bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inspiratory‐to‐expiratory ratio during ventilation for idiopathic respiratory distress syndrome
Authors: Field D. , Milner A. D. , Hopkin I. E. 
Published: March 2007

AbstractWe have studied the effects of changes in inspiratory‐to‐expiratory ratios (I/E ratios) on transcutaneous blood gases in a group of 30 infants receiving respiratory support for the idiopathic respiratory distress syndrome(IRDS). Following the use of a reversed I/E ratio (inspiration exceeding expiration), changes in oxygenation were very variable but improvements were seen most consistently in babies weighing > 1,750 g and <850 g. The use of reversed I/E ratios seemed less efficient than positive end‐expiratory pressure in raising TcP for the same increase in mean airway pressure. Changes from a 1:1 ratio to a normal I/E ratio, in which expiratory time exceeded inspiratory time by 50–100%, led to more marked and consistent falls in TcP. We conclude that a flexible attitude toward the use of I/E ratios should be adopted to avoid raising mean airway pressure needlessly. Pediatr Pulmonol. 1989; 7:2–7.
Granulocyte elastase‐mediated proteolysis of alpha1‐antitrypsin in cystic fibrosis bronchopulmonary secretions
Authors: Cantin André , Bilodeau Ginette , Bégin Raymond 
Published: March 2007

AbstractAirway secretions of patients with cystic fibrosis (CF) contain large amounts of alpha1‐antitrypsin (α1‐AT), yet elastase activity is also often detectable, suggesting that airway α1‐AT may not be functional in some CF patients. It is unknown whether in CF sputum α1‐AT is inactivated by oxidants, neutrophil metalloproteinases, bacterial elastase, or neutrophil elastase. To investigate the mechanism(s) by which α1‐AT may be inactivated in CF airway secretions, sputum samples were obtained from nine patients during respiratory physiotherapy. α1‐AT was measured by radial immunodiffusion. Sputum‐α1‐AT was purified by antibody affinity chromatography. Electrophoresis of α1‐AT from seven patients with acute infectious exacerbations revealed two distinct components: a minor band corresponding to an elastase/α1‐AT complex and a major band typical of proteolysed α1‐AT (Mr = 48 kD). Each patient had large amounts of sputum elastase activity. In contrast, two patients without free sputum elastase activity had intact sputum α1‐AT; however, α1‐AT was partially truncated by porcine pancreatic elastase suggesting that the α1‐AT may have been partially oxidized. Adding α1‐AT purified from normal serum to α1‐AT‐depleted sputum containing elastase activity resulted in a small α1‐AT/elastase complex with most α1‐AT being truncated. The serine proteinase inhibitor phenylmethylsulfonyl fluoride but not the metalloproteinase inhibitor EDTA prevented α1‐AT proteolysis, thus granulocyte elastase can mediate α1‐AT‐AT degradation in CF. Apparently, the large granulocyte elastase burden in some acutely ill patients with cystic fibrosis can proteolytically inactivate α1‐AT. Pediatr Pilmonol. 1989; 7:12–17.
Comparison of a new multidose powder inhaler with a pressurized aerosol in children with asthma
Authors: Fuglsang Gunver , Pedersen Søren 
Published: March 2007

AbstractThirteen children with asthma were treated with cumulative doses of terbutaline delivered as a pressurized aerosol and from a new multidose powder inhaler (Turbuhaler) in a randomized cross‐over dose‐response study. The cumulative dose of terbutaline was 2 mg on each study day. All children used a correct aerosol inhalation technique. At no time was there any difference in forced expiratory volume in 1 s (FEV1), forced midexpiratory flow, forced vital capacity, peak expiratory flow rate, or percent increase in these parameters between the two inhalers. The mean total increases in FEV1 after 2 mg terbutaline were 60% (aerosol) and 62% (Turbuhaler); 90% of these increases were measured after a cumulative dose of 0.5 mg terbutaline. One milligram of terbutaline inhaled from a Nebuhaler at the end of each study day did not result in additional increase of pulmonary functions, indicating that maximal bronchodilation had been achieved with both inhalers. After a cumulative dose of 2 mg terbutaline from the aerosol seven children complained of tremor and one of restlessness. No side effects were reported when the Turbuhaler was used (P < 0.02). Pediatr Pilmonol. 1989; 7:112–115.
Variation in peak expiratory flow of normal and asymptomatic asthmatic children
Authors: Albertini M. , Politano S. , Berard E. , Boutte P. , Mariani R. 
Published: March 2007

