bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of chest physical therapy on lung function in children recovering from acute severe asthma
Authors: Asher M. Innes , Douglas Catherine , Airy Margaret , Andrews Deborah , Trenholme Adrian 
Published: March 2007

AbstractThe effects of chest physical therapy in acute severe asthma in children have been studied in 38 children aged 6 to 13 years in a randomized placebo controlled trial. The study began between 6 and 24 hours after admission to hospital; 19 children received chest physical therapy (PT) and 19 children received placebo visits. Each child had 4 treatments over 2 days which were preceded by nebulized salbutamol. Lung volumes and flow rates were measured in a body plethysmograph before salbutamol and before and after either PT or placebo on the first and fourth treatments. Throughout the study standard asthma drug therapy was given. In both groups characteristics such as sex, race, age, height, weight, severity, and baseline lung function were similar. Taking into account the baseline, lung function at the end of the study was similar in both groups. Three 12 year old children in the PT group showed improvements in flows above those seen in any children in the placebo group. We conclude that chest PT, when combined with asthma drug therapy, does not improve lung function in most children in this age group with acute severe asthma. Pediatr Pulmonal 1990; 9:146–151.
Pulmonary vascular damage and the development of cor pulmonale following hyaline membrane disease
Authors: Hislop Alison A. , Haworth Sheila G. 
Published: March 2007

AbstractLight microscopic morphometric techniques have been used to study the lungs in 17 infants and young children aged 2 weeks to 3.5 years who were born prematurely, developed hyaline membrane disease (HMD), and died with chronic lung disease. They were divided into three groups. In group 1 the babies died without recovering from their intitial illness at age 2–13 weeks. In group 2 they died, aged 4–15 months, having recovered from the neonatal illness. Neither group showed clinical or pathological evidence of cor pulmonale (CP). In group 3 children died aged 6 months to 3.5 years with CP. None of the 17 patients had classical fibrotic bronchopulmonary dysplasia (BPD) but all had a reduced alveolar number and an increase in bronchial smooth muscle in small airways. All three groups showed an increase in pulmonary arterial medial thickness (P < 0.001). In group 1 the appearance of the arteries suggested persistance of the fetal state. In group 2 and 3 the vessels had a more mature structure; in group 3 a marked secondary increase in muscularity was found, approaching the thickness seen in fetal life. In groups 2 and 3 muscle extended into smaller arteries than normal. Vein wall thickness was increased. The alveolar to arterial ratio was normal, the alveolar number was reduced, therefore the total number of arteries was reduced in all three groups. Thus, babies who recover from HMD may have significant vascular abnormalities in the absence of CP; conversely, CP if present, does not mean advanced obliterative pulmonary vascular disease. Thus, pulmonary vascular morphology does not correlate with the presence or absence of CP. Pediatr Pulmonal 1990; 9:152–161.
Corticosteroids do not affect the clinical or physiological status of infants with bronchiolitis
Authors: Springer Chaim , Bar‐Yishay Ephraim , Uwayyed Kamal , Avital Avraham , Vilozni Daphna , Godfrey Simon 
Published: March 2007

AbstractThe treatment of infants aged 1.5–11.0 months suffering from acute bronchiolitis with a combination of inhaled albuterol and systemic corticosteroids or inhaled albuterol and placebo was compared in 50 infants in a double blind study. The mean initial clinical score and the rate of improvement was similar in the two groups. The mean ± SD hospital stay was 5.0 ± 1.2 days for the steroid group and 5.2 ± 1.7 days for the placebo group. Lung function was measured in 14 infants (7 from each group) and showed evidence of increased lung volumes and severe airway obstruction in the acute stage (the mean values for the steroid group were: TGV, 31 mL/kg; SGaw, 0.104 L/s·cmH2O; V̇maxFRC, 12.9 mL/s/kg; for the placebo group: TGV, 35 mL/kg; SGaw, 0.104 L/s·cmH2O; V̇maxFRC, 8.5 mL/s/kg) which had improved 2–4 weeks later (steroid group: TGV, 25 mL/kg; SGaw, 0.168 L/s·cmH2O; V̇maxFRC, 21.6 mL/s/kg; –placebo group: TGV, 24 mL/kg, SGaw, 0.198 L/s·cmH2O, V̇maxFRC, 17.5 mL/s/kg). There were no significant differences of thoracic gas volume, specific airway conductance, and forced expiratory flow at resting lung volume between the two groups, either in the acute or convalescent stages. We conclude that corticosteroids do not change the rate of clinical improvement in acute bronchiolitis, nor do they effect lung function 2–4 weeks later. Pediatr Pulmonal 1990; 9:181–185.
Evaluation of a mainstream capnometer and end‐tidal carbon dioxide monitoring in mechanically ventilated infants
Authors: Meredith Keith S. , Monaco Frank J. 
Published: March 2007

