bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in pulmonary mechanics following caffeine administration in infants with bronchopulmonary dysplasia
Authors: Davis Jonathan M. , Bhutani Vinod K. , Stefano John L. , Fox William W. , Spitzer Alan R. 
Published: March 2007

AbstractThe effects of caffeine upon pulmonary mechanics were measured in 16 infants with bronchopulmonary dysplasia (BPD). Pulmonary function tests were performed immediately prior to and 1 hour following a dose of 10 mg/kg of caffeine. A 37% increase in minute ventilation (mean ± SEM; 436.6 ± 26.3 to 580.8 ± 30.7 ml/min/kg) was seen with caffeine administration (P < 0.001), primarily from a 42% increase in tidal volume (6.2 ± 0.4 to 8.5 ± 0.4 ml/kg) (P < 0.001). Total lung resistance decreased by 20% (134.6 + 24.2 to 105.3 ± 20.1 cmH2O/L/sec) (P = 0.01), and total pulmonary compliance improved by 47% (0.642 ± 0.104 to 0.908 ± 0.190 ml/cmH2O/kg) (P < 0.01). In five matched control infants with BPD, no effects of placebo upon pulmonary mechanics were detected. Since caffeine has a wide therapeutic index with few side effects, it may be an effective adjunct in the treatment of infants with BPD.
Acute effects of oxygen, nifedipine, and diltiazem in patients with cystic fibrosis and mild pulmonary hypertension
Authors: Davidson Alex , Bossuyt Axel , Dab Isidoor 
Published: March 2007

AbstractThe acute effects of oxygen, nifedipine, and diltiazem were studied in eight patients with cystic fibrosis and mild pulmonary hypertension, to assess the possibility of relieving the latter before the occurrence of irreversible vascular changes. Oxygen decreased pulmonary pressure (− 23%) and resistance (− 21%), while increasing systemic resistance (+ 23%). Nifedipine increased cardiac index (+30%), at the expense of augmented right ventricular work (+ 42%), resulting in a decreased calculated pulmonary resistance (− 23%); pulmonary artery pressure remained unchanged, however. Nifedipine decreased arterial Po2 (− 10%), suggesting ventilation‐perfusion mismatch. Four of the eight patients responded to diltiazem. Their pulmonary pressure (− 35%) and resistance (− 43%) decreased, while systemic vascular tone remained unchanged. Oxygen in three patients, and diltiazem in two, returned pulmonary pressures and resistances to normal values. Early reversal of pulmonary hypertension is possible, and intervention is desirable before the establishment of chronic hypoxia, cor pulmonale, or right ventricular failure. Our data does not support the use of nifedipine in pulmonary hypertension, but shows that oxygen, and in some cases diltiazem, act as effective and selective pulmonary vasodilators.
Effects of inhaled metaproterenol and atropine on the pulmonary mechanics of infants with bronchopulmonary dysplasia
Authors: Kao Lily C. , Durand David J. , Nickerson Bruce G. 
Published: March 2007

AbstractWe evaluated the individual and combined effects of an inhaled beta‐adrenergic agent (metaproterenol) and an inhaled anticholinergic agent (atropine) on the pulmonary function of infants with bronchopulmonary dysplasia. In this randomized, double‐blind study we studied 15 infants at a mean postnatal age of 15.8 weeks (range 4–28 weeks).On 4 successive days, pulmonary function tests were measured before and after a single treatment with one of the following four aerosols: placebo, metaproterenol, atropine, and combined metaproterenol and atropine. Following treatment with metaproterenol, atropine, and combined metaproterenol and atropine, airway resistance and maximal expiratory flow at functional residual capacity improved significantly when compared with baseline. Pulmonary function values returned toward baseline by 3 hours after the treatments. We found no significant differences between the effects of metaproterenol and atropine and were unable to show any synergy of the two agents.
Wheezing at 8 and 13 years: Changing importance of bronchiolitis and passive smoking
Authors: McConnochie Kenneth M. , Roghmann Klaus J. 
Published: March 2007

