Diagnostic value and pathophysiologic basis of pulsus paradoxus in infants and children with respiratory disease.

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 arterial blood pressures, left atrial pressures (LAP, 16 patients), breathing cycles, and electrocardiograms (ECG) were taken in 54 nonintubated children. There was a close relationship between systolic and diastolic blood pressure variations (r = 0.92). The mean coefficient of variation of PP was 18.4% (SD 11.6%). The relationship between respiratory dependent LAP fluctuations (Delta LAP) and PP was logarithmic. PP correlated significantly with a respiratory severity score (RSS: wheeze, oxygen requirement, heart rate, arterial partial pressure of carbon dioxide) in a subgroup of 16 asthmatics (r = 0.66, P = 0.005); wheeze score was the only true independent determinant of RSS (multiple regression). In the nonasthmatics with restrictive lung disease, the correlation coefficient for the association between PP and RSS was 0.34 (P = 0.08), with a significant univariate correlation between PP and wheeze score (r = 0.62, P = 0.001). We conclude that PP correlates significantly with wheeze in obstructive and restrictive disease. PP is a valuable clinical sign of disease severity in patients with wheeze as clinical manifestation of obstructive airway disease. The relationship between Delta LAP and PP confirms the finding that an increase in PP is associated with a rise in left atrial transmural pressure.

journal_name

Pediatr Pulmonol

journal_title

Pediatric pulmonology

authors

Frey B,Freezer N

doi

10.1002/1099-0496(200102)31:2<138::aid-ppul1022>3.

subject

Has Abstract

pub_date

2001-02-01 00:00:00

pages

138-43

issue

2

eissn

8755-6863

issn

1099-0496

pii

10.1002/1099-0496(200102)31:2<138::AID-PPUL1022>3.

journal_volume

31

pub_type

杂志文章
  • Interrupter technique in infancy: Higher airway resistance and lower short-term variability in preterm versus term infants.

    abstract:BACKGROUND:In preschool children, measurement of airway resistance using interrupter technique (Rint) is feasible to assess the degree of bronchial obstruction. Although some studies measured Rint in infancy, values of Rint and its variability in preterm infants are unknown. In this study, Rint and its variability was ...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.23771

    authors: Usemann J,Demann D,Anagnostopoulou P,Korten I,Gorlanova O,Schulzke S,Frey U,Latzin P

    更新日期:2017-10-01 00:00:00

  • Descriptive analysis of central sleep apnea in childhood at a single center.

    abstract:UNLABELLED:Data on central sleep apnea (CSA) and its significance in children are limited. Our objectives were to describe the polysomnogram (PSG) characteristics and clinical features of children with significant CSA at a single pediatric sleep center. STUDY DESIGN AND METHODS:A retrospective chart review of children...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.21469

    authors: Kritzinger FE,Al-Saleh S,Narang I

    更新日期:2011-10-01 00:00:00

  • Lung disease in Niemann-Pick disease.

    abstract:BACKGROUND:Lung involvement in children with Niemann-Pick disease has rarely been studied systematically. OBJECTIVE:To assess the involvement of the lung and the value of bronchoalveolar lavage in children with Niemann-Pick diseases. DESIGN:Retrospective analysis of patient records. PATIENTS:Thirteen patients, with ...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.20725

    authors: Guillemot N,Troadec C,de Villemeur TB,Clément A,Fauroux B

    更新日期:2007-12-01 00:00:00

  • Advance care planning in adolescents with cystic fibrosis: A quality improvement project.

    abstract:INTRODUCTION:Advance care planning (ACP), though recommended, has not been studied in adolescents with cystic fibrosis (CF). This quality improvement project engaged adolescents with advanced CF disease in ACP and assessed patient and CF provider attitudes and preferences regarding ACP discussions and tools. MATERIALS...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.23559

    authors: Kazmerski TM,Weiner DJ,Matisko J,Schachner D,Lerch W,May C,Maurer SH

    更新日期:2016-12-01 00:00:00

  • Normal values for forced oscillatory respiratory resistance in children.

    abstract::Forced oscillatory respiratory resistance was measured in 138 healthy children aged 2- to 16-years-old using a commercial unit. Regression analysis was performed using the resistance measurements obtained at frequencies of 6 Hz and 26 Hz and averages of measurements obtained at frequencies of from 6-26 Hz, 6-10 Hz, an...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.1950010305

    authors: Hordvik NL,König P,Morris DA,Kreutz C,Pimmel RL

    更新日期:1985-05-01 00:00:00

  • Determinants of tidal flow volume loop indices in neonates and children with and without asthma.