AbstractPeak expiratory flow (PEF) variation was measured in 18 healthy children (Group I) aged 9.25 to 13.3 years (mean, 11 years) and in 17 asymptomatic asthmatic children (Group II) aged 8.75 to 14.25 years (mean, 11.9 years) receiving no bronchodilators. PEF was measured four times a day for a period of 10–14 days. There were no differences between Group I and Group II regarding age, height, weight, sex, duration of the study, and overall mean PEF values. Mean daily PEF variation amplitude (difference between the highest and the lowest daily values as a percent of the mean) was significantly higher in Group II than in Group I subjects (15.2 vs. 9.9%), and so was cosinor amplitude (9.6 vs. 5.9%). Significant circadian rhythm in PEF was detected by cosinor analysis in nine subjects of Group I and in eight subjects of Group II. Mean PEF bathyphase calculated by cosinor analysis (trough time in a 24 h scale) was similar in the two groups (0503 h, in Group I and 0434 h in Group II). The results of this study show that the amplitude of circadian variation in PEF tends to be higher in asymptomatic asthmatic children than in normal children, but there is too much overlap to use PEF monitoring to identify an individual asymptomatic asthmatic child. Therefore, diurnal variation of PEF is not suitable for diagnosing mild asthmatics. Pediatr Pilmonol. 1989; 7:140–144.
Connective tissue, mechanical, and morphometric changes in the lungs of weanling rats fed a low protein diet
Authors: Matsui Reiko , Thurlbeck William M. , Fujita Yoshiaki , Yu Shiu Yeh , Kida Kozui 
Published: March 2007

AbstractWe studied the effect of low‐protein diet (8% casein) on lung growth in rats from 3 to 7 weeks of age. Their diet was isocaloric with that of control animals fed a diet of 20% casein. The calorie intake of experimental animals was increased during the first 3 weeks of the experiment, but they increased less (about 10%) in body weight, had less protein and less water when the whole body was examined, and had lower serum proteins and decreased urinary hydroxyproline. The experimental animals remained in positive nitrogen balance by maintaining low urinary nitrogen excretion. The lungs of the experimental animals were abnormal, with decreased absolute amounts of hydroxyproline and desmosine and of these relative to unit lung weight. The lungs contained more air per gram of lung tissue, and the volume of air in the lung was increased at all transpulmonary pressures above zero. When corrected for increased total lung capacity, there was a loss of recoil at mid‐lung volumes. Saline‐filled volume‐pressure curves, corrected for lung volume, showed similar loss of recoil. Alveolar multiplication was quantitatively normal, but the experimental animals had larger alveoli. We conclude that the protein deprivation in isocalorically fed animals has a specific effect on lung scleroprotein content, which may be due to diminished synthesis, and this results in both structural and functional abnormalities in the lung. Our results indicate the importance of dietary protein in lung development and possibly as one of the causes of emphysema. Further studies are needed to know whether this would be a problem in infants of Kwashiokor. Pediatr Pilmonol. 1989; 7:159‐166.
Ventilatory response to combined high frequency jet ventilation and conventional mechanical ventilation for the rescue treatment of severe neonatal lung disease
Authors: Spitzer Alan R. , Butler Sharon , Fox William W. 
Published: March 2007

AbstractHigh frequency jet ventilation (HFJV) was used to treat 176 infants who were either failing to respond to conventional mechanical ventilation (CMV) or demonstrating pulmonary air leak. The median birthweight for infants treated with HFJV was 1530 g, median gestational age was 31 weeks. Median duration of therapy with HFJV was 3.0, with a range of 0.1 to 27 days. During the first 24 hours of treatment, mean airway pressure decreased from 16.2 ± 0.3 (Mean ± SEM) cmH2O to 12.2 ± 0.3 cmH2O, while mean Pa increased from 65.3 ± 3.0 torr to 93.3 ± 3.0 torr during the same time period. Simultaneously, mean Pa decreased from 46.4 ± 1.5 torr to 36.6 ± 1.0 torr, although peak inflating pressure decreased from 34.3 ± 0.7 cmH2O to 30.1 ± 0.8 cmH2O. Ninety‐five (54%) infants treated with HFJV survived. Of 123 infants with RDS 75 (61%) survived. The rate of complications for HFJV patients was similar to that seen with CMV in our nursery. This study suggests that HFJV provides improved oxygenation and ventilation of infants at lower mean and peak pressures compared to conventional mechanical ventilation. HFJV combined with CMV may be a valuable adjunct to therapy in infants with severe lung disease. Pediatr Pulmonol 1989; 7:244–250.
Tracking of lung function in healthy children and adolescents
Authors: Hibbert Marienne E. , Hudson Irene L. , Lanigan Anna , Landau Louis I. , Phelan Peter D. 
Published: March 2007