AbstractA group of 153 children (51 with a history of bronchiolitis and 102 matched controls) were evaluated in a historical cohort study at a mean age of 8 years and again at 13 years to test the primary hypothesis that mild bronchiolitis, far more common than severe (hospitalized) bronchiolitis, predicts wheezing. A secondary hypothesis was that passive smoking also predicts wheezing. Many potentially confounding variables such as family history of asthma were controlled in analyses.Analysis at 13 years produced results that were not anticipated from previous analysis of interviews at age 8. Although mild bronchiolitis was a powerful predictor of wheezing at age 8 years, it was no longer a strong predictor of wheezing at age 13 in either bivariate or multivariate analysis. Although epidemiologic studies, by their nature, cannot prove causality, findings are consistent with the hypothesis that sequelae often follow mild bronchiolitis but diminish during childhood.Maternal smoking was a powerful predictor of wheezing at age 13 in bivariate analysis (Kendall's Tau B = 0.19, P < 0.01) and in multivariate analysis (odds ratio = 2.67, P < 0.01). In children at highest risk for wheezing, males with a family history of asthma, multivariate analysis suggested that maternal smoking is associated with an increase in wheezing from 36% to 60%. We conclude that passive smoking, previously identified as a risk factor in this population for both bronchiolitis in infancy and wheezing at age 8, is a risk factor for wheezing‐associated morbidity throughout the childhood years.
Comparison of conventional and high‐frequency ventilation in piglets after lung lavage
Authors: Cordero Leandro , Tallman Richard D. , Wasielweski Ray , Rrt Cindy Nissen 
Published: March 2007

AbstractA piglet model of respiratory failure was used to compare airway pressures required for adequate gas exchange by a conventional positive pressure ventilator (CMV) and a highfrequency pneumatic flow interrupter (HFFI). Twelve newborn piglets (age ± = 3.8 days and weight ± = 1.4 kg) were given saline lung lavages after receiving intravenous Ketamine and Pavulon. Femoral and jugular vessels were catheterized for measurements of aortic and pulmonary blood pressures and gases, cardiac output, hematocrit, glucose and for the infusion of fluids. Airway pressures were measured 5 mm above the distal tip of the endothracheal tube. Lung lavage resulted in decreased static compliance and a twofold increase in pulmonary shunting. Following lavage the animals were kept on 100% oxygen and randomly assigned to either CMV (30/min) or HFFI (600/min) ventilation and thereafter were switched every 30 minutes to the alternate mode. Inspiratory duration was 33% of the total respiratory cycle during CMV and 30–50% for HFFI. Sixteen pairs of data comparing both ventilator modes were used. Blood gases, cardiovascular variables, alveolar‐arterial oxygen gradient, and pulmonary shunting were not different with either ventilator. Positive end‐expiratory pressure (5.3 and 5.6 cm H2O) and mean airway pressure (12.5 and 11.9 cm H2O) were equal for CMV and HFFI, respectively. Peak inspiratory pressure was significantly lower for HFFI (23.1 ± 3.7 SD cm H2O) than for CMV (30.4 ± 5.5 SD cm H2O). The lower peak inflation pressure required during HFFI ventilation may reduce the potential for lung rupture.
Hypercapnia in relation to pulmonary function in duchenne muscular dystrophy
Authors: Canny Gerard J. , Szeinberg Amir , Levison Henry , Koreska Jan 
Published: March 2007

AbstractArterialized blood gases were analyzed in 143 patients with Duchenne muscular dystrophy (DMD) to assess the relationship between forced vital capacity (FVC) and hypercapnia. The majority of patients studied had Paco2 values in the low or normal range. Only six older patients had hypercapnia (Paco2 ≥ 45 mm Hg), and all these patients had FVC values ⩽ 40% predicted. We conclude that hypercapnic respiratory failure occurs as a late preterminal event in DMD.
Bronchodilation from intravenous theophylline in patients with cystic fibrosis: results of a blinded placebo‐controlled crossover clinical trial
Authors: Pan Pharmd, Ms Shi‐Hui , Canafax Daniel M. , Cipolle Robert J. , Uden Donald L. , Le Chap T. , Warwick Warren J. 
Published: March 2007