AbstractWe evaluated a new lightweight capnometer with a < 1 mL deadspace neonatal airway adapter and endotracheal tube connector unit (NAC) for use in mechanically ventilated neonates. The evaluation consisted of: 1) a bench test comparison of air flow resistance between the standard endotracheal tube and connector with the new NAC (flow rates, 1.5 to 12.8 L/min); 2) a determination of the effect of NAC placement on Pa; 3) pre‐ and post‐NAC pulmonary mechanics; and 4) an analysis of paired Pet and Pa in 16 infants requiring mechanical ventilation. Paired t test of the slopes of the resistance curves was significant (P = 0.002) while analysis of variance of differential pressures was not (P = 0.29). All post‐NAC placement Pa were smaller than pre‐placement values; there were no differences in pulmonary mechanics, and Pet correlated closely with Pa (n = 132, r = 0.79) defined as Pet = 0.68 • Pa + 5.21; x̄ ± 1 SD, Pa–Pet was 4.7 ± 4.7 torr and Pet/Pa was 0.86 ± 0.14. Pediatr Pulmonal 1990; 9:254–259.
The paradox of adult respiratory distress syndrome in neonates
Authors: Pfenninger Juerg , Tschaeppeler Heinz , Wagner Bendicht Peter , Weber Jann , Zimmerman Arthur 
Published: March 2007

AbstractSix full‐term newborn infants are described who suffered from severe adult respiratory distress syndrome (ARDS). The triggering event was intrauterine/perinatal asphyxia in five, and group B streptococcal (GBS) septicemia in three. All had severe respiratory distress/failure and were ventilated mechanically with high concentrations of inspired oxygen and positive end‐expiratory pressure. Radiography of the chest showed dense bilateral consolidation with air bronchograms and reduced lung volume. Persistent pulmonary hypertension (PPH) was documented in all cases. The coincidence of ARDS and PPH rendered respiratory management extremely difficult. For this reason high‐frequency ventilation was instituted in all patients in order to improve CO2 elimination and induce respiratory alkalosis. Acute complications of respiratory therapy were encountered in five patients (pneumothorax, pulmonary interstitial emphysema, pneumopericardium). Three infants died (irreversible septic shock, progressive severe hypoxemia, and sudden cardiac arrest) after 17, 80, and 175 h of life. Histologic examination of the lungs was possible in all fatal cases and revealed typical changes of acute to subacute stages of ARDS. Three infants survived, the mean time of mechanical respiratory support being 703 h. Two patients were still dependent on oxygen after 1 month of life, and all survivors had increased interstitial markings and increased lung volumes on their chest roentgenograms at this time. Pediatr Pulmonol 1991; 10:18–24.
Effectiveness and safety of small vs. large doses of enteric coated pancreatic enzymes in reducing steatorrhea in children with cystic fibrosis: A prospective randomized study
Authors: Brady Mary Sue , Rickard Karyl , Yu Pao‐Lo , Eigen Howard 
Published: March 2007

AbstractAmong cystic fibrosis (CF) centers, usual doses of enteric coated (EC) pancreatic enzymes vary from one to six capsules per meal based upon arbitrary criteria for stool and growth patterns. Large doses of non‐EC enzymes are associated with increased serum urate (SU) and urinary uric acid (UUA) but data are unavailable for EC enzymes. This study compared the effectiveness and safety of a relatively large dose (patient's usual dose) versus a small dose (¼ usual dose) of EC enzymes in nine nourished children with CF, regarding decreasing fecal fat and stool nitrogen losses and maintaining normal SU and UUA concentrations. A crossover study design randomly assigned large or small doses to two consecutive 7 day treatment periods within each child. Large doses of EC enzymes reduced steatorrhea and increased SU and UUA. SU was normal with both treatments and UUA was normal, i.e., 17 of 18 values were between the 10th and 95th percentiles for healthy children eating a normal diet. When fat excretion was greater than 10% with small doses of EC enzymes, large doses resulted in reduced fat excretion and normal UUA. These data suggest that large doses of EC enzymes reduce steatorrhea and are safe in patients who have malabsorbtion with small doses. Pediatr Pulmonol 1991; 10:79–85.
Exercise performance and breathing patterns in cystic fibrosis: Male‐female differences and influence of resting pulmonary function
Authors: Orenstein David M. , Nixon Patricia A. 
Published: March 2007