AbstractTwo hundred twenty‐six healthy school children, with a mean age of 8.8 years; 62 girls mean age 8.8, 48 boys mean age 12.6 and 51 girls mean age 12.6 years at the start, were enrolled in a longitudinal study of lung function and tested annually for 5 years. All were free of respiratory symptoms, and none smoked more than five cigarettes per week during the 5 years. Static and dynamic lung volumes (other than residual volume), maximum expiratory and inspiratory flows, and maximum mouth pressures “track,” that is, individuals remain at a constant deviation from the sample mean over time. The data indicate that these measurements of lung function in healthy individuals grow in constant proportion relative to other healthy children and adolescents. Pediatr Pulmonol 1990; 8:172‐177.
Effect of inhaled disodium cromoglycate and albuterol on energy cost of running in asthmatic children
Authors: Zanconato Stefania , Baraldi Eugenio , Santuz Pierantonio , Magagnin Giampiero , Zacchello Franco 
Published: March 2007

AbstractThe purpose of this study is to evaluate the effect of disodium cromoglycate and albuterol on energy cost of running, gas exchange, and ventilation during maximal exercise in children with exercise‐induced asthma (EIA). Twelve children (7.1–15.5 years old) with a history of mild to moderate asthma and EIA performed three maximal exercise tests on a treadmill: 1) test A, without premedication; 2) test B, after premedication with inhaled disodium cromoglycate (DSCG) (40 mg); 3) test C, after premedication with inhaled albuterol (200 μg). The energy cost of running was calculated at each minute of exercise. None of the children were limited by dyspnea during the run. The post‐exercise fall in FEVi after test A was greater than 20% for each child, the mean fall being 32.8 ± 11.6%, in comparison with 12.6 ± 8.9% after test B (P < 0.001) and 2.5 ± 5.3% after test C (P < 0.001). There was no difference in the baseline oxygen uptake for the three tests. Maximum oxygen uptake (V̇ peak) decreased from 43.9 ± 7.7 mL/min/kg in test A to 37.7 ± 6.0 mL/min/kg in test B (P < 0.01) and 39.1 ± 7.2 mL/min/kg in test C (P < 0.05). Ventilatory anaerobic threshold in tests B and C was significantly lower than in test A (P < 0.01). Ventilation (L/min) and energy cost of running (O2 mL/kg/m) were significantly lower in tests B and C than in test A at comparable times. Running time was longer in B and C (P < 0.05) with respect to A. In conclusion, premedication with DSCG and albuterol causes a decrease in ventilation and energy cost of running during exercise in children with EIA. Pediatr Pulmonol 1990; 8:240‐244.
Single breath versus panting technique in salbutamol delivery through a 750 mL spacing device
Authors: James R. W. , Masters I. B. 
Published: March 2007

AbstractSpacing devices have been widely advocated for asthmatic patients having difficulty actuating metered aerosols and co‐ordinating inspiration. Studies have generally supported the slow inspiration/breath hold technique. This requires conscious respiratory control. Such control is often not possible in young children; consequently panting techniques are widely recommended. The panting technique has not been studied.The aim of this study was to compare the bronchodilator effectiveness of panting and the single breath maneuver, each followed by a breath hold, and each at functional residual capacity (FRC), using a Volumatic Spacer®.The study design was a randomly allocated cross‐over assessment of bronchodilator response for each technique. The drug dosage was controlled by limiting the inspired volumes of gas (single and cummulative) to the pretested inspiratory capacity. Two hundred micrograms of salbutamol was delivered into the spacer.Twenty‐one patients were entered in the study and 15 (mean age ± SD = 10.9 ± 3.3 years) completed the protocol. There was no significant difference in bronchodilator response between the two groups. We conclude that the panting and the single breath techniques are equally effective in children of this age group. Pediatr Pulmonol 1990; 8:263‐267.
Pseudomonas hyperimmune globulin passive immunotherapy for pulmonary exacerbations in cystic fibrosis
Authors: van Wye John E. , Collins Michael S. , Baylor Marjorie , Pennington James E. , Hsu Yao‐Pi , Sampanvejsopa Vic , Moss Richard B. 
Published: March 2007