AbstractMost patients with cystic fibrosis (CF) eventually develop chronic obstructive pulmonary disease and theoretically could benefit from theophylline therapy. The purpose of this study was to investigate the pharmacologic response to intravenous theophylline by pulmonary function tests (PFT) and the theophylline pharmacokinetics in patients with CF. A randomized, double‐blind, placebo‐controlled, crossover trial was conducted in 10 ambulant patients with CF (5 females, 5 males), aged 11 to 21 years. Each patient received an intravenous dose of theophylline and normal saline over 1/2 hour on consecutive days. Spirometry and whole‐body plethysmography were performed at baseline, 1, 3, 5, and 7 h after the theophylline dose, and 10 blood samples were collected over 9 h on both study days. The percent change of PFT from the baseline was recorded. Analysis of variance for balanced two‐period crossover design was used to evaluate the effectiveness of theophylline therapy. The serum concentration (Conc.) vs. time data were fitted using nonlinear least‐squares regression analysis. The theophylline dose administered was 7.9 ± 0.4 (mean ± SD) mg/kg, which produced a maximal Conc. (Cmax) of 14.6 ± 2.7 m̈g/ml. The half‐life (T1/2), volume of distribution (Vd), and total body clearance (TBC) were 4.9 ± 1.9h, 537 ± 124 mL/kg, and 80 ± 16 ml/h/kg, respectively. The results of PFT data analysis indicated that maximal improvement in PFT was observed at 5 h, and statistically significant improvements occurred in forced expiratory flow during the first .75 s (FEV.75), FEV1.0, FEV1.0/vital capacity (VC), FEF when 50% and when 75% of VC is expired, and FEF between 25% and 75% of VC (P <0.05). These results suggest that in CF patients, theophylline can produce a delayed but significant improvement in PFT.
Effect of cyclic adenosine monophosphate elevations on functional responses of polymorphonuclear leukocytes from patients with cystic fibrosis
Authors: Suter Susanne , Chevallier Isabelle , Krause Karl H. , Lew Daniel P. 
Published: March 2007

AbstractRecently, it has been suggested that the primary metabolic defect of cystic fibrosis (CF) is in the metabolic steps between an elevation of cyclic adenosine monophosphate (cAMP) and the opening of the CI−ion channel in airway epithelial cells. Results from other studies have indicated that the primary defect may also be present in polymorphonuclear leukocytes (PMNL). In PMNL, cAMP is a potent inhibitor of cell function. We therefore used three compounds (epinephrine, theophylline, and forskolin) known to elevate cAMP in PMNL by three different mechanisms, to study the effect of an elevation of cAMP on various cell functions, such as superoxide production, membrane depolarization, and degranulation of CF patient PMNL and PMNL from healthy individuals. The baseline rates of superoxide production, degranulation, and membrane depolarization were identical for CF and control PMNL. After exposure to epinephrine as well as theophylline plus forskolin, the cell function of CF PMNL was inhibited to the same extent as that of control PMNL. Our results argue against an abnormal response of PMNL from patients with CF to an elevation of cAMP.
Risk factors for the development of posterior subcapsular cataracts in patients with cystic fibrosis and allergic bronchopulmonary aspergillosis treated with corticosteroids
Authors: Majure Marc , Mroueh Salman , Spock Alexander 
Published: March 2007

AbstractPosterior subcapsular cataracts (PSCC) occur in a high percentage of patients treated with long‐term systemic corticosteroids (Naumann Gott, Apple DJ, eds: Pathology of the Eye.New York: Springer‐Verlag, 1986). Fifteen patients with cystic fibrosis treated at Duke University Medical Center between January 1982 and October 1987 required prednisone for treatment of allergic bronchopulmonary aspergillosis (ABPA). Two of these patients (13.3%) were noted to have PSCC during prednisone therapy. We retrospectively examined factors associated with steroid administration that may have been predictive of the development of PSCC in these patients including: 1) steroid therapy for longer than 2 years, 2) steroid dose of 10 mg/day or greater for longer than 6 months, 3) steroid dose of 40 mg/day or greater for longer than 2 months, and 4) change in linear growth pattern during steroid therapy. None of these factors predicted the risk of developing PSCC. Therefore, we recommend that all patients with cystic fibrosis who receive steroids for the treatment of a concomitant condition such as ABPA should undergo careful examination for opacities of the ocular lens at each clinic visit regardless of the duration or dose of steroids.
Use of maximal expiratory flows to evaluate central airways obstruction in infants
Authors: Tepper Robert S. , Eigen Howard , Brown John , Hurwitz Roger 
Published: March 2007

