Abstract:
OBJECTIVE:To simultaneously record tracheal and oesophageal pH in mechanically ventilated children to determine: (1) the feasibility and safety of the method; (2) the incidence of gastro-oesophageal reflux (GOR) and pulmonary contamination; and (3) their associated risk factors. DESIGN:Prospective study. SETTING:Paediatric intensive care unit in a university hospital. PATIENTS:Twenty mechanically ventilated children (mean age 6.7 years) who met the following inclusion criteria: endotracheal tube with an internal diameter of 4 mm or more (cuffed or uncuffed), mechanical ventilation for an acute disease, no treatment with antiacids, prokinetics, or H2-receptor blockers, and no nasogastric or orogastric tube. METHODS:The tracheal antimony pH probe was positioned 1 cm below the distal end of the endotracheal tube. The oesophageal antimony pH probe was positioned at the lower third of the oesophagus. pH was recorded on a double channel recorder and analysed with EsopHogram 5.01 software and by examination of the trace. The following definitions were used: GOR index, percentage of time pH < 4; pathological GOR, GOR index > 4.8%; tracheal reflux, fall in tracheal pH < 4, 4.5, or 5, or a decrease of one unit from baseline, in both cases preceded by an episode of GOR. The results were analysed statistically by Fisher's exact and the Kruskal-Wallis test. RESULTS:The procedure was well tolerated and the median duration of analysable recording was 6 hours (range 5-22.6). Pathological GOR was observed in eight (40%) children. GOR was more frequent with an uncuffed endotracheal tube than with a cuffed one (p = 0.01). Tracheal reflux (pH < 4) was observed in four children (20%) without clinical evidence of pulmonary aspiration. Episodes of tracheal reflux were associated with a GOR index > 10% (p < 0.01) and were more frequent with a maximal inspiratory pressure of < 25 cm H2O (p = 0.03), but were not related to the indication for mechanical ventilation, whether the endotracheal tube was cuffed or not, age, or drug treatment. CONCLUSIONS:Simultaneous tracheal and oesophageal pH monitoring was feasible in the setting of this study. Tracheal reflux can occur without pathological GOR, and GOR may occur without tracheal reflux. Further prospective studies in larger groups of patients are now justified.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Hue V,Leclerc F,Gottrand F,Martinot A,Crunelle V,Riou Y,Deschildre A,Fourier C,Turck Ddoi
10.1136/adc.75.1.46subject
Has Abstractpub_date
1996-07-01 00:00:00pages
46-50issue
1eissn
0003-9888issn
1468-2044journal_volume
75pub_type
杂志文章abstract:SITUATION:Patient I is a 15 year old female with ornithine transcarbamylase deficiency prescribed L-arginine 1.5 g three times daily and sodium benzoate 4.2 g three times daily. By taking her medication and controlling her diet she is able to lead a normal life and does well at school. However she struggles with the pa...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2016-311535.8
更新日期:2016-09-01 00:00:00
abstract::Fulminant endocarditis affecting the mitral valve in an 11-year-old boy was caused by a nontoxogenic strain of Corynebacterium diphtheriae. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.51.3.227
更新日期:1976-03-01 00:00:00
abstract:BACKGROUND:The number of children admitted to hospital is increasing year on year, with very short-stay admissions doubling in the last decade. Childhood head injury accounts for half a million emergency department attendances in the UK every year. The National Institute for Health and Care Excellence (NICE) has issued...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2015-308615
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between ethnicity and health outcomes among fetuses and infants with congenital left heart obstruction (LHO). DESIGN:A retrospective population-based review was conducted of fetuses and infants with LHO including all terminations, stillbirths and live births from 20 weeks' ges...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2018-315887
更新日期:2019-09-01 00:00:00
abstract::The temperatures of 587 children were taken before and after diphtheria/tetanus/pertussis (DTP) or diphtheria/tetanus (DT) vaccine. Only slight temperature increases were found but these were notably more frequent after plain than adsorbed DTP vaccine preparations and the frequency increased with each successive dose....
