bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonbronchoscopic bronchoalveolar lavage in mechanically ventilated infants: Technique, efficacy, and applications
Authors: Koumbourlis Anastassios C. , Kurland Geoffrey 
Published: March 2007

AbstractBronchoalveolar lavage with the fiberoptic bronchoscope is commonly used for the diagnosis of pulmonary infections in mechanically ventilated adults and children. However, its use for intubated infants is precluded because the small artificial airway does not permit the passage of the bronchoscope. We have developed a technique for nonbronchoscopic bronchoalveolar lavage, performed via a sterile, disposable feeding tube. We have used this technique in 15 infants with diffuse interstitial disease and/or atelectasis, while they were intubated and mechanically ventilated. The volume of the lavage effluent averaged 70.3% of the volume instilled. Specific diagnosis on the basis of the cytologic evaluation and/or culture of the lavage fluid was possible in 9 (SOYO) patients. Two patients with atelectasis showed radiographic evidence of improvement following the procedure. There were no complications. We conclude that nonbronchoscopic bronchoalveolar lavage is well tolerated, and clinically useful in small, mechanically ventilated infants with respiratory failure due to diffuse pulmonary disease. This technique provides a lower risk alternative to more invasive, and costly procedures. © 1993 Wiley‐Liss, Inc.
What limits endurance in normal children?
Authors: Bogaard Jan M. , Bijl Annemarie , van Dongen Arthur R. , Kerrebijn Karel F. , de Jongste Johan C. 
Published: March 2007

AbstractWe have compared the results of a standard progressive maximal exercise test to those of an endurance exercise test in 22 healthy school children (13 girls, 9 boys, mean age 14.8 years) in order to examine whether it is possible to extrapolate results from a maximal test to predict their endurance capacity. All children performed a standard progressive maximal exercise test (15 W increments every minute until exhaustion) and an endurance test (individually calculated loads to mimic cycling at 20 km/h against a windforce 5 of Beaufort for 30 minutes) on 2 separate days. In both tests metabolic [oxygen uptake (Vo2), CO2 production, blood lactate accumulation], ventilatory [minute ventilation (VE)], and circulatory variables were measured. From the maximal test the threshold of lactate accumulation (LT) was determined. Thirteen children were capable of enduring the 30 minute exercise (Group l), and 9 could not complete the endurance test (Group 2). These two groups were comparable with respect to age, height, and baseline lung function. Children in Group 2 had a higher mean weight (P < 0.005) than those in Group 1. Eight of the 9 children in Group 2 were girls, whereas Group 1 consisted of 5 girls and 8 boys. There was no significant difference between Group 1 and 2 in the mean values of Vo2 max, maximal respiratory exchange ratio (R max), VEmax, LT, oxygen pulse, and other variables obtained during the maximal exercise tests. Lactate accumulation during the endurance test in Group 2 was larger than in Group 1 (P < 0.005). This confirms that lactate metabolism is a key factor that determines endurance capacity. The endurance time also correlated significantly (P < 0.01) with the ratio between VE and maximal voluntary ventilation (MVV). We conclude that exercise endurance in healthy children correlates with variables related to lactate metabolism. It appears that a load at or lower than the LT can be sustained for 30 minutes in the great majority of healthy children. © 1993 Wiley‐Liss, Inc.
Spirometry in the asthmatic child: Is FEF25–75 a more sensitive test than FEV1/FVC?
Authors: Lebecque P. , Kiakulanda P. , Coates A. L. 
Published: March 2007

AbstractThe use of spirometry in the assessment of children with asthma is taking on new importance with the realization that considerable airway obstruction may exist in the absence of clinically detectable abnormalities. There has been controversy over the value and relative sensitivity of various spirometric indices. This study evaluated the forced expiratory flow between 25% and 75% of vital capacity (FEF25–27), forced expired volume in 1 second (FEV1 ), and the ratio between the FEV1 and the forced vital capacity (FVC) in 100 asthmatic children aged 6–17 years, 29 of whom were wheezing at the time of the evaluation. All children with clinical wheezing had a FEV25–27 <2 standard deviations (SD) below the mean (–2 SD), whereas 8 had a normal FEV1. The majority of the wheezing children had abnormalities of all 3 indices, whether expressed as ⩽ −2 SD or, in the case of the FEV1/FVC, arbitrarily taken as <80%. Sixty‐seven children of the entire study group had at east 1 abnormal spirometric index, but 38 of these had no clinical abnormalities. Twelve children had a reduced FEF25–27 as the only abnormality. These results suggest that FEF25–27 is a sensitive index of airway obstruction. Pediatr Pulmonol. 1993; 16: 19‐22. © 1993 Wiley‐Liss, Inc.
Dexamethasone treatment suppresses collagen synthesis in infants with bronchopulmonary dysplasia
Authors: Co Edward , Chari Gopal , McCulloch Kristine , Vidyasagar Dharmapuri 
Published: March 2007

