bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of sleep state on chest wall movements and gas exchange in infants with resolving bronchopulmonary dysplasia
Authors: Rome Ellen S. , Miller Martha J. , Goldthwait David A. , Osorio Ivan O. , Fanaroff Avroy A. , Martin Richard J. 
Published: March 2007

AbstractDuring active sleep, neonates exhibit asynchronous chest wall movements, which have been associated with a small but significant decrease in oxygenation. To determine the effects of maturation and residual chronic lung disease on both these phenomena, we studied 11 preterm infants with resolving bronchopulmonary dysplasia (BPD) and compared these infants to ten healthy preterm infants all at time of discharge. Synchrony of chest wall (upper rib cage and abdominal) movements, sleep state, O2 saturation, and transcutaneous CO2 (TcPco2) were recorded during both active (AS) and quiet sleep (QS). Sleep state was determined by electroencephalographic and behavioral criteria. Normal preterm infants displayed asynchronous chest wall movements only in AS, whereas, in infants with BPD, asynchrony predominated in both sleep states, although O2 saturation and TcPco2 did not differ between sleep states in either group. The O2 saturation during AS was lower in the BPD group than in the group of normal infants (92% vs 96%; P < 0.02), whereas TcPco2 was higher in the BPD group unrelated to sleep state. We conclude that infants with resolving BPD exhibit asynchronous chest wall movements in both AS and QS, and that change in sleep state from QS to AS is not associated with a detrimental fall in oxygenation in these infants.
Are sex, age at diagnosis, or mode of presentation prognostic factors for cystic fibrosis?
Authors: Hudson Irene , Phelan P. O. 
Published: March 2007

AbstractData on 622 patients with cystic fibrosis born in Victoria, Australia from 1955 to 1980 and on 344 surviving patients in the care of a specialist clinic on June 30, 1983 were analyzed for factors associated with better survival and a less rapid progress of lung disease. Presentation with predominantly gastrointestinal symptoms, other than meconium ileus, was associated with an improved prognosis, whereas presentation with predominantly respiratory symptoms was associated with a worse prognosis. While infants diagnosed before the age of 6 months as a result of routine testing because of a family history of the disease seemed to have less rapid progress of lung disease, their ultimate survival did not seem to be better than that of patients presenting symptomatically after the newborn period. The sex of the patients did not appear to have prognostic significance. Age at diagnosis did not affect rate of progress of lung disease or survival when infants dying within 6 months of birth were excluded. There was a close association between the extent of lung disease at diagnosis and current lung disease. Failure to reverse extensive disease at diagnosis or deterioration of lung disease in the first year after diagnosis was associated with a less favourable course.Pediatr Pulmonol 1987; 3:288–297.
Recovery from hypopnea in preterm lambs: Effects of breathing air or oxygen
Authors: Hutchison Alastair A. 
Published: March 2007

AbstractThe aim of this study was to determine if resuscitation from hypopnea when breathing oxygen resulted in a slower recovery than that seen when breathing room air. Hyperoxia, in preterm human neonates and lambs, decreases minute ventilation (V̇I), but no study has shown this effect during recovery from apnea or hypopnea, a common clinical setting. Thus, recovery from hypopnea was studied in eight unanesthesized preterm lambs, breathing spontaneously via an endotracheal tube placed into a tracheostomy. Hypopnea, defined here as a decrease in V̇I from baseline greater than 50%, was induced by instillation of distilled water onto the larynx. After a baseline 30 sec when V̇I heart rate, and arterial blood gas were measured, a standard hypopnea stimulus was given over 30 sec. The lambs then breathed air or oxygen during a 2‐min recovery period, which started with 15 sec of artifical ventilation. The degree of recovery at 2 min was less in the oxygen (O2) breathing group: V̇I (ml/kg/min) = 381 ± 27 in air and 270 ± 18 in O2, P < 0.01; pH = 7.38 ± 0.005 in air and 7.34 ± 0.008 in O2, P < 0.01; arterial carbon dioxide tension (Pa mrnHg) = 45.0 ± 1.3 in air and 49 ± 1.3 in O2 P < 0.01; base excess = 2.1 ± 0.6 in air and 1.1 ± 0.5 oxygen, P < 0.01. By 2 min a return to baseline values of V̇I, pH, and Pa was noted only in the air breathing group, where the arterial oxygen tension also returned to normal. The heart rate recoveries at 2 min were not different and, in both groups, were less than their baseline values. Resuscitation with O2 in contrast to room air, delays ventilatory recovery from hypopnea. Pediatr Pulmonol 1987; 3:317–323.
Bronchiolar obstruction associated with repeated aspiration of vegetable material in two children with cerebral palsy
Authors: Gadol Charles L. , Joshi Vijay V. , Lee Eun Young 
Published: March 2007