AbstractDespite improved prognosis for patients with cystic fibrosis (CF), they continue to suffer from progressive decline in pulmonary function and exercise tolerance. Beyond puberty, female patients have greater loss of pulmonary function and higher mortality than males, yet no one has studied male‐female differences in exercise tolerance among patients. We therefore compared the responses to progressive exercise in 58 male and 52 female patients with CF and analyzed the influence of resting pulmonary function and gender on these responses and on breathing patterns during exercise. Within each of three pulmonary function groups (group 1: FEV1 ⩾ 65% predicted; group 2: FEV1 = 50–64% predicted; and group 3: FEV1 < 50% predicted), female patients had lower exercise tolerance than males. This was reflected in the overall group for each gender: males' peak work load was 130 ± 64 W, females' 111 ± 32 W (P = 0.04); males' peak oxygen consumption, 36.9 ± 11.4 mL/kg/min and females', 31.0 ± 7.4 mL/kg/min (P = 0.0006). There was no interactive effect between gender and pulmonary function. Neither respiratory rate nor tidal volume differed between sexes. Male and female patients, irrespective of disease severity, employed similar proportions of their ventilatory capacity at exhaustion; group mean minute ventilation to maximum voluntary ventilation ratio ranged from 62.9 to 78.3%, with no apparent relationship to disease severity. Pediatr Pulmonol 1991; 10:101–105.
Repeated provocation tests in asthmatic children for testing tachyphylaxis to histamine
Authors: Roorda Ruurd Jan , Gerritsen Jorrit , van Aalderen Wim M. C. , Schouten Jan P. , Knol Klaas 
Published: March 2007

AbstractTachyphylaxis to histamine was investigated in 16 children, aged 7–15 years, with mild asthma. Three consecutive histamine challenges were performed at intervals of 24 hours and 1 hour, respectively. No significant differences in IVC, FEV1, and PC20‐histamine values between the three measurements were observed. After a 24 hour interval there was no difference in percentage fall of FEV1, but there was a slight (not significant) decrease in fall of FEV1 after a 1 hour interval. The PC20‐histamine values showed good reproducibility with a 24 hour as well as with a 1‐hour period between the tests (geometric mean PC20, 2.04 mg/mL ± 3.50 %SD, 1.96 mg/mL ± 4.37 %SD, 2.17 mg/mL ± 4.12 %SD; correlation coefficients for a 24 hour interval, r = 0.87 and for a one‐hour interval, r = 0.94 (P < 0.01)).We conclude that in children there is no strong evidence for tachyphylaxis to histamine. Our results differ from studies on tachyphylaxis in adult asthmatics. Possibly different mechanisms exist in children and in adults. Pediatr Pulmonol 1991; 10:106–111.
Sleep apnea and hypoxemia in recently weaned premature infants with and without bronchopulmonary dysplasia
Authors: Sekar K. C. , Duke James C. 
Published: March 2007

AbstractInfants with bronchopulmonary dysplasia (BPD) experience significant hypoxemia. Apnea indices and oxygen saturation levels of ten infants with BPD were compared to ten healthy premature infants who were evaluated to rule out apnea or bradycardia prior to discharge from the hospital. Infants with BPD who had been recently (< 7 days) weaned from supplemental oxygen were evaluated on and off supplemental oxygen. Premature controls had never received oxygen nor ventilation assistance. Infants with BPD were born significantly more prematurely (28.1 ± 1.0 vs. 33.0 ± 3.9 weeks; P = 0.0012) while chronologic ages at the time of evaluation, adjusted for prematurity, were equal (37.1 ± 3.1 vs. 38.0 ± 2.7 weeks). Comparisons of apnea densities (expressed as percent of sleep time) between BPD and non‐BPD prematures revealed the following: neither the average obstructive apnea (0.15 ± 0.36 vs. 0.14 ± 0.31) nor periodic breathing densities (6.0 ± 8.56 vs. 10.2 ± 5.84) were different. Infants with BPD experienced significantly more central apnea (0.62 ± 0.34 vs. 0.16 ± 0.11; P = 0.003) than did non‐BPD prematures. Average oxygen saturation levels were significantly less among BPD vs. non‐BPD prematures (90.0 ± 10.18% vs. 95.7 ± 4.33%; P = 0.033). When supplemented with oxygen, BPD prematures had significantly higher saturation (X̄ = 94.5%) than when breathing room air (X̄ = 90.0%). Both central apnea and periodic breathing densities declined significantly with this improvement in saturation (0.64 vs. 0.04% and 6.0 vs. 1.4%, respectively). These data suggest that saturation status may indicate central respiratory stability in chronic lung disease. Pediatr Pulmonol 1991; 10:112–116.
Acute effect of passive smoking on lung function and airway responsiveness in asthmatic children
Authors: Oldigs Maike , Jörres Rudolf , Magnussen Helgo 
Published: March 2007