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.58.11.921
更新日期:1983-11-01 00:00:00
abstract:OBJECTIVE:To determine risk factors for childhood overweight that can be identified during the first year of life to facilitate early identification and targeted intervention. DESIGN:Systematic review and meta-analysis. SEARCH STRATEGY:Electronic database search of MEDLINE, EMBASE, PubMed and CAB Abstracts. ELIGIBIL...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,meta分析,评审
doi:10.1136/archdischild-2012-302263
更新日期:2012-12-01 00:00:00
abstract::Most of the consequences of early intercourse affect the woman and much research has focused upon her. As part of a study on teenage pregnancy, where 137 women were interviewed, 46 men were also interviewed. They were less likely to have had teaching about sex from parents and were subject to less parental supervision...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.63.8.935
更新日期:1988-08-01 00:00:00
abstract::Growth velocity of head circumference was studied longitudinally in different gestational age groups of 222 appropriate-weight-for-dates (AFD) and 94 small-for-dates (SFD) healthy infants during the first 5 months of life. Term AFD and SFD infants showed a steady slowing of growth rate of head circumference from birth...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.52.2.105
更新日期:1977-02-01 00:00:00
abstract::A review of 105 children with urinary tract infection showed an increasing prevalence of grades II-III vesicoureteric reflux with diminishing age. During infancy reflux was almost always severe, and affected boys as often as girls. Radiologically scarred kidneys were drained by refluxing ureters in 98% of cases. The p...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.53.3.210
更新日期:1978-03-01 00:00:00
abstract::Two cases of atypical Kawasaki disease (KD) manifested as persistent lobar lung consolidation, prolonged fever, and active inflammatory laboratory markers unresponsive to antibiotic treatment are reported. One of the children developed a giant coronary aneurysm. Atypical KD should be considered in the differential dia...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.88.10.940
更新日期:2003-10-01 00:00:00
abstract::The aim of this study was to determine whether doctors recognise eating disorders in children, in particular anorexia nervosa. A group of paediatricians, general practitioners, and school medical officers was approached to participate in the study. Each was sent a questionnaire including two case vignettes of children...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.67.1.103
更新日期:1992-01-01 00:00:00
abstract::Thyroid function was studied in 54 low birthweight infants during a 3-week period. Each infant was placed in one of three groups. Group 1 (n = 21), infants who were well and appropriately grown fro gestational age; group 2 (n = 23), infants who were appropriately grown but who had hyaline membrane disease; group 3 (n ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.56.3.214
更新日期:1981-03-01 00:00:00
abstract::The effect of raising the airways resistance of 56 normal newborn babies by blocking alternate nostrils was studied by means of oesophageal intubation and the trunk plethysmograph. Increased resistance was associated with reduced respiratory rate and ventilation. A comparison was made of the response in different slee...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.51.8.602
更新日期:1976-08-01 00:00:00
abstract::Retrospective analysis of glycosylated haemoglobin concentrations in a diabetic outpatient clinic over three and a half years showed a small seasonal variation in the mean value with a peak in mid February and a nadir in mid August. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.62.9.959
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVE:To study the epidemiology of pyridoxine dependent seizures and other forms of pyridoxine responsive seizures. DESIGN:Monthly notifications to the British Paediatric Surveillance Unit over two years. Questionnaire follow up. SETTING:UK and the Republic of Ireland. PATIENTS:Children aged 15 years or younger ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.81.5.431
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVES:To determine if there had been changes in the size of the UK paediatric workforce and working patterns between 1999 and 2013. DESIGN:Analysis of prospectively collected datasets. SETTING:UK consultant paediatricians. INTERVENTIONS:Data from the Royal College of Paediatrics and Child Health's workforce cen...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2016-312055
更新日期:2017-02-01 00:00:00
abstract::The utility of point-of-care lung ultrasound in neonatology is rapidly expanding. This review summarises current evidence of a diagnostic, procedural and observational tool valuable in the management of newborns requiring intensive care. Approaching a patient, probe in-hand with focused clinical question is essential,...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2017-314538
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:The value of comparative effectiveness trials in informing clinical and policy decisions depends heavily on the choice of control arm (comparator). Our objective is to identify challenges in comparator reasoning and to determine justification criteria for selecting a control arm in paediatric clinical trials....
