bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of positive end‐expiratory pressure changes on functional residual capacity in surfactant treated preterm infants
Authors: da Silva Wanderlan José , Abbasi Soraya , Pereira Gilberto , Bhutani Vinod K. 
Published: March 2007

AbstractBoth surfactant replacement and positive end‐expiratory pressure (PEEP) increase lung volume in infants with respiratory distress syndrome (RDS). We measured pulmonary mechanics and functional residual capacity (FRC) in 21 preterm infants with RDS, > 48 hr post‐surfactant therapy (BW, 1,168 ± 441 g; GA, 28.3 ± 2.8 weeks; postnatal age, 3–7 days). A non‐linear but significant increase in mean FRC was noted as PEEP increased from 2 to 5 cmH2O: 18.4 ± 4.7mL/kg at 2 cmH2O; 19.7 ± 4.3 mL at 3 cm H2O; 22.6 ± 5.5ml/kg at 4 cmH2O; and 26.2 ± 6.2 mL/kg at 5 cmH2O (P < 0.01). Because of the synergistic combined effect on lung volume, surfactant treated neonates should be weaned cautiously from PEEP during ventilatory management. Our study also suggests that the occurrence of inadvertent end‐distending pressure during FRC measurement in the ventilated neonate lead to erroneous results.Pediatr Pulmonal. 1994;18:89–92. © 1994 Wiley‐Liss, Inc.
An expanded scoring system including an index of nutritional status for patients with cystic fibrosis
Authors: Cabrera Marco E. , Lough Marvin D. , Doershuk Carl F. , Salvator Ann E. 
Published: March 2007

AbstractEvaluation of success or failure of therapy for patients with cystic fibrosis (CF) commonly relies on the results of a single pulmonary function test (PFT). Most PFT measurements reflect different functional aspects of the lung. Although no single parameter can summarize all aspects of lung function, a combination of several may provide an advantage by reflecting the overall abnormality of lung function in one number. Cropp et al. (1982, Am Rev Respir Dis 126:211–216) developed a multiparameter pulmonary function score (PFS) using the results of six separate parameters obtained from a PFT. In CF, there is also the potential for declining nutritional status (NS), leading to malnutrition and skeletal muscle wasting. Our aim was to expand the PFS by including weighted information on NS, and to determine whether the expanded score (nutritional‐pulmonary function score, NPFS) was more sensitive in detecting change in outcome variables than the PFS. Individual PFT parameters, percent ideal body weight (%IBW), and an index of anaerobic performance (AP) were measured in 21 patients on admission to the hospital and again at discharge. In the group as a whole, in‐hospital therapy resulted in improvement (P < 0.01) in individual PFT parameters, YJBW, PFS, and NPFS, and no change in AP. While the PFS more effectively reflected improvement in lung function than did any single PFT parameter, the NPFS resulted in an even more sensitive index of change. Based on these results, we believe that the NPFS, which includes both lung and nutritional status, provides an effective and sensitive index of disease severity that can be used as a unifying measure to: (1) detect disease progression; (2) guide rehabilitation and training; (3) stratify patients for clinical trials; or (4) evaluate the effects of a therapeutic intervention.Pediatr Pulmonol. 1994;18:199–205. ©1994 Wiley‐Liss, Inc.
Effects of breathing a normoxic helium mixture on exercise tolerance‐of patients with cystic fibrosis
Authors: Martin Daniel , Day Jane , Ward Glenn , Carter Edward , Chesrown Sarah 
Published: March 2007