    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

    authors: Lødrup Carlsen KC,Stenzler A,Carlsen KH

    更新日期:1997-12-01 00:00:00

  • Associations of obesity and asthma with functional exercise capacity in urban minority adolescents.

    abstract:PURPOSE:To examine the independent association of asthma and obesity and of their co-existence with functional exercise capacity among urban adolescents. METHODS:One hundred eighteen Hispanic- and African-American adolescents including 33 obese asthmatics, 18 normal-weight asthmatics, 38 obese non-asthmatics, and 29 n...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.22547

    authors: Rastogi D,Khan UI,Isasi CR,Coupey SM

    更新日期:2012-11-01 00:00:00

  • Randomized controlled trial of salbutamol aerosol therapy via metered dose inhaler-spacer vs. jet nebulizer in young children with wheezing.

    abstract::The jet nebulizer is a common device used for administering aerosol medication in young children. However, compared to a metered dose inhaler-spacer (MDI-spacer), it takes more time and personnel. This study aimed to compare the efficacy of salbutamol aerosol therapy given via these two devices in young wheezing child...

    journal_title:Pediatric pulmonology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1002/ppul.20204

    authors: Deerojanawong J,Manuyakorn W,Prapphal N,Harnruthakorn C,Sritippayawan S,Samransamruajkit R

    更新日期:2005-05-01 00:00:00

  • Ciliary beat frequency in children with adenoid hypertrophy.

    abstract:BACKGROUND:Children with adenoid hypertrophy (AH) have impaired respiratory system defense mechanisms, such as mucociliary clearance. We hypothesized that AH negatively affects one of the most important aspects of mucociliary clearance-ciliary beat frequency (CBF) and that adenoidectomy could potentially restore this e...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.24622

    authors: Marusiakova L,Durdik P,Jesenak M,Bugova G,Kvassayova J,Oppova D,Banovcin P

    更新日期:2020-03-01 00:00:00

  • Limitations of electronic compensation for measuring plethysmographic airway resistance in infants.

    abstract::Electronic compensation to overcome thermal artifacts during plethysmographic estimations of airway resistance is now used routinely in adults and school-age children, and was shown to be a valuable means of discriminating airway function between preschool children with and without lung disease. A similar system is no...

    journal_title:Pediatric pulmonology

    pub_type: 临床试验,杂志文章

    doi:10.1002/ppul.20217

    authors: Subbarao P,Hulskamp G,Stocks J

    更新日期:2005-07-01 00:00:00

  • Steroid-sparing effect of omalizumab for allergic bronchopulmonary aspergillosis and cystic fibrosis.

    abstract::Allergic bronchopulmonary aspergillosis (ABPA) is a complication commonly encountered in patients with CF that produces significant respiratory morbidity. Chronic airway colonization with Aspergillus induces strong inflammatory responses with high IgE levels. Current guidelines for therapy include prolonged courses of...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.20804

    authors: Zirbes JM,Milla CE

    更新日期:2008-06-01 00:00:00

  • Obstructive sleep apnea in infancy: a 7-year experience at a pediatric sleep center.

    abstract:PURPOSE:To investigate the common indications for polysomnogram (PSG) associated co-morbid conditions, evaluation strategies, treatment options, and outcomes in a series of infants diagnosed with obstructive sleep apnea (OSA) by a PSG. METHODS:Retrospective chart review of infants who underwent PSG over a 7-year perio...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.22867

    authors: Ramgopal S,Kothare SV,Rana M,Singh K,Khatwa U

    更新日期:2014-06-01 00:00:00

  • Anti-inflammatory effects of macrolides in lung disease.

    abstract::During the past five decades there has been increasing interest in the potential anti-inflammatory effects of macrolide antibiotics. Low-dose macrolide therapy has dramatically increased survival in patients with diffuse panbronchiolitis, a disease with many similarities to cystic fibrosis (CF). This has led to furthe...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章,评审

    doi:10.1002/ppul.1076

    authors: Jaffé A,Bush A

    更新日期:2001-06-01 00:00:00

  • Heme oxygenase-1 alleviates eosinophilic inflammation by inhibiting STAT3-SOCS3 signaling.

    abstract::Airway inflammation of eosinophilic asthma (EA) attributes to Th2 response, leaving the role of Th17 response unknown. Signal transducer and activator of transcription 3 (STAT3) induce both suppressors of cytokine signaling 3 (SOCS3) and retinoic acid receptor-related orphan nuclear receptor γ (RORγt) to initiate Th17...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.24759

    authors: Lin X,Lv J,Ge D,Bai H,Yang Y,Wu J

    更新日期:2020-06-01 00:00:00

  • Measurement of single breath-hold carbon monoxide diffusing capacity in healthy infants and toddlers.