AbstractPartial expiratory flow‐volume (PEFV) curves obtained by the rapid compression technique were employed to assess airway function in three infants with three different lesions of the central airways (vascular ring, congenital tracheal stenosis, subglottic polyp). Preoperatively, all three demonstrated severe flow limitation with a relativity constant forced expiratory flow over the tidal volume range. Postoperatively the PEFV curves changed to a normal convex shape, and the maximal expiratory flows at functional residual capacity (VmaxFRC) returned to normal. The PEFV curve adds to our physiologic assessment of the severity of the central airway obstruction in infants and to the efficacy of our therapeutic intervention.
Comparison of high‐frequency oscillatory ventilation and high‐frequency jet ventilation in cats with normal lungs
Authors: Boros Stephen J. , Mammel Mark C. , Coleman J. Michael , Horcher Phillip , Gordon Margaret J. , Bing Dennis R. 
Published: March 2007

AbstractFour adult cats received alternating high‐frequency oscillatory ventilation (HFOV) and high‐frequency jet ventilation (HFJV) at equivalent proximal airway pressures. Physiologic measurements were made before and after each ventilator change. Proximal airway pressures were then adjusted as necessary to reestablish normal pH and Pa values. Aortic, pulmonary artery, and central venous pressures were monitored. Cardiac outputs were measured. Pulmonary and systemic vascular resistance, intrapulmonary shunt, and alveolar‐arterial oxygen gradient were determined. Following the change from HFOV to HFJV at similar proximal airway pressures, HFJV always produced higher pH values (P < 0.0001), higher Pa values (P < 0.05), lower Pa values (P < 0.0001), as well as higher cardiac outputs (P < 0.01), lower pulmonary artery pressures (P < 0.001), and lower pulmonary vascular resistances (P < 0.001). Following the reciprocal crossover, from HFJV to HFOV, HFJV pH values were again higher (P < 0.001), and Pa values were again lower (P < 0.001). A comparison of HFOV and HFJV at similar pH and Pa values showed that HFOV consistently required higher peak inspiratory pressures (P < 0.001), higher mean airway pressure (P < 0.001), and higher pressure wave amplitudes (P < 0.001). Under the circumstances of this study, HFJV produced better gas exchange at lower proximal airway pressures. Pediatr Pilmonol. 1989; 7:35–41.
Long‐term effects of inhaled tobramycin in patients with cystic fibrosis colonized with Pseudomonas aeruginosa
Authors: Maclusky Ian B. , Gold Ronald , Corey Mary , Levison Henry 
Published: March 2007

AbstractTwenty‐seven patients with cystic fibrosis and endobronchial colonization with Pseudomonas aeruginosa were randomly assigned to inhale either 2 mL saline (12 patients) or 80 mg tobramycin solution (15 patients) 3 times daily. One control patient died; all others completed the study (mean duration 32 months). No significant differences were found between the two groups at enrollment. The treatment group showed no change, while the control group had a significant decline in both pulmonary function and clinical status over the study period. Individually, 11 of 12 patients in the control group showed deterioration, while 9 of 15 in the treatment group either did not change or actually improved (P < 0.01). Thirty‐three percent of patients in the treatment group with susceptible P. aeruginosa at enrollment acquired resistant organisms. There was no evidence of significant nephro‐ or ototoxicity. Although inhaled tobramycin appeared to arrest the decline in pulmonary status, further work is required to identify patients most likely to respond. Pediatr Pilmonol. 1989; 7:42–48.
Transplacentally acquired caffeine and the occurrence of apnea, bradycardia, and periodic breathing in preterm infants: Preliminary communication
Authors: McCulloch Kristine M. , Braun Richard J. , Simms Patricia E. , Evans Michael A. , Kelly Dorothy H. 
Published: March 2007

AbstractCord blood caffeine concentrations were measured by high‐pressure liquid chromatography in 79 preterm infants. Eleven infants (14%) had detectable Caffeine concentrations ranging from 1.1 to 3.7 μg/mL X SD = 2.5 ± (0.8), and 68 infants had no measurable caffeine. Seven infants with detectable caffeine (group 1) had impedance pneumograms recorded before 2 weeks of age. Each infant in group 1 was matched with two infants without detectable caffeine by birthweight, gestational age, and chronologic age at pneumogram recording to yield a control group (group 2) of 14 infants. Comparison of the groups using quantitative measures of apnea, bradycardia, and periodic breathing obtained from pneumogram analysis and the incidence of monitor alarms on bedside nursing records showed no significant differences. Thus, caffeine was present infrequently and at low concentrations at birth in 79 preterm infants. The amount of apnea, bradycardia, and periodic breathing experienced before 2 weeks of age in 7 preterm infants with detectable cord blood caffeine was not different from that in 14 similar infants without caffeine. Future studies are planned to examine the relationship between postnatal changes in transplacentally acquired methylxanthine concentrations and quantitative measures of apnea, bradycardia, and periodic breathing in a larger number of preterm infants without cardiorespiratory disease. Pediatr Pilmonol. 1989; 7:66–70.
Expiratory muscle activity in anesthetized children: Effect on the single breath technique
Authors: Shulman David L. , Volgyesi George A. , Burrows Frederick A. , Lerman Jerrold , England Sandra J. 
Published: March 2007