AbstractBreathing helium‐oxygen (HeO2,) mixtures of 20.9% O2/79.1% He has been shown to increase exercise ventilation and peak oxygen uptake in healthy subjects. The improved exercise performance is thought to be due to the reduced density of HeO2 compared to air and the resulting increases in ventilation. Patients with cystic fibrosis (CF) frequently have abnormal pulmonary function test results, low exercise ventilations and diminished exercise tolerance. This led to the hypothesis that in CF the exercise tolerance of patients might improve when breathing HeO2. To test this hypothesis, 11 patients with CF or mild to severe airway obstruction performed spirometry and progressive maximal exercise tests while breathing air or HeO22. The HeO2 mixture significantly increased (P <0.05) forced expiratory volume in 1 sec (FEV1) by 8.2%, peak expired flow by 39%, and maximal voluntary ventilation (MVV) by 17.9% compared to air, while forced vital capacity (FVC) and forced mid‐expiratory flow rate (FEF25–75%,) were unchanged by breathing HeO2. Ventilation and oxygen uptake at matched submaximal power outputs were not increased while breathing HeO2. nor were peak exercise ventilation (V̇Epeak) or peak exercise oxygen uptake (V̇O2peak). Estimated hemoglobin saturation and total exercise time were also unchanged during HeO2, breathing. However, there was a trend for the subjects with the better FEV1, to increase V̇O2peak. Increases in V̇O2peak when breathing HeO2, and air were correlated (r = 0.67, P<0.05) with the percent of predicted FEV, values. Still, in the 11 patients as a group, breathing HeO2, did not significantly improve V̇O2peak V̇Epeak or exercise tolerance. Therefore HeO2, is unlikely to have additional benefits to patients with CF who use an exercise program to help optimize their health status.Pediatr Pulmonol. 1994;18:206–210. ©1994 Wiley‐Liss, Inc.
Proximal and tracheal airway pressures during different modes of mechanical ventilation: An animal model study
Authors: Zobel G. , Dacar D. , Rödl S. 
Published: March 2007

AbstractObjective: To determine the differences between the mean proximal and tracheal airway pressures during 3 different modes of mechanical ventilation (MV) in an animal model of acute cardiac failure (CF) and respiratory failure (RF). Design: Prospective, randomized, crossover design. Setting: University research laboratory. Subjects: Twelve young pigs weighing 10–16 kg. Interventions: The experimental protocol consisted of 3 stable 30 min conditions: when ventricular and pulmonary function was normal (control), after the induction of acute cardiac failure by a β‐blocking agent and after respiratory failure induced by repeated lung lavages. Modes of MV included controlled mechanical ventilation (CMV), high‐frequency oscillation (HFO), and high‐frequency jet ventilation (HFJV). Measurements and results: The tracheal mean airway pressure (Paw) was measured at the distal port of the Hi‐lo jet tube using an air‐filled pressure transducer. The mean transpulmonary Pawaw increased significantly from 0.41 + 0.14 kPa during the control period to 1.15 ± 0.17 kPa (P < 0.0001) during the RF period. In all study periods both the proximal and tracheal Paw were lowest during HFJV. There was no difference between the proximal and tracheal Paw during CMV and HFJV throughout the protocol. In the cardiac and respiratory failure periods the proximal Paw (CF, 1.45 ± 0.08 kPa; RF, 3.13 ± 0.27 kPa) was significantly higher than the tracheal Paw (CF, 1.04 ± 0.09 kPa, P < 0.01; RF, 2.18 ± 0.3 kPa, P < 0.01) with HFO. When ventilated by HFO, the mean external oscillatory amplitude was 4.33 ± 0.14 kPa and the intratracheal oscillatory amplitude was	only 0.49 ± 0.06 kPa (P < 0, 0001). Conclusion: HFJV provides adequate respiratory support at lower Paw than CMV and HFO. Proximal Paw closely reflects tracheal during CMV and HFJV. However, with HFO great pressure differences between the proximal and tracheal airways are evident. Therefore, additional intratracheal airway pressure monitoring seems to be very useful for optimizing ventilator settings during HFO.Pediatr Pulmonol. 1994;18:239–243. ©1994 Wiley‐Liss, Inc.
Ventilation techniques to minimize circulatory depression in rabbits with surfactant deficient lungs
Authors: Nicol Margaret E. , Dritsopoulou Antonia , Wang Chen , Holdcroft Anita , Chakrabarti Mihir K. , Whitwam James G. 
Published: March 2007

AbstractChanges in aortic blood flow were measured in rabbits with both normal and surfactant depleted lungs in order to elucidate the effect of different modes of ventilation on the circulation while optimizing arterial oxygenation (Pao2). Conventional mechanical ventilation (CMV), reversed inspiratory to expiratory ratio of CMV (IRV), high frequency positive pressure ventilation (HFV), and high frequency oscillation (HFO) were used. Normocapnia was maintained throughout during different modes of ventilation. In normal lungs the aortic blood flow during IRV was significantly lower with similar levels of PaO2 compared with CMV, HFV, and HFO. In lavaged lungs, without positive end‐expiratory pressure (PEEP), the aortic blood flow during CMV was significantly higher than with other modes of ventilation. When 10 cm H2O of PEEP was applied, the Pao2 increased maximally to normal values at all modes of ventilation, but the aortic blood flow was significantly reduced (P < 0.05) during CMV and IRV compared to HFV and HFO. The aortic blood flows at 5 cm H2O of PEEP were very similar during CMV, HFV, and HFO but significantly reduced during IRV. This study showed that at an optimal arterial oxygenation with higher PEEP levels, maintenance of aortic blood flow was maximal during HFV and HFO.Pediatr Pulmonol. 1994;18:317–322 © Wiley‐Liss, Inc.
Functional residual capacity (FRC) measurements by plethysmography and helium dilution in normal infants
Authors: McCoy Karen S. , Castile Robert G. , Allen Elizabeth D. , Filbrun David A. , Flucke Robert L. , Bar‐Yishay Ephraim 
Published: March 2007