AbstractThe effect of a 1‐hour exposure at rest during passive cigarette smoking (20 ppm CO) or Sham was investigated in 11 children with bronchial asthma (age range, 8–13 yr; ten boys, one girl). Nine of the subjects were on regular therapy with inhaled β2‐agonists and disodium cromoglycate. Both drugs were withheld at least 6 hours prior to each study session. Exposure was performed in an environmental chamber. Before and immediately after exposure, lung function and symptom scores were determined. After exposure, a histamine inhalation challenge was performed to determine the concentrations that caused a 100% increase in SRaw (PC100SRaw) and a 20% fall in FEV1, (PC20FEV1). Mean (SD) SRaw before and after Sham was 8.7 (3.6) and 9.0 (3.2) cmH2O·s, and mean FEV1 (SD) was 1.97 (0.32) and 1.98 (0.40) L, respectively. Before and after cigarette smoking, mean SRaw (SD) was 10.4 (5.3) and 9.4 (3.3) cmH2O·s, and mean FEV1 (SD) was 1.95 (0.37) and 1.94 (0.35 L, respectively. Geometric mean (SD) PC100SRaw and PC20FEV1 after Sham was 1.39 (3.0) and 0.70 (2.7) mg/mL, and after passive smoking 1.65 (2.5) and 0.96 (2.3) mg/mL, respectively. There were no statistical differences in lung function and PC values between Sham and passive cigarette smoking. The main symptoms during passive smoking were irritation of the eye and the nasopharynx. Our observations suggest that in children with mild bronchial asthma 1 hour of passive cigarette smoking does not cause consistent changes of lung function and bronchial responsiveness. Pediatr Pulmonol 1991; 10:123–131.
Comparison of three methods for measuring respiratory mechanics in ventilated children
Authors: Seear Michael , Wensley David , Werner Heinrich 
Published: March 2007

AbstractContinuous measurements of airway pressure, gas flow, and tidal volume were made in 22 mechanically ventilated children, both during steady state conditions and following airway occlusion at end‐inflation. For each child, three methods of analyzing the stored data were used to generate values of respiratory system compliance and resistance: 1) end‐inspiratory hold technique (Bone: Respir Care 28:597, 1983; Rossi et al. Am Rev Respir Dis 131:672, 1985); 2) constant flow technique (Rossi et al. J Appl Physiol 58:1849, 1985; Suratt et al. J Appl Physiol 49:1116, 1980); and 3) multiple linear regression (Roy et al. Comput Biomed Res 7:21, 1974; Bhutani et al. Pediatr Pulmonol 4:150, 1988). In the absence of an accepted standard, we used the inspiratory hold technique as a reference. All methods gave comparable values for respiratory mechanics over a wide clinical range. However, multiple linear regression was the most convenient of the three: it can be automated and continuously displayed, there is no subjective input, values are taken throughout the respiratory cycle, and it is completely noninvasive. We also found that respiratory system resistance was largely a measure of endotracheal tube resistance and that respiratory compliance is a more sensitive monitor of lung function in intubated children. Pediatr Pulmonol 1991; 10:291–295.
Longitudinal changes in lung function during the first three years of premature infants with moderate to severe bronchopulmonary dysplasia
Authors: Mallory George B. , Chaney Hollis , Mutich Rebecca L. , Motoyama Etsuro K. 
Published: March 2007