    abstract::We describe a method for measuring carbon monoxide diffusing capacity (DL(CO)) and alveolar volume (V(A)) in sleeping infants, using a single 4-sec breath-hold technique. The breath-hold maneuver is obtained by inducing a respiratory pause of the respiratory system. Several inflations of the respiratory system with ro...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.20403

    authors: Castillo A,Llapur CJ,Martinez T,Kisling J,Williams-Nkomo T,Coates C,Tepper RS

    更新日期:2006-06-01 00:00:00

  • Sidestream microstream end tidal carbon dioxide measurements and blood gas correlations in neonatal intensive care unit.

    abstract:OBJECTIVE:The study was designed to assess the use of newer sidestream microstream end tidal carbon dioxide (ETCO(2) ) device in predicting blood carbon dioxide (PCO(2) ) measurements in very low birth weight (VLBW = birth weight <1,500 g) and non-VLBW NICU neonates. STUDY DESIGN:Sidestream microstream ETCO(2) detecto...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.22593

    authors: Singh BS,Gilbert U,Singh S,Govindaswami B

    更新日期:2013-03-01 00:00:00

  • Radiographic findings among children hospitalized with severe community-acquired pneumonia.

    abstract:BACKGROUND:Community-acquired pneumonia (CAP) is a leading cause of childhood death. There are few published reports of radiographic findings among children with severe CAP. OBJECTIVE:To describe chest X-ray (CXR) findings and assess association between these radiographic findings and pneumococcal isolation in childre...

    journal_title:Pediatric pulmonology

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1002/ppul.21287

    authors: Ferrero F,Nascimento-Carvalho CM,Cardoso MR,Camargos P,March MF,Berezin E,Ruvinsky R,Sant'Anna C,Feris-Iglesias J,Maggi R,Benguigui Y,CARIBE group.

    更新日期:2010-10-01 00:00:00

  • Effect of low altitude at the Dead Sea on exercise capacity and cardiopulmonary response to exercise in cystic fibrosis patients with moderate to severe lung disease.

    abstract::Oxygen supplementation may improve exercise tolerance and the physiological response to exercise in cystic fibrosis (CF) patients. Elevated barometric pressure at low altitude is a simple means of increasing the quantity of inspired oxygen. Our objectives were to examine the effect of natural oxygen enrichment (at the...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章,随机对照试验

    doi:10.1002/ppul.20342

    authors: Falk B,Nini A,Zigel L,Yahav Y,Aviram M,Rivlin J,Bentur L,Avital A,Dotan R,Blau H

    更新日期:2006-03-01 00:00:00

  • Evaluation of pulmonary reexpansion in a porcine model of bronchial foreign body.

    abstract:OBJECTIVES:This study was designed to establish a porcine model of reversible obstruction of endobronchial foreign body (FB) and to assess the natural pulmonary reexpansion process using radiology and histopathology after removal of the bronchial FB. METHODS:A metal stent was placed in the right lower lobe bronchial l...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.23947

    authors: Wang S,Tu J,Song Y

    更新日期:2018-03-01 00:00:00

  • Evaluation and management of pulmonary disease in ataxia-telangiectasia.

    abstract:SUMMARY:Ataxia-telangiectasia (A-T) is a rare autosomal recessive disorder caused by mutations in the ATM gene, resulting in faulty repair of breakages in double-stranded DNA. The clinical phenotype is complex and is characterized by neurologic abnormalities, immunodeficiencies, susceptibility to malignancies, recurren...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.21277

    authors: McGrath-Morrow SA,Gower WA,Rothblum-Oviatt C,Brody AS,Langston C,Fan LL,Lefton-Greif MA,Crawford TO,Troche M,Sandlund JT,Auwaerter PG,Easley B,Loughlin GM,Carroll JL,Lederman HM

    更新日期:2010-09-01 00:00:00

  • Passive smoking does not increase hydrogen peroxide (H2O2) levels in exhaled breath condensate in 9-year-old healthy children.

    abstract::Environmental tobacco smoke, also called passive smoking, was shown to have adverse effects on the health of children. Hydrogen peroxide (H2O2) is proposed as a sensitive marker of oxidative injury and inflammatory processes in the airways, being increased in adult active cigarette smokers. We tested whether passive s...

    journal_title:Pediatric pulmonology

    pub_type: 临床试验,杂志文章

    doi:10.1002/ppul.20129

    authors: Doniec Z,Nowak D,Tomalak W,Pisiewicz K,Kurzawa R

    更新日期:2005-01-01 00:00:00

  • Pulmonary dysfunction after primary closure of an abdominal wall defect and its improvement with bronchodilators.