AbstractComparative measurements of functional residual capacity (FRC) made by plethysmography (FRCpleth) and by helium dilution (FRCHe) were obtained on 27 infants and young children without known pulmonary disease (14 males, 13 females; 4 weeks–26 months; mean age 32.2 weeks) while under chloral hydrate sedation. Clinical histories, clinical examinations, and pulmonary functions were normal for all members of the group. FRCpleth, whether measured near end expiration (EE) or near end inspiration (EI), and corrected to mean expiratory levels of at least 3 breathing cycles, was consistently and significantly greater than FRCHe. Comparative values for mean (± standard deviation) were FRCpleth EE, 182.0 (±79.7) mL and FRCpleth El, 171.8 (±77.4) mL vs. FRCHe 154 (±72.2) mL, P < 0.0001 and P < 0.005, respectively. Normalizing values by weight, FRCpleth EE was 23.8 mL/kg (±5.3) vs. FRChe 20.2 (±4.7) mL/kg, mean (+ standard deviation). The difference between FRCpleth and FRChe, expressed as FRCpleth – FRCHe/FRCpleth × 100, was 9% for occlusions at end inspiration and 16% for occlusions at end expiration. The following equations describe our FRC results in relation to length: In magnified image The difference between FRCpleth and FRCHe was more marked when occlusions were performed at end expiration than at end inspiration. We conclude that normal infants and young children, at least when studied supine and sedated, have a small but significant amount of airway closure. © 1995 Wiley‐Liss, Inc.
A computer algorithm for differentiating valid from distorted pulse oximeter waveforms in neonates
Authors: Adams J. A. , Inman I. M. , Abreu S. A. , Zabaleta I. A. , Sackner M. A. 
Published: March 2007

AbstractCurrent pulse oximeter technology is fraught with a significant false alarm rate. This is mainly due to motion artifacts at the sensor site which distort the pulse waveform and render the computation of SaO2 invalid. If the pulse waveform could be automatically recognized as either normal or distorted, then only valid SaO2 values would be displayed. We observed that the systolic upstroke time (Sy) of the pulse waveform has a narrow and consistent range in normal appearing pulses. The systolic upstroke time (Sy) is the time from the onset of systole to the peak of the pulse waveform. Comparison of a preset range of Sy was made against Sy obtained by computer analysis of each pulse waveform. Visual examination of 14,090 pulses was carried out to determine the sensitivity and false positive rate of the algorithm. Sensitivity of computer detection of valid pulses was 92% with a positive predictive value of 92%. When used on line for continuous recording of SaO2 in patients, this simple algorithm has the potential to decrease the false alarm rate of pulse oximeters and improve the accuracy of long‐term SaO2 recordings. © 1995 Wiley‐Liss, Inc.
Comparison of airway reactivity induced by cold air and methacholine challenges in asthmatic children
Authors: de Benedictis Fernando M. , Canny Gerard J. , MacLusky Ian B. , Levison Henry 
Published: March 2007

AbstractBronchial responsiveness to isocapnic hyperventilation with cold air (CAH) and to inhaled methacholine (MCH) was compared in 17 children with bronchial asthma. The response to cold air was expressed as the percent drop in FEV1 from baseline at 4 min. after the challenge (Δ% FEV1 CAH), and the response to methacholine as the provocative concentration required to reduce the FEV1 by 20% from baseline (PC20MCH). Both tests were sensitive (94%) for detecting airway hyperreactivity. There was no statistically significant relationship between A% FEV, CAH and the log PC20MCH (r = 0.39; P = 0.12). In clinical practice, methacholine test is easier to perform, but in the research field cold air challenge may be preferable because it avoids potential drug effects. © 1995 Wiley‐Liss, Inc.
Lung sounds in neonates with and without an added dead space
Authors: Blowes R. W. , Yiallouros P. , Milner A. D. 
Published: March 2007