AbstractChronic reactive bronchiolar obstruction has not been noted to occur with repeated aspiration of food materials. In this report, we describe two autopsy cases of children aged 8 years and 22 months with cerebral palsy, one with documented and treated esophageal reflux, and both with histories of repeated aspiration pneumonia. In each case, the lungs showed multiple nodules of hyalinized tissue and organized exudate obstructing the bronchiolar lumina, with multinucleated foreign body‐type giant cells surrounding intraluminal vegetable particles. It is suggested that chronic bronchiolar obstruction was a significant contributing cause of respiratory insufficiency and consequent morbidity in these patients with cerebral palsy.
Forced vital capacity and maximal respiratory pressures in patients with mild and moderate scoliosis
Authors: Szeinberg Amir , Canny Gerard J. , Rashed Nashed , Veneruso Giuseppina , Levison Henry 
Published: March 2007

AbstractSummary. Lung function and maximal respiratory pressures of 24 adolescent females with mild‐to‐moderate idiopathic scoliosis (spinal curvature 10‐60°) were determined and compared with 38 age‐ and sex‐matched controls. Twelve patients with moderate scoliosis (Cobb angle 35‐60°) had significantly reduced mean values for FVC (% predicted) and maximal inspiratory pressure (MIP), as compared to the controls. Twelve patients with mild scoliosis (Cobb angle <35°) had normal mean values for FVC and maximal respiratory pressures, but five individual patients had FVC values less than 80% predicted. All but one of the patients with mild scoliosis had normal MIP values. FVC (% predicted) was significantly correlated with the degree of spinal curvature (r = ‐0.466; P<0.05) but was not related to MIP. These results indicate that reduced FVC values do occur in patients with mild‐to‐moderate idiopathic scoliosis and suggest that these low FVC values can be attributed to the rib cage deformity rather than to an inability to generate adequate inspiratory pressures.
Intestinal permeability to chromium‐51 ethylenediamine tetraacetic acid in children with chronic obstructive respiratory disease: Relationship with clinical and duodenal biopsy findings
Authors: Hoyoux CI. , Forget P. P. , Borlee‐Hermans G. , Geubelle F. 
Published: March 2007

AbstractIntestinal permeability (IP) to 51‐Cr ethylenediamine tetraacetic acid was investigated in 47 children with chronic obstructive respiratory disease (CORD). Endoscopic duodenal biopsies were performed in 22 of these patients. IP was significantly increased in CORD patients when compared to either control children or adults (P < 0.001). Mean ± 1 SD were 4.3 ± 1.71%, 2.5 ± 0.78%, and 2.3 ± 0.77% in the three groups, respectively.IP was not related to the presence of atopy. Significant differences in IP results were found between CORD children with abdominal pain (4.5 ± 1.4%) and both control children and CORD patients without abdominal pain (2.5 ± 0.78% and 3.2 ± 1.49%, respectively). A significant correlation was found between small bowel injury on the one hand and IP on the other hand (P < 0.02). Furthermore, small bowel injury was significantly related to the presence of abdominal pain (P < 0.05).We speculate that in CORD patients with abdominal pain, a factor exists that causes small bowel injury responsible for both abdominal pain and increased small bowel permeability. Food intolerance could, presumably, play a role in the mucosal damage‐linked IP increase found in the subset of CORD patients who complain of abdominal pain.
Noninvasive determination of respiratory mechanics during mechanical ventilation of neonates: A review of current and future techniques
Authors: Sly Peter D. , Brown Karen A. , Bates Jason H. T. , Spier Sheldon , Milic‐Emili Joseph 
Published: March 2007