AbstractWe studied the effect of an intravenously administered gamma globulin [Ps‐ivlG] enriched fivefold over conventional ivlG for Pseudomonas aeruginosa lipopolysaccharide [PA LPS] antibodies on ten patients with cystic fibrosis [CF] aged 19–32 years during hospitalization for pulmonary deterioration. All were colonized with ≥1 PA phenotype resistant to all antibiotics at the time of admission and they received 500 mg/kg Ps‐ivlG intravenously as a single dose in addition to conventional treatment, including antibiotics and chest physiotherapy. No adverse effects occurred. Circulating immune complexes and complement levels remained unchanged from baseline. Serum levels of anti‐PA LPS lgG, as measured by ELISA for eight PA LPS immunotypes, increased to 244 ± 65% (mean ± SE) of baseline levels 1 hour post‐infusion (P < 0.01), remained significantly elevated during a mean hospital stay of 17 days, and returned to near baseline by follow‐up 4 weeks after hospital discharge. Plasma half‐life and clearance values were similar to those of other subjects receiving conventional ivlG. Sputum PA density declined from 3.0 to 1.2 × 108 cfu/mL 1 week post‐infusion (P ≌ 0.05), and returned to baseline at follow‐up. Serum anti‐PA opsonic activity increased after infusion (P < 0.01), but returned to baseline by 72 hours. Clinical scores improved from admission to discharge (P < 0.005) without decline at follow‐up. Forced vital capacity [FVC] and forced expiratory volume in one second [FEV1] increased from admission to discharge (P < 0.01 and P < 0.05, respectively) without decline at follow‐up. Using autologous historical control data, standard hospital therapy without Ps‐ivlG resulted in no improvement in FVC or FEV1, and a subsequent decline in these parameters (P < 0.05 for each) during a similar follow‐up period. This occurred despite the fact that half the patients did not have antibiotic‐resistant PA on the control admission. We conclude that Ps‐ivlG is a safe adjunctive therapy for pulmonary exacerbations in moderately ill cystic fibrosis patients colonized with resistant PA, and may be associated with both greater and more prolonged improvement in pulmonary function than standard therapy alone. Pediatr Pulmonol 1990; 9:7–18.
Compliance, alveolar–arterial oxygen difference, and oxygenation index changes in patients managed with extracorporeal membrane oxygenation
Authors: Brudno D. Spencer , Boedy R. Frederick , Kanto William P. 
Published: March 2007

AbstractEighteen patients with meconium aspiration syndrome who failed conventional management were treated with extracorporeal membrane oxygenation (ECMO) for reversible respiratory failure. Dynamic lung compliance measurements were made prior to, during, and after ECMO support. P(A‐a)O2 and oxygenation index (Ol) measurements were calculated prior to and after ECMO support. Lung compliance decreased significantly comparing before‐ECMO to during‐ECMO, and increased significantly comparing during‐ to after‐ECMO, but not comparing before‐ to after‐ECMO measurements. P(A‐a)O2 and Ol decreased significantly from before to after ECMO. The improvement in oxygenation allowing removal from ECMO does not appear to be related to improved pulmonary mechanics, but may rather be secondary to increased effective pulmonary capillary blood flow. Pediatr Pulmonol 1990; 9:19–23.
Varying tracheal cross‐sectional area during respiration in infants and children with suspected upper airway obstruction by computed cinetomography scanning
Authors: Newth Christopher J. L. , Lipton Martin J. , Gould Robert G. , Stretton Mark 
Published: March 2007

AbstractAn ultrafast cinetomography computed tomographic scanner (cine‐CT) was used to evaluate infants and children (n = 15) with suspected obstruction of the larynx or trachea. One scan sequence provided a single image at each of eight cross‐sectional levels (volume‐mode study). Each study, lasting 224 ms, covered the distance between the supraglottic area and the carina. Each patient also underwent a “dynamic” study at a specific level of interest determined from the volume‐mode study. Forty images within 2.3 s covered at least one respiratory cycle. The images were displayed as a closed‐loop movie and dynamic changes in laryngeal and tracheal caliber with respiration were monitored and quantitated. Tracheal boundaries were outlined either by a trackball‐guided cursor (freehand) or semi‐automated computer edge detection, and cross‐sectional areas and diameters were determined. Reproducibility was tested among three investigators' freehand drawings and two automated computer drawings, at the same and at varying image intensities. The coefficient of variation for the computer‐assisted records (0.2%) was smaller than for the best freehand drawing (1.5%). Tracheal diameters were reproducible, but with greater intra‐individual investigator variability. Four normal tracheas had close to published measurements with conventional CT scanners. Cine‐CT gives objective tracheal dimensions and their variation during respiration; it provides good anatomical detail above the carina, and also of the extra‐ and intra‐thoracic vessels if injected with contrast medium. Pediatr Pulmonal 1990; 9:224–232.
Pneumocystis carinii pneumonia in young children with AIDS
Authors: Bye Michael R. , Bernstein Larry J. , Glaser Joy , Kleid David 
Published: March 2007