AbstractPrevious studies have reported great difficulty in recording lung sounds from neonates and have found conflicting results. We studied lung sounds in neonates during the inspiratory phase of the respiratory cycle as monitored by inductive plethysmography (A) and by pneumotachograph and face mask (8) which added dead space of 12 mL. Sixteen term babies were tested 12 hr to 6 days (median 45 hours) after birth. Lung sounds were recorded and then analysed using overlapping and nonoverlapping fast Fourier transforms. The two methods of analysis showed difference in intensity but not in frequency. Fourteen babies provided enough breaths for comparison; total of 596 inspirations were analysed. The intensity of lung sounds on occasion B was higher in all but two babies with mean B/A ratio of 2.4. The mean (SD) power on occasions A and B was 13.9(8.5) mW and 26.9 (21.0) mW, P = 0.02, respectively. In all but 4 babies the B/A ratios of the median (f50) and 90th centile (f90) frequencies were scattered randomly within 20% of unity. The mean (SD) f50 on occasions A and B was 205.5 (51.1) Hz and 225.8 (32.3) Hz, P = 0.10, respectively; the mean f50 was 370.3 (91.0) Hz and 396.1 (67.8) Hz, P = 0.25, respectively. Linear regression showed that there is third‐order polynomial relationship between sound intensity and air flow at the mouth. A weaker positive association exists between frequency and air flow, showing that the median and 90th centile frequencies approach an asymptote as flow increases. We conclude that adding dead space increases the intensity of lung sounds in neonates due to increased flow, but has no consistent effect on frequency content. © 1995 Wiley‐Liss, Inc.
Intratracheal administration of phosphodiesterase III inhibitor attenuates bronchoconstriction in cats: A preliminary report
Authors: Hu Hong , Takata Masao , Kusakawa Isao , Fujita Michio , Miyasaka Katsuyuki 
Published: March 2007

AbstractThe effects of intratracheal administration of MKS 492, selective phosphodiesterase (PDE) 111 inhibitor, were studied in five anesthetized bronchoconstricted cats. The animals were challenged by four repeated doses of intratracheal methacholine (67 μg/kg), and the degree of bronchoconstriction was assessed from increases in respiratory system resistance (Rrs). All animals demonstrated good bronchoconstrictive responses (i.e., 86–99% increases in Rrs) to methacholine without tachyphylaxis. On separate day, the cats received the same four doses of methacholine after being pretreated with either intratrachael saline or three different doses of MKS 492 (0.17, 1.7, and 17 μg/kg). The increases in Rrs with 1.7 μg/kg [;52.6 ± 8.4% (SE)] and 17 μg/kg of MKS 492 (44.4 ± 10.1%) were smaller than those with saline pretreatment (88.1 ± 16.8%) (P < 0.05). There were no treatment‐associated changes in mean arterial pressure or heart rate during administration of MKS 492. We conclude that intratracheal MKS 492 effectively reduced methacholine‐induced bronchoconstriction in dose‐dependent fashion without substantial systemic effects. These preliminary results suggest that inhalation of isozyme‐selective PDE inhibitors may deserve consideration for clinical trials provided that more extensive preclinical investigations justify such trials. © 1995 Wiley‐Liss, Inc.
Aerosolized furosemide in wheezy infants: A negative report
Authors: Van Bever Hugo P. , Desager Kristine N. , Pauwels Johan H. , Wojciechowski Marek , Vermeire Paul A. 
Published: March 2007

AbstractWe investigated the effects of 10 mg aerosolized furosemide on clinical score in 28 acutely wheezing infants (Part A) and in a second group of 20 intermittently wheezing babies on airway resistance and functional residual capacity during a symptomfree period (Part B), using a double‐blind, placebo‐controlled design. In both parts of the study no therapeutic effects were observed during and following aerosol inhalation of 10 mg furosemide. Pediatr Pulmonol. 1995; 20:16–20. © 1995 Wiley‐Liss, Inc.
Detection of Pseudomonas (Burkholderia) cepacia using PCR
Authors: Campbell Preston W. , Phillips John A. , Heidecker Gwendolyn J. , Krishnamani M. R. S. , Zahorchak Robert , Stull Terrence L. 
Published: March 2007

