October 2008

AARC Congress is the Place to be for Neonatal-Pediatrics
Neonatal-pediatric RTs will have plenty to choose from at this year’s AARC Congress, coming up December 13–16 in Anaheim, CA. Here are just a few of the topics devoted especially to our area of expertise—

• Pediatric Acute Lung Injury: Beyond Routine Pediatric Conventional Ventilation
• Sedation Management for Mechanically Ventilated Infants and Children
• National Asthma Education and Prevention Program (NAEPP) 2007: Differences from Prior Versions
• You’ve Come A Long Way Baby! 40 Years of NICU Respiratory Care
• Difficult Airway Management in Neonatal and Pediatrics Population: A Case-Based Approach

Check out the ADVANCE PROGRAM to learn more about the meeting, and if you plan to attend, don’t forget to make time for our section business meeting, 11:35 a.m.–12:05 p.m., Monday, December 15.

Unexpected Hospitalization from a 23-Hour Observation Unit
Are the patients you care for in a 23-hour observation unit (OU) more likely to end up in the hospital than others? According to a new study out of the Children’s Hospital of Philadelphia, the answer may be yes. The research involved a review of 4453 patients who were admitted to the hospital’s 23-hour OU. The unexpected hospitalization rate was 20.3%, with the analysis linking unexpected hospitalization to utilization of subgroup resources such as cardiorespiratory monitoring, use of a respiratory therapist, and supplemental oxygen. Diagnostic categories associated with an unexpected hospitalization included asthma, adenitis, cellulites, bronchiolitis, and esophageal foreign body ingestions. The report appeared in the September issue of Pediatric Emergency Care. READ ABSTRACT

Inhaled Hypertonic Saline May be Warranted for Young Kids with CF Too
Studies show inhaled hypertonic saline (HS) benefits older patients with cystic fibrosis, but little is known about the effect of the therapy in preschool children and infants. Researchers from the University of North Carolina tested 3% and 7% HS protocols in children age four to seven who were able to perform spirometry and those age four months to three years using the raised volume rapid thoracoabdominal compression technique, finding the therapy was generally safe and well-tolerated. “Given the demonstrated benefits in older patients, a therapeutic trial in this age group is warranted,” write the authors. The study was published in the September 30 Epub edition of Pediatric Pulmonology. READ ABSTRACT

Spirometry Success Rises with Age
Mayo Clinic investigators who looked at the influence of age on the ability of children to meet updated spirometry criteria for acceptable and repeatable tests issued by the American Thoracic Society/European Respiratory Society, find most children are able to perform spirometry successfully on the first attempt. The study involved 393 tests conducted in children ages 4 to 17; 74% met ATS/ERS criteria. The percentage of acceptable and repeatable tests rose to more than 50% at age 6 and plateaued at about 85% at age 10. Among preschool children, the most common unmet criteria resulting in an unacceptable study was glottic closure and non-maximal efforts. In school-age children, the most common unmet criteria was failure to plateau. The research appeared in the September 10 Epub edition of Pediatric Pulmonology. READ ABSTRACT

Finding the Right Balance
Postnatal corticosteroids are a double-edged sword: they both protect preterm infants from developing chronic lung disease (CLD) and raise the risk of impaired neurodevelopment. Australian researchers who looked at CLD and cerebral palsy rates in infants treated before and after the use of dexamethasone was reduced in their facility and doses were lowered find no difference in CLD rates in the two time periods. However, cerebral palsy rates dropped from 10.4% to 6.6%. The investigators conclude, “Decreased postnatal corticosteroid use had no impact on the incidence of CLD or need for home oxygen therapy. The trend towards a reduced rate of cerebral palsy requires further investigation.” The study was published in the September 6 Epub edition of Neonatology. READ ABSTRACT