    abstract::To determine the extent of pulmonary dysfunction following primary closure of an abdominal wall defect, we obtained pulmonary function tests (PFT) in 11 newborn infants with gastroschisis and 6 with large omphaloceles admitted to a newborn ICU in a children's hospital. Patients were 1 to 30 days of age at the time of ...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.1950120309

    authors: Nakayama DK,Mutich R,Motoyama EK

    更新日期:1992-03-01 00:00:00

  • Harvesting airway surface liquid: a comparison of two techniques.

    abstract::The quantity and composition of airway surface liquid (ASL) are essential to host defense. To date, attempts to harvest ASL and measure its composition have yielded conflicting results. We investigated the physical principles underlying two techniques that were proposed for harvesting ASL: filter paper pledgets and po...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.10409

    authors: Landry JS,Landry C,Cowley EA,Govindaraju K,Eidelman DH

    更新日期:2004-02-01 00:00:00

  • Transition of respiratory technology dependent patients from pediatric to adult pulmonology care.

    abstract:OBJECTIVE:Recent advances in medicine have allowed children with chronic life-threatening disorders to survive longer than ever before with the use of complex medical device technology (e.g., mechanical ventilation, dialysis, etc.). The care of children with chronic pulmonary disorders and respiratory-technology depend...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.23155

    authors: Agarwal A,Willis D,Tang X,Bauer M,Berlinski A,Com G,Ward WL,Carroll JL

    更新日期:2015-12-01 00:00:00

  • Survival of an infant with homozygous surfactant protein C (SFTPC) mutation.

    abstract::Lung diseases caused by surfactant protein C (SFTPC) mutations are inherited as autosomal traits with variable penetrance and severity or as sporadic disease caused by a de novo mutation on one allele. Here, we report the case of a child surviving with a homozygous surfactant protein C mutation after aggressive clinic...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.22976

    authors: Arıkan-Ayyıldız Z,Caglayan-Sozmen S,Isık S,Deterding R,Dishop MK,Couderc R,Epaud R,Louha M,Uzuner N

    更新日期:2014-03-01 00:00:00

  • FGR in the setting of preterm sterile intra-uterine milieu is associated with a decrease in RDS.

    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

    authors: Park CW,Park JS,Jun JK,Yoon BH

    更新日期:2016-08-01 00:00:00

  • NAVA-synchronized compared to nonsynchronized noninvasive ventilation for apnea, bradycardia, and desaturation events in VLBW infants.

    abstract::Neurally adjusted ventilatory assistance (NAVA) can overcome technical difficulties with synchronizing noninvasive ventilation breaths with the patient, a modality often used in very low birthweight infants (VLBW) with apnea of prematurity (AOP). This study is a retrospective single-center investigation into whether N...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.24464

    authors: Tabacaru CR,Moores RR Jr,Khoury J,Rozycki HJ

    更新日期:2019-11-01 00:00:00

  • Long-term tobramycin aerosol therapy in cystic fibrosis.

    abstract::The long-term efficacy and safety of aminoglycoside aerosol therapy for Pseudomonas aeruginosa colonization/infection in cystic fibrosis has not been fully investigated. In the present study, 14 patients with cystic fibrosis, ages 8-19 years (mean: 13.3 years), received tobramycin aerosol therapy for a mean duration o...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.1950060207

    authors: Steinkamp G,Tümmler B,Gappa M,Albus A,Potel J,Döring G,von der Hardt H

    更新日期:1989-01-01 00:00:00

  • Assessing bronchodilator responsiveness in infants using partial expiratory flow-volume curves.

    abstract::Our objective was to compare the effectiveness of maximum forced expiratory flow measured at functional residual capacity (V'maxFRC) and the ratio of flow at 75% of the forced expiratory volume to peak forced expiratory flow (FEF(75)/FEF(peak)) for detecting bronchodilator-related changes in wheezy infants. In 55 infa...

    journal_title:Pediatric pulmonology

    pub_type: 临床试验,杂志文章

    doi:10.1002/ppul.10325

    authors: Sheikh S,Castile R,Hayes J,McCoy K,Eid N

    更新日期:2003-09-01 00:00:00

  • Induced sputum to detect lung pathogens in young children with cystic fibrosis.

    abstract:INTRODUCTION:Induced sputum sampling holds promise as a method for obtaining samples representative of the lower airways in young children. Collection of induced sputum samples in young children differs from older children and adults' as pharyngeal suctioning is often required. Our aim was to determine the sensitivity ...

    journal_title:Pediatric pulmonology

    pub_type: 杂志文章

    doi:10.1002/ppul.23636

    authors: D'Sylva P,Caudri D,Shaw N,Turkovic L,Douglas T,Bew J,Keil AD,Stick S,Schultz A

    更新日期:2017-02-01 00:00:00