AbstractPseudomonas cepacia colonization of the lung is associated with increased morbidity and mortality for cystic fibrosis (CF) patients. The lack of a sensitive detection method for Pseudomonas cepacia in CF sputum has resulted in controversy regarding its epidemiology. We designed a PCR method to detect P. cepacia using P. cepacia 16 S rRNA sequences as the amplification target region. The PCR amplification with purified DNA as template yielded the expected 209‐bp products from P. cepacia, but not from related Pseudomonas species of medical importance or other bacteria which have been reported to colonize CF patients. In serial dilution experiments as few as 102 P. cepacia CFU were detectable. When sputum samples from three CF patients chronically colonized with P. cepacia and P. aeruginosa were analyzed, P. cepacia was detected in all three specimens by PCR, but only in two when selective culture was performed. Our data support the potential role of PCR technology in the rapid, sensitive, and definitive detection of P. cepacia in CF sputum samples, even in the context of concomitant P. aeruginosa colonization. Pediatr Pulmonol. 1995; 20:44–49. © 1995 Wiley‐Liss, Inc.
The relationship between infection and inflammation in the early stages of lung disease from cystic fibrosis
Authors: Balough K. , McCubbin M. , Weinberger M. , Smits W. , Ahrens R. , Fick R. 
Published: March 2007

AbstractWe examined the relationship of pulmonary infection and inflammation in cystic fibrosis (CF) by performing 31 bronchoalveolar lavages (BAL) in 14 young children with minimal lung disease from CF. While 10 of the 14 patients had elevated polymorphonuclear leukocyte (PMN) counts initially, only 4 had bacteria generally regarded as pathogenic in the recovered BAL fluid. Three of these 4 and 6 of the others had follow‐up bronchoscopies at 6 months intervals. PMN counts remained normal for only one patient. However, pathogenic bacteria were recovered during the repeat BALs only in those patients who were colonized initially. Proinflammatory cytokines and proteinases were generally elevated, and interleukin‐8 (IL–8) concentration correlated inversely with oxygen saturation (SaO2). No complications of the procedure occurred. We conclude that BAL identifies inflammation and the presence of bacteria in the lower airway at an early stage of the disease. This information may be used to guide therapy in patients too young or otherwise unable to produce sputum. These data also suggest that inflammation is present early in the course of CF lung disease before colonization and infection of the lungs with potentially pathogenic bacteria occurs. Since inflammation appears to be the earliest detectable evidence of lung disease in CF, monitoring of inflammation with BAL may serve as a useful marker of clinical benefits from new treatments in patients with minimal lung disease. Pediatr Pulmonol. 1995; 20:63–70. © 1995 Wiley‐Liss, Inc.
Staphylococcal pneumonia in childhood: Will early surgical intervention lower mortality?
Authors: Joosten Koen F. M. , Hazelzet Jan A. , Tiddens Harm A. W. M. , Hazebroek Frans W. J. , Dzoljic‐Danilovic Gordena , Neijens Herman J. , de Groot Ronald 
Published: March 2007

AbstractStaphylococcus aureus pneumonia (SAP) continues to be a serious bacterial infection which is associated with a high incidence of complications. We retrospectively reviewed the case records of 36 infants and children admitted with SAP to the Sophia Children's Hospital between 1970 and 1992 to analyse changes over time in the clinical presentation, diagnostic work‐up, management and complications. Fifteen of these 36 children (42%) were less than 1 year old. Fever (97%) and respiratory distress (83%) were the most common symptoms at the initial presentation. Chest X‐ray findings on admission or during hospitalisation included pleural effusion (75%), pneumothorax (47%), and abscess and/or pneumatocele (39%). Diagnostic and/or therapeutic thoracentesis of pleural fluid was performed in 17 of the 36 patients (47%). Twenty‐one patients (58%) needed chest tube drainage. Twelve had a thoracotomy (33%). Artificial ventilation was needed in 13 of the patients (36%). Extrapulmonary complications included convulsions in 6 patients (17%) and osteomyelitis in 2 children (6%). The mean duration of hospitalization was 36 days. Two of the 36 children died (6%). The low mortality rate in this study may be the result of the relatively high rate of thoracotomy and of improvements in supportive treatment. Pediatr Pulmonol. 1995; 20:83–88. © 1995 Wiley‐Liss, Inc.