AbstractStudy of the mechanical properties of the respiratory system is needed to help provide a better understanding of the pathogenesis of diseases causing respiratory failure. The nature of neonatal intensive care requires that any technique for monitoring respiratory mechanics be simple, noninvasive, and allow continued free access to the neonate. The peak airway pressure developed during volume cycled ventilation reflects the mechanical properties of the respiratory system but cannot distinguish between changes in the flow‐resistive or elastic properties. Similarly, dynamic compliance combines both the flow‐resistive and elastic components of the respiratory system in a single number and flow‐volume loops also reflect both elements. Extracting a single time‐constant from the expiratory limb of the latter assumes a single‐compartment model for the respiratory system and, as such, does not provide sufficient information to describe frequency dependence of resistance and compliance. Furthermore, flow‐volume loops are markedly distorted by the presence of an endotracheal tube, which must be corrected for, before calculating values of resistance and compliance. To provide the information to understand better the physiologic processes and adaptive mechanisms in diseased states causing acute respiratory failure, it is necessary to use a method that is based on a more detailed and realistic model of the respiratory system. Two such techniques that appear to warrant further investigation in ventilated infants are the interrupter technique and the forced‐oscillation technique.
Current techniques for assessing pulmonary function in the newborn and infant: Advantages and limitations
Authors: England Sandra J. 
Published: March 2007

AbstractOne of the major problems in pediatric pulmonology has been the shortage of tools to assess objectively the mechanical status of the lung and the effects of therapy. In the last few years this has changed; there are now a large number of methodologies to choose from. One method has rarely been tested against another, and as there does not appear to be a gold standard, the situation is becoming confused. Choice of the technique to be applied must be based on the characteristics of the patient to be studied. With the recent introduction of commercially available devices for performing some of these techniques, it is essential that those using them have a clear understanding of what they are measuring, the limitations of the measurements, and their interpretation.
Derepressed beta‐lactamase production as a mediator of high‐level beta‐lactam resistance in pseudomonas cepacia
Authors: Aronoff Stephen C. 
Published: March 2007

AbstractA mechanism of high‐level resistance to readily and poorly hydrolyzable betalactam substrates in Pseudomonas cepacia was identified using a hypersusceptible, betalactamase‐inducible, non‐CF clinical isolate, 75–26, and a drug‐resistant mutant derived from this strain. Inoculation of 75–26 onto agar containing 16 μg/ml of ceftazidime produced a stable, beta‐lactam‐resistant mutant at a frequency of 1.7 × 10−5. Baseline beta‐lactamase production by a representative mutant isolate (75–26z) was almost 40‐fold greater than the parent. Both strains produced major beta‐lactamase bands with isoelectric points of 6.9, 7.8, 8.1, 8.5, and 9.2 by isoelectric focusing. Compared with the parental strain, multiple satellite bands associated with the major beta‐lactamase bands were present in the mutant. Growth of an indicator strain, E. coli ATCC 25922, was inhibited by ceftazidime and piperacillin but was not inhibited after the compounds were preincubated with the beta‐lactamase preparation from 75–26z. Preincubation of ceftazidime with beta‐lactamase, followed by the addition of a beta‐lactamase inhibitor, inhibited the growth of the indicator strain; piperacillin failed to inhibit growth of the indicator strain in a similar experiment. One mechanism of high‐level resistance to both poorly and readily hydrolyzable beta‐lactam substrates in P. cepacia is derepressed chromosomal beta‐lactamase production. Pediatr Pulmonol 1988; 4:72–77.
Cost savings and economic considerations using home intravenous antibiotic therapy for cystic fibrosis patients
Authors: Kane Robert E. , Jennison Karla , Wood Carol , Black Philip G. , Herbst John J. 
Published: March 2007

