL/kg in comparison with baseline, regardless of the patient-triggered mode. The transdiaphragmatic pressure-time product was higher at a volume-targeted level of 4 mL/kg in comparison with 5 mL/kg and at 5 mL/kg in comparison with 6 mL/kg. The mean work of breathing was below that at baseline only at a volume-targeted level of 6 mL/kg. CONCLUSIONS:Low volume-targeted levels increase the work of breathing during volume-targeted ventilation. Our results suggest that, during weaning, a volume-targeted level of 6 mL/kg, rather than a lower level, could be used to avoid an increase in the work of breathing.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Patel DS,Sharma A,Prendergast M,Rafferty GF,Greenough A

doi

10.1542/peds.2008-2635

subject

Has Abstract

pub_date

2009-04-01 00:00:00

pages

e679-84

issue

4

eissn

0031-4005

issn

1098-4275

pii

peds.2008-2635

journal_volume

123

pub_type

杂志文章,随机对照试验
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    abstract:BACKGROUND:In the safety community, it is widely thought that a culture of safety is required to achieve high levels of safety. However, the press tends to report accidents, which are negative by their nature. Pediatric cases are often especially tragic. Relatively few data have been available on the role that the medi...

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    authors: Morgan T,McDonald J,Anderson C,Ismail M,Miller F,Mao R,Madan A,Barnes P,Hudgins L,Manning M

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    abstract::The possibility that arterial oxygen saturation (SaO2) decreases during sleep in children with chronic bronchial asthma was investigated. The relationship between decreases in sleep SaO2 and airflow obstruction and ventilatory drives, as characterized by ventilatory and inspiratory muscle activity responses to hypoxia...

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    abstract:OBJECTIVES:The objectives of this investigation were: (1) to determine degree of elevation of serum C-reactive protein (CRP) in uncomplicated acute otitis media (AOM); (2) to compare serum CRP levels in bacterial and viral otitis media; and (3) to determine whether a single serum CRP level, obtained early in the course...

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  • A Healthy Toddler With Fever and Lethargy.

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    journal_title:Pediatrics

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    doi:10.1542/peds.2018-0412

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  • Developmental Assessments in Preterm Children: A Meta-analysis.

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    journal_title:Pediatrics

    pub_type: 杂志文章,meta分析

    doi:10.1542/peds.2016-0251

    authors: Wong HS,Santhakumaran S,Cowan FM,Modi N,Medicines for Neonates Investigator Group.

    更新日期:2016-08-01 00:00:00

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  • Improving Discharge Efficiency in Medically Complex Pediatric Patients.

    abstract:BACKGROUND AND OBJECTIVE:Children with medical complexity have unique needs when facilitating transitions from hospital to home. Defining readiness for discharge is challenging, and preparation requires coordination of family, education, equipment, and medications. Our multidisciplinary team aimed to increase the perce...

    journal_title:Pediatrics

    pub_type: 杂志文章

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    authors: Statile AM,Schondelmeyer AC,Thomson JE,Brower LH,Davis B,Redel J,Hausfeld J,Tucker K,White DL,White CM

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  • 3% Hypertonic Saline Versus Normal Saline in Inpatient Bronchiolitis: A Randomized Controlled Trial.

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    pub_type: 杂志文章,随机对照试验

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  • Early Postnatal Discharge for Infants: A Meta-analysis.

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    更新日期:2014-11-01 00:00:00

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    更新日期:2012-11-01 00:00:00

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    pub_type: 杂志文章

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

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    journal_title:Pediatrics

    pub_type: 杂志文章,评审

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    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章,随机对照试验

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    abstract::The interval from the beginning of the Q wave to the origin of the T wave (Q-oTc interval) and total and ionized serum calcium levels were measured in 27 full-term and 77 premature infants. The correlation between Q-oTc and total and ionized calcium levels was significant in both full-term and normal premature infants...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Giacoia GP,Wagner HR

    更新日期:1978-06-01 00:00:00

  • Developmental changes in energy expenditure and physical activity in children: evidence for a decline in physical activity in girls before puberty.

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    更新日期:1998-05-01 00:00:00

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Stevenson RE,Howell RR,McKusick VA,Suskind R,Hanson JW,Elliott DE,Neufeld EF

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  • Causal thinking in practice: strengths and weaknesses of the clinical vantage point.

    abstract::The place of causal inference in clinical practice is considered. One function relates to the validation of existing knowledge, as in the evaluation of the medical literature, and is exemplified by the process of editorial selection. A second function relates to the validation of potential knowledge, as in the testing...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Susser M

    更新日期:1984-11-01 00:00:00

  • Neurodevelopment and in utero antiretroviral exposure of HIV-exposed uninfected infants.

    abstract:OBJECTIVE:Antiretroviral (ARV) drugs are routinely provided to HIV-infected pregnant women to prevent HIV mother-to-child transmission. Although ARV use has significantly reduced mother-to-child transmission to <2% in the United States, it remains crucial to monitor uninfected infants and children for adverse consequen...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2009-1112

    authors: Williams PL,Marino M,Malee K,Brogly S,Hughes MD,Mofenson LM,PACTG 219C Team.

    更新日期:2010-02-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1542/peds.2008-1871

    authors: Kanegaye JT,Wilder MS,Molkara D,Frazer JR,Pancheri J,Tremoulet AH,Watson VE,Best BM,Burns JC

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Chamberlin RW

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  • Survival after neonatal myocardial infarction.

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    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:

    authors: Boulton J,Henry R,Roddick LG,Rogers D,Thompson L,Warner G

    更新日期:1991-07-01 00:00:00

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    doi:10.1542/peds.2010-3664

    authors: Jago R,Davison KK,Thompson JL,Page AS,Brockman R,Fox KR

    更新日期:2011-09-01 00:00:00

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Shirley A

    更新日期:1995-10-01 00:00:00

  • Narrow vs broad-spectrum antimicrobial therapy for children hospitalized with pneumonia.

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    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究

    doi:10.1542/peds.2013-1614

    authors: Williams DJ,Hall M,Shah SS,Parikh K,Tyler A,Neuman MI,Hersh AL,Brogan TV,Blaschke AJ,Grijalva CG

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  • Trends in Health Care Spending for Children in Medicaid With High Resource Use.

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    doi:10.1542/peds.2016-0682

    authors: Agrawal R,Hall M,Cohen E,Goodman DM,Kuo DZ,Neff JM,O'Neill M,Thomson J,Berry JG

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