AbstractPhasic expiratory activity of the abdominal muscles occurs in adults during halothane anesthesia, but has not been demonstrated in children. If present, abdominal muscle activity would preclude the use of recently developed tests of respiratory mechanics in children during anesthesia. We therefore measured abdominal muscle activity throughout induction of anesthesia with halothane in 10 patients between 1.5 and 9.5 years of age, seven with normal respiratory function and three with chronic airway obstruction. During induction of anesthesia with halothane in N2O and oxygen, the abdominal wall electromyograph (a‐EMG) was continuously recorded from surface electrodes. At the same time, the expiratory time constant (τa) was measured using the single breath test (SBT). The patients were then paralyzed with succinyl choline, and the a‐EMG signal and expiratory time constant during paralysis (τP) were recorded. The raw a‐EMG signal and its moving time average were compared with the phase of respiration and with the end‐tidal fraction of halothane (Fehalo), and the effect of abdominal muscle activity on τa was noted. Of the 10 patients, 2 had no abdominal muscle activity at any time during induction. Of the remaining 8 patients, 3 had continuous abdominal muscle activity throughout induction, including one patient with asthma. In the remaining five patients, abdominal muscle activity was present during light halothane anesthesia and disappeared at increased Fehalo. When abdominal muscle activity was present, τa was significantly less than τρ. It is concluded that abdominal muscle activity in expiration is undetectable during deep halothane anesthesia in most children. But abdominal muscle activity persists throughout halothane induction in some children, and, when this occurs, there is an apparent decrease in τa, invalidating the SBT as a test of passive respiratory mechanics. Pediatr Pilmonol. 1989; 7:82–88.
Formoterol and salbutamol metered aerosols: Comparison of a new and an established beta‐2‐agonist for their bronchodilating efficacy in the treatment of childhood bronchial asthma
Authors: von Berg Andrea , Berdel Dietrich 
Published: March 2007

AbstractIn this placebo‐controlled, double‐blind, single‐dose study the new beta‐2‐agonist formoterol (one puff, 12 μg) was intraindividually compared with salbutamol (one puff, 100 μg) for onset, magnitude, and duration of bronchodilating efficacy in 15 young asthmatics aged 5 to 14 years with mild to severe asthma. All but one had regular antiasthmatic medication before beginning the study, but none was oral steroid dependent. Both medications produced rapid bronchodilatation within 10 minutes, reflected by a decrease in specific airway resistance (sRaw) with maximum effects at 10 minutes (salbutamol, 51%) and 30 minutes (formoterol, 60%). Significant bronchodilation was present at 10 minutes to 2 hours after inhalation of salbutamol and at 30 minutes to 8 hours after formoterol. Mean percent improvement over baseline was higher for formoterol at all measured times from 30 minutes to 12 hours, when 55% mean decrease in sRaw was still present. The effect of salbutamol was a less than 10% mean decrease in sRaw after 6 hours. The differences in sRaw decrease between the two medications were statistically significant at 4 to 10 hours after inhalation. Neither medication administered as an aerosol caused cardiac side effects. Both had a rapid onset of action and a comparable maximal effect. However, at the doses studied, formoterol produced a larger decrease in sRaw from baseline for longer periods after inhalation than did salbutamol. Pediatr Pilmonol. 1989; 7:89–23.
Fiberoptic bronchoscopy in the neonate
Authors: Finer Neil N. , Etches Philip C. 
Published: March 2007

AbstractOver a 37 month period 113 flexible fiberoptic bronchoscopies were perfomed in 77 neonates, using a variety of instruments. Thirty‐six examinations were done via an endotracheal tube or tracheostomy. In addition to elective examination of the infant's airway, bronchoscopy has been found valuable in the management of emergency situations such as suspected tube blockage or malposition and difficult intubations. A video recording system is useful for teaching and documentation of abnormal findings. Pediatr Pilmonol. 1989; 7:116–120.