AbstractCollagen is an essential component of connective tissue and is present in the pulmonary interstitium. Collagen deposition is known to increase in many acquired chronic diseases, including bronchopulmonary dysplasia (BPD). Urinary excretion of hydroxyproline has been used as a specific index of collagen synthesis. Many studies have demonstrated that dexamethasone therapy is associated with respiratory improvement in infants with BDP but the mechanism of this effect is not well understood. We postulated that in infants with BDP who receive dexamethasone, suppression of collagen synthesis may cause respiratory improvement. Therefore, we studied the effect of dexamethasone on respiratory status and urinary excretion of hydroxyproline in 14 ventilator‐dependent infants with BDP. Infants received 0.5 mg/kg/day dexamethasone, tapered by half every 3 days to complete a 12 day course. Eleven of the 14 infants were extubated at a mean ± SD of 8.7 ± 4.9 days after starting dexamethasone. Mean urinary hydroxyproline/creatinine ratios at 3, 6, 9, and 12 days of dexamethasone therapy were significantly lower than the mean pretreatment value, but after discontinuation rapidly rose toward baseline values. Decreased urinary excretion of hydroxyproline indicates that dexamethasone suppressed collagen synthesis in these infants. We speculate that suppression of collagen synthesis reduced pulmonary inflammation and fibrosis, resulting in respiratory improvement. Pediatr Pulmonol. 1993; 16:36–40. © 1993 Wiley‐Liss, Inc.
Association between pulmonary and gastric inflammatory cells on the first day of life in preterm infants
Authors: Arnon Shmuel , Grigg Jonathan , Silverman Michael 
Published: March 2007

AbstractIt has been shown that inflammatory cells in the newborn lung are fetal in origin, whereas those in the amniotic fluid are maternal. In order to explore the relationship between fetal amnionitis and neonatal pneumonitis, we collected paired samples of gastric aspirate within 2 hours of birth, and bronchoalveolar lavage fluid within 24 hours of birth from intubated preterm infants. Leukocyte counts in bronchoalveolar lavage fluid correlated with the duration of membrane rupture (r = 0.68, P = 0.0001). There was a high degree of correlation between leukocyte counts in the two fluids (r = 0.86, P = 0.0001). The factors responsible for this association are unknown. Pediatr Pulmonol. 1993; 16:59–61. © 1993 Wiley‐Liss, Inc.
Unusual form of endobronchial aspergillosis in a patient with cystic fibrosis
Authors: Sammut Paul H. , Howard Susan T. , Linder James , Colombo John L. 
Published: March 2007

AbstractThe isolation of Aspergillus fumigatus from airway secretions from patients with cystic fibrosis (CF) is common and usually denotes asymptomatic colonization or allergic broncho‐pulmonary aspergillosis (ABPA). A 12‐year‐old boy with CF acutely developed moderately severe symptoms of unremitting cough, fever, dyspnea, weight loss, and cyanosis. Chest radiographs demonstrated widespread unilateral infiltrates and volume loss. By bronchoscopy tenacious mucous plugs were seen occluding the left lower lobe bronchus. Cultures from sputum and sequential bronchoalveolar lavage grew Aspergillus fumigatus, but other significant criteria for diagnosing APBA were lacking. No improvement was seen with a 3 week course of systemic corticosteroid and antibiotic therapy. Treatment with amphotericin B and short‐term mechanical ventilation resulted in rapid resolution of all symptoms. This form of endobronchial aspergillosis has not been described previously. Pediatr Pulmonol. 1993; 16:69–73. © 1993 Wiley‐Liss, Inc.
Chronic modifications of lung and heart development in glucocorticoid‐treated newborn rats exposed to hyperoxia or room air
Authors: Thibeault D. W. , Heimes B. , Rezaiekhaligh M. , Mabry S. 
Published: March 2007