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2016-310644
更新日期:2016-10-01 00:00:00
abstract::Intestinal D-fructose absorption in 31 children was investigated using measurements of breath hydrogen. Twenty five children had no abdominal symptoms and six had functional bowel disorders. After ingestion of fructose (2 g/kg bodyweight), 22 children (71%) showed a breath hydrogen increase of more than 10 ppm over ba...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.59.8.735
更新日期:1984-08-01 00:00:00
abstract::Approximately 90% of children with cancer reside in low-income and middle-income countries (LMIC) where healthcare resources are scarce and allocation decisions difficult. The cost effectiveness of treating childhood cancers in these settings is unknown. The objective of the present work was to determine cost-effectiv...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2011-301419
更新日期:2013-02-01 00:00:00
abstract::The performance of indirect indices of infection in the newborn vary because of differences in techniques, including diagnostic cut off levels. We have compared serial neutrophil band cell counts with C reactive protein measured by rate nephelometry. The 'gold standard' was a positive culture and the performance of th...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.67.7_spec_no.808
更新日期:1992-07-01 00:00:00
abstract::Information is presented about 19 children, under age 7 years, from 17 families, whose mothers consistently gave fraudulent clinical histories and fabricated signs so causing them needless harmful medical investigations, hospital admissions, and treatment over periods of time ranging from a few months to 4 years. Epis...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.57.2.92
更新日期:1982-02-01 00:00:00
abstract::Eleven very low birthweight babies being ventilated for respiratory problems during the first week of life developed air leaks on 22 occasions. On 16 out of 19 occasions the infants showed increases in urinary excretion of vasopressin after these events and on 10 occasions out of 13 there was a rise in the plasma argi...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.65.11.1259
更新日期:1990-11-01 00:00:00
abstract::Lymphocytes bearing the T cell receptor gamma delta (TCR-gamma delta) were searched for in human early milk lymphocyte suspensions by two colour cytofluorimetric analysis. It was found that the proportion of TCR-gamma delta+ cells was twofold greater in colostrum than in either autologous or heterologous blood samples...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.65.11.1274-a
更新日期:1990-11-01 00:00:00
abstract::Interferon is becoming the standard treatment in adults for chronic hepatitis C. Twenty one children with histologically proved chronic hepatitis C (10 boys, range 2.5-13 years), who were otherwise healthy, were enrolled in a randomised controlled study to test their response to interferon alfa. Eleven children were t...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/adc.74.2.152
更新日期:1996-02-01 00:00:00
abstract::The duration of symptoms before diagnosis (lag time) was defined for 184 of 236 children diagnosed as having a malignancy at the Royal Hospital for Sick Children, Edinburgh for the time period January 1982 until December 1990. The natural logarithm of the lag time was correlated with age, gender, diagnostic group, whi...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.68.6.771
更新日期:1993-06-01 00:00:00
abstract::Cystic fibrosis is a disease that still causes a reduced life expectancy. The treatment burden remains high for affected individuals with often a combination of multiple oral and inhaled medications, as well as physiotherapy, required on a daily basis. In this article, we look at an overview of the pathogenesis, how t...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2013-304400
更新日期:2014-11-01 00:00:00
abstract::A cohort of schoolchildren was followed up over 6 years from 1996 to 2001. In the final year, 315 of 500 targeted children were measured. Body mass index (BMI) increased substantially over time (p<0.001), indicating a further rise in obesity into the secondary school years. Two new indicators of obesity were also meas...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2002.020552
更新日期:2004-03-01 00:00:00
abstract::Respiratory disease is a common cause of morbidity and mortality in children with Down's syndrome (DS). Causes range from those problems common to many children with DS, such as a narrow airway or impaired immunity, to rare structural lesions, such as tracheal bronchus. Additionally, other organ systems or extrinsic f...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2013-304611
更新日期:2013-10-01 00:00:00
abstract::The past year has produced several new clinical guidelines germane to paediatric dermatology, as well as important work related to rheumatologic overlap disorders, psoriasis comorbidities, pigmented lesions and quality of life impact. This review highlights common diagnoses and treatments useful for the practicing pae...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2013-304398
更新日期:2014-10-01 00:00:00