AbstractBronchopulmonary dysplasia (BPD) is a chronic obstructive pulmonary disease of prematurely born infants following prolonged mechanical ventilation and oxygen therapy. Developmental changes in pulmonary function of children with BPD during their early years have been difficult to study. We longitudinally studied maximal expiratory flow‐volume curves by the forced deflation technique in 11 infants who had previous tracheostomy with moderate to severe BPD. Patients were classified into: those who were mechanically ventilated for less than 5 months (Group A), and those who were ventilated for 10 or more months (Group B). At 6 months of age, forced vital capacity (FVC) was 28.1 and 25.5 mL/kg in Group A and B, respectively, significantly less than normal (41.8 mL/kg). The maximum expiratory flow at 25% FVC (MEF25) at 6 months of age was 6.9 and 8.1 mL · kg−1 · s−1 in Group A and B, respectively, (predicted value, 39.2 mL · kg−1 · s−1). FVC reached the normal range by 12 months of age in Group A, but remained lower until 36 months of age in Group B. MEF25 gradually increased in Group A, reaching 18.0 mL · kg−1 · s−1 at 36 months of age, whereas in Group B it was severely decreased at the same age (3.5 mL · kg−1 · s−1). More than 75% of the patients had airway hyperreactivity at all ages. We have demonstrated that in patients with moderate to severe BPD, vital capacity is moderately decreased, but catches up to normal levels by 36 months of age. In contrast, severe lower airway obstruction persists in all infants, although in those with moderate BPD gradual improvement is seen. These findings suggest that in BPD neither obstruction of the smaller intrathoracic airways nor bronchial hyperreactivity resolves during the first 3 years of life.Pediatr Pulmonol. 1991; 11 :&14.
Bronchial hyperreactivity in children with Marfan syndrome
Authors: König Peter , Boxer Robert , Morrison John , Pletcher Beth 
Published: March 2007

AbstractMarfan syndrome is known to have pulmonary manifestations such as pneumothorax. There have been few previous studies of pulmonary function tests and none of bronchial hyperreactivity. Therefore, pulmonary function tests were performed in 11 children with Marfan syndrome and 11 normal children. Bronchial responsiveness was tested in ten of the Marfan patients by methacholine challenge test and response to bronchodilator. Because of disproportionate length of legs in Marfan patients, an “ideal” standing height was calculated from sitting height. Pulmonary function tests, as absolute values or as percent predicted based on “ideal” height, were not different in Marfan patients and normals, although a few individual patients had abnormal function (mostly airway obstruction and hyperinflation). Response to methacholine challenge was positive on forced expiratory volume in 1 second (FEV1), forced expiratory flow between 25 and 75% VC (FEF25–75%), and FEF50%, in 37.5%, 60%, and 70% of tests respectively. A significant response to bronchodilators was obtained in 40% of patients as measured by FEV1, in 90% by FEF25–75% and in 100% by FEF50%. Pulmonary function tests after bronchodilator were significantly higher when compared with values before the bronchodilator as well as with the baseline before methacholine. Therefore, most if not all patients with Marfan syndrome had hyperreactive airways in this relatively small group of patients. Even though only one patient had a diagnosis of asthma, six more had subtle symptoms. It is concluded that tests for bronchial hyperreactivity could be part of the routine investigation in Marfan syndrome. Further studies on larger numbers of patients are still needed. Pediatr Pulmonol. 1991;11 :29‐36
Effect of positive end‐expiratory pressure on respiratory compliance in children with acute respiratory failure
Authors: Sivan Yakov , Deakers Timothy W. , Newth Christopher J. L. 
Published: March 2007

AbstractWe studied the effect of positive end‐expiratory pressure (PEEP) on the compliance of the respiratory system (Crs) in 25 children (age, 3 weeks to 10 years) requiring mechanical ventilation. Functional residual capacity (FRC) measurements were performed at 2 cm H2O increments, from 0 to 18 cm H2O of PEEP, and the FRC values were regressed versus PEEP. Static Crs, Crs/kg, and specific compliance (Crs/FRC) were calculated for each PEEP level. When FRC normality was reached Crs/kg improved in 15/25 (60%) patients but decreased in 2/25 (8%). Overall, Crs/kg increased from a mean ± SE of 0.94 ± 0.09 to 1.35 ± 0.13 mL/cm H2O/kg (P = 0.003) and Crs/FRC from a mean ± SE of 0.067 ± 0.006 to 0.077 ± 0.007 mL/cm H2O/mL (P = 0.057).The maximum compliance (mean Max Crs/kg, 1.56 ± 0.12 mL/cm H2O/kg, and mean Max Crs/FRC, 0.089 ± 0.005 mL/cm H2O/mL) was significantly higher than the compliance at the clinically chosen PEEP level and the compliance at the PEEP that normalized FRC. Maximum compliance was achieved within 4 cm H2O of the PEEP that normalized FRC. In 14/25 (60%) of cases the PEEP at maximum compliance coincided with the PEEP that resulted in FRC normalization.We concluded that static respiratory compliance improves in most (but not all) children with acute respiratory failure when FRC is normalized. Static respiratory compliance reaches maximum levels at PEEP values that are close (but not equal) to those that result in FRC normalization. Thus, assessment of the effect of PEEP on compliance is required in individual patients.