AbstractOur Cystic Fibrosis (CF) Center made an effort to utilize home intravenous antibiotic therapy (HIVAT) as an alternative to continued hospitalization during a 1‐year study. After thorough individual clinical and financial evaluation, 27 of 41 CF patients admitted for treatment, including antibiotic therapy, were selected for HIVAT to complete a 14‐ to 21‐day treatment course (mean 15.1 days). The 27 patients (6–28 years old, mean 16 years) incurred a total of $698,587 in hospital charges and physician fees during 96 admissions. The average charge for 974 inpatient days was $717/day ($7,280 per admission). After an average of 10.2 days of inpatient care, the 27 patients underwent 79 courses of HIVAT for an additional 8 days; 21 additional HIVAT courses in six of these patients were initiated on an outpatient basis between frequent readmissions. The 811 days of HIVAT resulted in $85,027 total charges by two home care companies. The charges per day of HIVAT by one company were almost twice that of the other. The average daily cost of HIVAT was $108/day. If the HIVAT patients had remained hospitalized to complete the course of intravenous antibiotic therapy, the projected inpatient costs would have been $589,271. Therefore, the 811 days of HIVAT over a 1‐year period resulted in total estimated direct cost savings of $501,770. The average savings per course of HIVAT was $5,017, or $618/day. We concluded: 1) HIVAT was a safe, less expensive alternative to prolonged hospitalization with few complications; 2) the use of HIVAT at our center effected a 1‐year estimated cost saving of $501,770; and 3) additional cost savings could have been realized by cost comparison between home health care companies offering comparable services.
Lung pathology after high frequency jet ventilation combined with low rate intermittent mandatory ventilation in a canine model of meconium aspiration
Authors: Keszler Martin , Klappenbach R. Scott , Reardon Eileen 
Published: March 2007

AbstractThe microscopic appearance of lungs subjected to six hours of conventional ventilation (CV), standard high frequency jet ventilation (HFJV), and HFJV combined with low rate intermittent mandatory ventilation (CHFJV) was studied in 22 mongrel puppies. A lung injury model was created by insufflating 4 ml/kg of a 20% mixture of meconium into the trachea. The animals were initially ventilated at the same mean airway pressure (Paw). Subsequently, if Pco2 fell below 20 torr, peak and mean airway pressures were reduced. A scoring system was devised which assigned 0–3 points for each of eight lung injury parameters, and a total lung injury score (TLIS) was calculated.CHFJV resulted in significantly less bronchopneumonia and edema, when compared to CV. A consistent, though not significant, trend toward lesser injury scores in CHFJV animals was noted for several other parameters. Six of eight lungs exposed to CV had TLIS > 5 compared to only 1 of 9 ventilated by CHFJV. (P= 0.02). It is concluded that CHFJV may have a protective effect on the lung, perhaps because effective gas exchange is achieved with a lower pressure amplitude and at lower Paw.
Evaluation of neonatal pulmonary mechanics and energetics: A two factor least mean square analysis
Authors: Bhutani Vinod K. , Sivieri Ms Emidio M. , Md Soraya Abbasi , Shaffer Phd Thomas H. 
Published: March 2007

AbstractPulmonary mechanics, using a two factor least mean square analysis technique, were determined in 22 preterm neonates with respiratory failure. The respiratory system is modelled as a linear mechanical system. Concurrent signals of airflow and transpulmonary pressure were utilized to calculate values of dynamic lung compliance and pulmonary resistances; these determinations were made over the entire tidal volume range. In addition, values of resistive work of breathing, pulmonary time constants, scalar records of sequential breaths, pressure‐volume and flow‐volume relationships were available for data review and interpretation. The mean ± SEM value of tidal volume was 7.4 ± 0.6 ml/kg; dynamic lung compliance was 0.44 ± 0.04 ml/cmH2O/kg; and the pulmonary resistance of the whole breath was 106 ± 9.1 cmH2O/liter/s. The resistive work of breathing (hysteresis) was 41.8 ± 5.9 gm.cm/kg. In correlating the measured values of pressure and flow to those predicted by the model, the mean value of the correlation coefficient for the least mean square analysis for all 22 studies was 0.995 ± 0.001; the standard error of estimate of the predicted pressure was <4.4% of the range of pressures measured. Thereby, the model was considered to be appropriate for the neonatal respiratory system. In addition to the traditional procedures of evaluating the respiratory status of a sick neonate, bedside analysis of pulmonary mechanics provide graphical information, and quantitative data which should be useful in day‐to‐day pulmonary management.
Airway obstruction and airway wall instability in cystic fibrosis: The isolated and combined effect of theophylline and sympathomimetics
Authors: Eber Ernst , Oberwaldner Beatrice , Zach Maximilian S. 
Published: March 2007