AbstractWe present our experience with 54 episodes of Pneumocystis carinii pneumonia in 50 young children with AIDS, all but one representing congenitally acquired infection. Findings at history and physical examination are not helpful in suggesting the diagnosis. The diagnosis is suggested by marked hypoxemia, diffuse disease on chest radiograph, and elevated serum LDH level. Because important aspects of the history may be withheld, a high index of suspicion may be necessary for the correct diagnosis. The mortality rate for ventilated patients was 50%. Pediatr Pulmonal 1990; 9:251–253.
The effect of triclofos sodium sedation on respiratory rate, oxygen saturation, and heart rate in infants and young children
Authors: Jackson E. A. , Rabbette P. S. , Dezateux C. , Hatch D. J. , Stocks J. 
Published: March 2007

AbstractChloral hydrate is frequently used to sedate infants for lung function testing. While no effect on respiratory function has been demonstrated, a recent study has reported a fall in oxygen saturation (Sa) following sedation in wheezy infants. This study was designed to assess the effects of the closely related but less gastrically irritant drug triclofos sodium on respiratory rate (RR), heart rate (HR), and Sa in infants without cardiopulmonary disease. Paired measurements using respiratory inductance plethysmography and pulse oximetry were obtained in 10 infants (4–19 months of age) during natural and sedated sleep. Following sedation with triclofos, mean RR rose by 1.9 breaths min−1 (95% confidence intervals [Cl] of the mean difference: 0.13–3.7 min−1). Mean heart rate rose by 5.5 beats min−1 (95% Cl: −0.9–11.9 min−1). Mean Sa fell by 0.68% (95% Cl – 1.8–0.45%). None of these changes are considered to be of clinical importance, and only the change in RR reached statistical significance at the 5% level. Pediatr Pulmonol 1991; 10:40–45.
Morphometric and biochemical changes in lungs of growing rats treated with a calmodulin antagonist
Authors: Ofulue Anwuli F. , Sekhon Harman , Cherukupalli Kamala , Khadempour Hassan , Thurlbeck William M. 
Published: March 2007

AbstractTo determine the role of calmodulin in postnatal lung growth and development, 4‐week‐old rats were injected intraperitoneally on consecutive days with trifluoperazine (TFP), a potent and specific calmodulin antagonist, for a period of 3 weeks and studied in comparison with normal controls and undernourished weight‐matched animals. TFP treatment resulted in stunting of lung growth such that observed normal increments in morphometrically determined total number of alveoli and alveolar surface area and in biochemically determined DNA, elastin, and collagen contents of the lungs were diminished in comparison with age‐matched normal controls. However, the TFP treatment also resulted in reduced daily food intake and body weight gain. In the TFP group, lung weight and lung volume were also reduced compared with the weight‐matched control group. This resulted in reduced alveolar surface area, total number of alveoli, DNA, collagen, and elastin in the TFP group compared with values in the weight‐matched controls. Thus the TFP‐induced lung changes were not due to inanition and/or reduced somatic growth. The TFP treatment resulted in reduced activities of calmodulin and cyclic adenosine monophosphate (cAMP)‐phosphodiesterase in the lungs of the animals, independent of their nutritional status. Based on these findings, we suggest that calmodulin may be an important regulatory component of postnatal lung growth and development. Pediatr Pulmonol 1991; 10:46–51.
Effect of infant position on breath amplitude measured by transthoracic impedance and strain gauges
Authors: Baird Terry M. , Neuman Michael R. 
Published: March 2007

AbstractContinuous monitoring of respiration by transthoracic electrical impedance gives a signal that has certain not well understood irregularities. Among them is a change in the amplitude of the signal when there is no apparent change in the infant's tidal respiration. One factor that could hypothetically account for alterations of the impedance signal is a change in current path through the thorax secondary to a change in body position. To test this hypothesis we have studied the relationships between breath amplitude measured by transthoracic impedance, one strain gauge on the chest and one on the abdomen, and tidal volume by integrated flow in four body positions. Median breath amplitude was found to vary significantly with body position according to the measuring device. The median impedance breath amplitude increased by 27% in the supine position compared with the prone position, with no associated change in tidal volume. Differences in the strain gauge signal amplitude for these positions were not statistically significant. Correlation between breath amplitude measured by impedance changes and tidal volume was minimal (r = 0.114). These results indicate that infant position affects impedance breath amplitude independently of changes in tidal volume. Pediatr Pulmonol 1991; 10:52–56.