AbstractWe assessed the mechanics and morphology of the lung in 165 rats treated neonatally with either room air (RA), O2, RA + steroids, or O2, + steroids. Newborn Sprague‐Dawley male rats were randomly assigned to these groups. O2,‐exposure (0.96‐1.0 FiO2 lasted 5 days, and dexamethasone treatment consisted of eight daily S.C. injections of drug or buffer in successive doses of 0.5,0.4.0.3,0.2,0.1, 0.1. 0.1. and 0.1 mg/kg. At 58 days, right ventricular systolic pressure (RVP) was measured. At 60 days, all rats were sacrificed for obtaining lung weight and DNA, saline pressure‐volume (P‐V) curves, and morphometry. We weighed right ventricles (RV) and left ventricles + septa (LV). Hyperoxia alone did not, but steroid decreased survival rate to 79.4% (95.3% in RA rats, P < 0.02). Only 21 of 40 (52%) O2 + steroids rats survived, less than in both RA groups (P < 0.001). RV weight, RVP and muscularization of alveolar duct arteries were significantly increased in O2 vs. RA rats. In RA + steroids rats, weight of the LV was decreased but RV, RVP, and lung vasculature were not affected. These effects were additive in the O2 + steroid group. Wet lung weights and DNA were increased for RA + steroid rats over all others. O2 and steroids shifted the P‐V curve to the left and O2+ steroids still further. Maximal lung volume increased significantly with RA + steroids and still further in O2 + steroids but not in O2 alone. O2 and steroids significantly increased the mean linear intercept and O2 + steroids even more so. In O2‐ and steroid‐treated rats, the parenchymal air space increased. In conclusion, both neonatal hyperoxia and steroid administration caused aberrations in the growth of lung and connective tissue. The effects of the two were additive. The vascular system, maximal lung volume, and DNA responded differently, presumably by different modes of action. Pediatr Pulmonol. 1993; 16:81–88. © 1993 Wiley‐Liss, Inc.
Predictive value of pulmonary function testing during pulmonary exacerbations in cystic fibrosis
Authors: Rosenberg Samuel M. , Schramm Craig M. 
Published: March 2007

AbstractThe optimal duration of therapy for acute exacerbations of cystic fibrosis (CF) has not been defined, and the utility of serial pulmonary function testing in predicting the duration of therapy has yet to be established. In a review of 90 pulmonary exacerbations of 39 patients with CF requiring hospitalization, we found that 72% of the patients recovered following 2 weeks of intravenous antibiotics and aggressive chest physiotherapy, and that 28% required an extended third week of therapy. Recovery was delayed in patients with more severe chronic pulmonary disease, but the rate of improvement was independent of the degree of pulmonary deterioration with the acute exacerbation. A 40% recovery of FEV, at 1 week was found to correlate significantly with the duration of hospitalization in the 90 patients. When prospectively applied to a second series of consecutively hospitalized patients with CF, 25/28 patients admitted for 2 weeks demonstrated > 40% improvement in FEV, at 1 week, as compared to 5/10 patients subsequently treated for ≤3 weeks (P = 0.030). The predictive values for 2‐ or 3‐week hospitalizations with 1‐week interval recovery of > 40% or > 40% in FEV, were 79% and 62%, respectively. These findings suggest that the response to intensive therapy in CF exacerbations is variable and that improvements in pulmonary function after 1 week of therapy may be used to predict the subsequent duration of therapy in the majority of CF patients with pulmonary exacerbations. Pediatr Pulmonol. 1993; 16:227–235. © 1993 Wiley‐Liss, Inc.
Bronchial responsiveness to inhaled metabisulfite in asthmatic children increases with age
Authors: Vandenbossche L. E. G. , Hop W. C. J. , de Jongste J. C. 
Published: March 2007

