July 2007

Section Input Drives AARC Congress
The 2007 AARC International Respiratory Congress may still be several months away – this December 1-4 in Orlando, FL – but it’s not too soon to begin making plans to attend. And as a Specialty Section member, you have even more reason to register for the meeting, because much of what you’ll see on the Final Program will have come directly from your peers. Every year the sections recommend topics for the Congress, and most end up on the agenda, in the form of lectures and symposia geared directly to your special interests and concerns. LEARN MORE

ED Common Route into Hospital for Kids with Respiratory Problems
A new report from the federal Agency for Healthcare Research and Quality illustrates why the respiratory therapist should be a key provider in the emergency department: asthma was the top reason for pediatric hospital admissions through the ED in 2004, accounting for 95,400 admissions. Overall, about a third of all the children admitted through the ED were suffering from asthma, pneumonia, acute bronchitis, or another respiratory disease. READ REPORT

VLBW Survival Better at High Level, High Volume NICUs
High level, high volume NICUs are the best places for very low birth weight (VLBW) infants, report researchers who looked at birth records and death certificates for 48,000 VLBW infants born in California between 1991 and 2000. Their analysis showed these infants are significantly more likely to die when cared for in lower level NICUs that see fewer than 100 such patients each year. "Previous studies have established a link between high volume and high quality among NICUs, and this study offers further evidence of that relationship," says Carolyn M. Clancy, MD, director of the Agency for Healthcare Research and Quality, which helped to fund the study. "It is becoming increasingly clear that some very low birth weight infants are not getting the care they need, and that we need to make sure that patients and clinicians know how important high-quality NICU care is." READ PRESS RELEASE

NI-PSV Outperforms NCPAP in VLBW Infants
Noninvasive pressure support ventilation (NI-PSV) may be better than nasal continuous positive airway pressure (NCPAP) in very low birth weight (VLBW) infants. That’s the key finding from University of Miami researchers who compared results among 15 stable, preterm infants with a birth weight of less than 1250 grams who received two hour periods of NCPAP and NI-PSV in random order. Results showed no differences in VT, V(E), PCO2 or hypoxemia episodes, but peak and minute inspiratory effort were significantly reduced in the NI-PSV mode, and there was a significant reduction in indices of chest wall asynchrony as well. The authors conclude, “When compared to NCPAP, NI-PSV did not increase minute ventilation, but it effectively unloaded the patient's respiratory pump as indicated by a lower inspiratory effort and reduced chest wall distortion.” The study appeared in the June 26 Epub edition of Pediatric Pulmonology. READ ABSTRACT

Strategy to Avoid Hyperoxia Benefits Females More Than Males
Female infants may benefit more from a change in target SpO2 to avoid hyperoxia than males. Researchers arrived at that conclusion after comparing outcomes for very low birth weight (VLBW) infants treated in two perinatal centers during period one, which SpO2 high alarms were set at 100% and low alarms at 92%, and period two, when a change was initiated to avoid hyperoxia with target SpO2 at 85-93%. Gender analysis showed female infants had significantly better outcomes for retinopathy of prematurity, bronchopulmonary dysplasia, and length of stay in period two. No increase in short-term neurological morbidity in response to the lower SpO2 targets was noted in either gender. “There is a significant gender-specific difference favouring females in the beneficial effects produced by avoiding high SpO2 and hyperoxia, with no difference in the distribution of any potential short-term detrimental effects,” write the authors. The study appears in this month’s Acta Paediatrica. READ ABSTRACT