AbstractMultiple aspects of lung function were measured in 17 cystic fibrosis (CF) patients on four occasions: without therapy (0); with oral theophylline medication (Th); after inhalation of salbutamol (β); and with combined medication (Th + β2). In addition to routine measurements, partial and maximum expiratory flow‐volume (MEFV) curves were superimposed, and the flow transient equivalent of the MEFV curve was determined. Its volume dimension (volume of airway contribution, VACMEFV) partially reflects airway distensibility. Changes in airway compressibility—the other consequence of airway wall instability—were assessed by observing changes in end‐expiratory flow rate. Airway resistance, expired volumes, and early expired flow rates, as well as VACMEFV improved significantly after β2 medication. Mean endexpiratory flow also increased after β2; in two patients, however, it decreased significantly, indicating that enhanced airway compression dominated over the release of bronchospasm. Th alone had only minor effects on lung function. Early expired volume and flow rates as well as VACMEFV showed no significant difference between β2 alone and Th + β2; airway resistance even decreased significantly with this drug combination. End‐expiratory flow rate, however, was significantly lower after Th + β2 than after β2 alone. Although theophylline does not alter lung function in most patients with CF, sympathomimetics relieve bronchospasm in many, but they enhance airway compressiblity and thereby decrease peripheral expiratory airflow in some. Th + β2 shows no clearcut therapeutic advantage over β2 alone but, due to destabilized bronchial walls, can lead to maximum expiratory airway compression in some patients; consequently, caution and detailed individualized assessment of induced lung function changes are recommended before considering such combined medication for treatment of hyperreactive airway disease in CF patients.
Effects on respiration of CPAP immediately after extubation in the very preterm infant
Authors: Andréasson Bengt , Lindroth Magnus , Svenningsen Nils W. , Jonson BjöN 
Published: March 2007

AbstractThe effects of continuous positive airway pressure (CPAP) on pulmonary function during weaning from ventilator treatment were examined immediately after extubation in 17 very preterm infants, who had been ventilator‐treated because of hyaline membrane disease (15 infants) and chronic pulmonary insufficiency of prematurity (two infants). Seven infants had bronchopulmonary dysplasia. Median birthweight was 920 g and median gestational age 26 completed weeks. The median duration of ventilator treatment was 10 days.Application of CPAP by means of a face chamber device after endotracheal extubation significantly lowered the frequency of apnea (P = 0.02) and enhanced oxygenation (P = 0.001). The respiratory mechanical indices derived from flow rate and juxta‐diaphragmatic esophageal pressure measurements showed a reduced elastic (P = 0.03) and resistive (P = 0.02) load on the diaphragm. Even if the measured values do not accurately represent absolute resistances and compliances, the relative values of end‐inspiratory and end‐expiratory pressures differed significantly with and without CPAP (P = 0.001 and 0.002, respectively). We found CPAP applied via the face chamber technique immediately after extubation to be beneficial and to facilitate weaning from ventilator treatment in very preterm infants. Pediatr Pulmonol 1988; 4:213–218.
Mechanics of the ventilatory system in sedated infants: Forced oscillations versus single‐breath method
Authors: Marchal F. , Peslin R. , Duvivier C. , Gallina C. , Crance J. P. 
Published: March 2007

AbstractThe real—Re(Z)—and imaginary—Im(Z)—parts of the ventilatory system impedance were measured between 6 and 30 Hz in 18 normal infants and in 19 with airway obstruction. The intercept (RO) and slope (S) of the Re(Z)‐frequency function, as well as inertance (I) and compliance (C) estimated from Im(Z), were compared with ventilatory system resistance (Rrs) and compliance (Crs) (single‐breath method). RO correlated significantly with Rrs (r = 0.86), although the slope of the regression equation was significantly lower than 1 (P < 0.01). Negative frequency dependence of Re(Z) was observed in all subjects and a significant correlation was found between S and Rrs (r = ‐ 0.80). “Inertance” was negative in 20 subjects and correlated negatively with Rrs (r = ‐0.61). C correlated with Crs (r = 0.64) and with 1/Rrs (r = 0.85). The ratio of C to Crs (mean ± SD = 0.168 ± 0.082) also correlated with 1/Rrs (r = 0.51). The main characteristics of the total impedance/frequency function could be simulated with a model featuring the upper airway wall (Zuaw) in parallel with the ventilatory system (Zrs). It is suggested that the differential change in Zuaw and Zrs with growth accounts for the marked frequency dependence of Re(Z) as well as the inaccurate estimation of both I and C in this population.