AbstractInhaled bisulfite (HSO3) aerosol produces bronchoconstriction in asthmatics but not in normals. This effect is probably due to local formation of SO2 which stimulates vagal afferents in the airway mucosa, and gives rise to bronchoconstriction that is partly due to a cholinergic reflex. Metabisulfite (MBS) produces bronchoconstriction in most adult asthmatics, but its effect in children has received little attention. The present study was done to assess MBS‐induced bronchoconstriction as a function of age in asthmatic children, and to compare MBS responsiveness with the response to inhaled metacholine (MCH), which is commonly used for bronchoprovocation testing. In 36 children with moderate asthma, selected to cover the age range between 3 and 20 years, we compared airway responsiveness to MBS and MCH, expressed as the provocative dose that causes a 20% fall in baseline forced expiratory volume in 1 sec (FEV1, PD20). We also measured the PD20 to MBS after pretreatment with the anticholinergic ipratropiumbromide, to estimate the noncholinergic component of the response. After bronchial provocation with MCH, a PD20 was reached in 32 children, and no significant relation of PD, to age was found. A PD20 [MBS] was seen in only 17 patients, and more frequently in older children. There was a significant negative correlation between age and PD20 [MBS]. Ipratropium pretreatment reduced the response to MBS in 14 of the 17 children who had a PD20 [MBS]. The PD20 [MBS] after ipratropium pretreatment was also significantly negatively related with age. This suggested that the increased prevalence of MBS responsiveness was due to an increase of the noncholinergic component of the response. We conclude that, in this cross‐sectional study, the sensitivity of asthmatic children to MBS‐induced bronchoconstriction increases with age, and that this is because of an increase of the noncholinergic component of the response to MBS. We speculate that this reflects an abnormal development of the autonomic control of airway caliber in children with asthma. Pediatr Pulmonol. 1993; 16:236–242. © 1993 Wiley‐Liss, Inc.
Measurement of breath amplitudes: Comparison of three noninvasive respiratory monitors to integrated pneumotachograph
Authors: Adams Jose A. , Zabaleta Ignacio A. , Stroh David , Sackner Marvin A. 
Published: March 2007

AbstractMeasurement of breath amplitude (BA) and similarly tidal volume (VT) in newborn infants is the standard for detection of apnea and hypopneas. The purpose of our study was to compare the accuracy for BA by three frequently utilized noninvasive respiratory monitors: respiratory inductive plethysmography (RIP), mercury in silastic strain gauges (SG), and impedance pneumography (IP). Twenty healthy full‐term infants were studied in both supine and prone postures. The RC and AB gain factors for RIP were obtained using qualitative diagnostic calibration (QDC) procedure. The electrical gain of IP was set equivalent to the BA signal of a pneumotachograph (PNT). The three devices were calibrated in the supine posture and measurements were repeated in the prone posture without changing their calibration factors. Compared to PNT, postural change did not significantly alter BA measured by RIP. The accuracy of breath‐to‐breath BA measurement in the prone posture was worse for IP and SG compared to RIP and PNT. In contrast to SG or IP, the accuracy of BA measurement maintained was by RIP after a postural change from supine to prone in fullterm newborns. Pediatr Pulmonol. 1993; 16:254–258. © 1993 Wiley‐Liss, Inc.
Familial congenital bronchiectasis: Williams‐Campbell syndrome
Authors: Jones V. Faye , Eid Nemr S. , Franco Sofia M. , Badgett J. Thomas , Buchino John J. 
Published: March 2007

AbstractWilliams–Campbell syndrome was first described in 1960 as a rare form of bronchiectasis. Its pathogenesis is characterized by the absence or markedly diminished cartilage around the bronchi. Although the familial nature was postulated early on, only one possible familial Occurrence has been reported in the literature. We present two family members in whom respiratory symptoms developed within the first year of life and were found to have histopathologic changes consistent with Williams–Campbell syndrome. This would lend further support of a developmental origin for this type of bronchiectasis. Pediatr Pulmonol. 1993; 16:263–267. © 1993 Wiley‐Liss, Inc.
Parental childhood respiratory illness and respiratory illness in their infants
Authors: Camilli Anthony E. , Holberg Catharine J. , Wright Anne L. , Taussig Lynn M. ,   Group Health Medical Associates
Published: March 2007

AbstractParental histories of childhood respiratory trouble (CRT) were examined as risk factors for lower respiratory tract illnesses in healthy infants enrolled in the Children's Respiratory Study, Tucson, Arizona. A parental history of childhood respiratory trouble before age 16 was a risk factor for infantile lower respiratory tract illnesses (LRIs). Early age of onset of the parental CRT and those illnesses described as asthma or bronchiolitis showed the greatest risk: odds ratio = 2.8, P < 0.05. After controlling for known and suspected confounders, a parental history of CRT described as asthma or bronchiolitis with onset before age 3 was associated with wheezing LRls in their children, with an odds ratio of 2.6, P < 0.05. A parental history of CRT described as bronchitis/croup was associated with nonwheezing LRls in their children: odds ratio = 2.2, P < 0.05. These findings suggest a familial component to childhood respiratory trouble which may have a hereditary basis. Pediatr Pulmonol. 1993; 16:275–280. © 1993 Wiley‐Liss, Inc.
Effects of sidestream smoke exposure and age on pulmonary function and airway reactivity in developing rats
Authors: Joad Jesse P. , Pinkerton Kent E. , Bric John M. 
Published: March 2007

AbstractChildren exposed to environmental tobacco smoke (ETS) in their homes have in‐ creased cough, respiratory illness, airway obstruction, and hyperreactivity. Since an animal model is needed to understand the mechanism by which this occurs, our study was designed to determine if immature rats develop airway obstruction and increased airway reactivity when exposed to sidestream smoke (SSS, respirable suspended particulate concentration 1.00±0.03 mg/m3, CO concentration 6.48±0.29 ppm). In the first of 3 studies, rats were exposed to filtered air (FA) or SSS for 6 hr/day, 5 days/week from day 2 to week 8 or week 15 of life (n = 6‐8 in each group). SSS exposure did not change lung resistance (RJ, dynamic lung compliance (Cldyn), lung weighthody weight ratio (LW/BW), pulmonary artery pressure (PPA), body weight, or airway reactivity to methacholine (all P > 0.2, 2‐way ANOVA). Regardless of exposure, lungs from younger rats were relatively heavier and more reactive to methacholine than lungs from older rats (P < 0.05, 2‐way ANOVA). In the second study, 15‐week‐old rats were exposed to FA or SSS for 3 hr or for 4 days (6 hr/day, n = 6 in each group). SSS exposure again had no effect on Cldym RL, LW/BW, Ppa, or airway reactivity to methacholine (all P > 0.2, ANOVA). In the third study, rats were exposed to FA or SSS from day 2 to week 11 of life (n = 7 in each group). SSS exposure reduced airway (P = 0.004) but not pulmonary artery (P = 0.63) reactivity to serotonin. We conclude that (1) SSS exposure to the immature rats did not mimic the effects of ETS seen in children, (2) younger rats had greater muscarinic airway reactivity than older rats, and (3) serotonin may play a role in ETS‐induced lung problems.Pediatr Pulmonol. 1993; 16:281–288. © 1993 Wiley‐Liss, Inc.
Effect of amrinone during group B Strepfococcus‐induced pulmonary hypertension in piglets
Authors: Berger James I. , Gibson Ronald L. , Clarke William R. , Standaert Thomas A. , Redding Gregory J. , Henderson William R. , Truog William E. 
Published: March 2007

AbstractIntravenous infusion of group B Streptococcus (GBS) into neonatal animals pro‐ duces pulmonary hypertension, ventilation/perfusion (V̇A/Q̇) mismatch, and an increase in serum levels of thromboxane B2, (TxB2) and tumor necrosis factor (TNF)α. The vasodilator amrinone (amr) is a cGMP‐inhibited phosphodiesterase inhibitor and is reported to inhibit thromboxane A2 and TNF production. We hypothesized that infusion of amr would cause pulmonary vasodilation and reduce serum TxB2, and TNF levels in piglets with late phase GBS‐induced pulmonary hypertension. The effect of amr on gas exchange was also determined. A continuous infusion of GBS was administered for 5 hr to 4 groups of anesthetized, mechanically ventilated neonatal piglets. An amr bolus of 8 mg/kg was given at 4 hr followed by a 1 hr continuous infusion of either 10 or 20μg/kg/min of amr (amr 10 and amr 20, respectively). Control piglets received a bolus and 1 hr infusion of amr carrier. The infusion of amr, but not of carrier reversed late phase GBS‐ induced pulmonary hypertension. Piglets infused with amr 20 showed transient selective pulmo‐ nary vasodilation, based on a reduced ratio of pulmonary to systemic vascular resistance (PVW SVR ratio) value at 30min but not at 1 hr. compared to pre‐amr treatment values. The PVR/SVR ratio values for amr 10 and control group did not change after treatment with either amr or carrier. Treatment with amr 10 or 20 did not decrease serum TxB2, or TNF levels or increase VA/Q mismatch. A subsequent group of piglets received an 8 mg/kg bolus and 40 μg/kg/min infusion of amr (amr 40) to determine if the increased infusion rate would sustain a selective pulmonary vasodilatory effect beyond 30 min. The PVR/SVR ratio values for amr 40 did not change after treatment for 30 min or 1 hr, compared to pretreatment values. We conclude that amr is effective in reversing GBS‐induced pulmonary hypertension. However, the reduction in SVR caused by amr may preclude its use in septic newborns. Pediatr Pulmonol. 1993; 16:303–310. © 1993 Wiley‐Liss, Inc.