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August 2009
- The Summer issue of our SECTION
BULLETIN is online now, with a very timely article on
H1N1 in the pediatric setting, plus a look at congenital heart defects
and how early identification can save lives.
- The 2009 nominations deadline for our
Specialty Practitioner of the Year award is rapidly approaching — August
31 — so please take a few moments to brainstorm deserving members, then
nominate them via our ONLINE
FORM .
- Keep a watch. The advance program for
the AARC INTERNATIONAL
RESPIRATORY CONGRESS will be online soon, but you can register
right now for best rates. Plenty of good programming in the area of
care for infants and children will be offered. Save the date -- San
Antonio, Dec. 5-8.
Evaluating Bronchiolitis: Can Physicians,
RTs, and Nurses Agree?
According to a new study in
this month's Pediatric Pulmonology, physicians, respiratory therapists,
and nurses showed a high level of inter-observer agreement on a tool aimed
at the clinical evaluation of children hospitalized for a first episode
of bronchiolitis. The respiratory evaluation included the respiratory
rate, retraction signs, and wheezing. If these results are duplicated
in a larger study, the investigators believe the test could be used to
“monitor children hospitalized with bronchiolitis and as an endpoint in
clinical trials.” READ
ABSTRACT
Scandinavian Approach Lowers Risk
for BPD
Danish researchers report
on the Scandinavian approach for the treatment of respiratory distress
syndrome and prevention of bronchopulmonary dysplasia (BPD) in the July
1 Epub edition of Acta Paediatrica, noting the strategy relies on early
treatment with nCPAP and surfactant therapy, with caffeine citrate and
noninvasive positive pressure ventilation for apnea added when needed.
According to the authors, the strategy has resulted in a low incidence
of BPD, with the main effect attributed to a reduced need for mechanical
ventilation in the first few days of life. READ
ABSTRACT
NIV Improves Outcomes for Extubated
Infants Developing Respiratory Failure
A new study out of Switzerland
suggests noninvasive pressure support ventilation (NIV) can benefit infants
who show signs of developing respiratory failure following extubation.
Comparing a period of spontaneous breathing with a period of NIV in each
child, the investigators found:
- The dyspnea score was reduced by 44% with
NIV.
- The respiratory rate was reduced by 32%
- The esophageal inspiratory pressure swing
was reduced by 45%.
- The esophageal pressure-time product was
reduced by 57%.
- A non-significant trend for decrease in
PaCO2 was observed.
The authors conclude, “NIV can be used with
some benefits in infants with respiratory failure after extubation.” The
research was published in the June 17 Epub edition of Intensive Care Medicine.
READ
ABSTRACT
Rolling Refreshers Improve CPR Among
Physicians, Nurses, and RTs
Ensuring CPR competency is
a challenge, but researchers from the Children's Hospital of Philadelphia
have developed a novel approach to training that might help other hospitals
as well. Their “Rolling Refreshers” strategy is based on a portable manikin/defibrillator
system with chest compression sensor providing automated corrective feedback
to optimize CPR skills. The portable system is available on a daily basis
in the PICU for physicians, nurses, and respiratory therapists. A study
on the system compared skill success among frequent users of the system
(defined as two refresher sessions per month or more) with that of infrequent
users (defined as fewer than two refresher sessions per month). Time to
achieve CPR skill success was significantly shorter in the frequent users
group. On a questionnaire administered following real resuscitations,
clinicians gave the Rolling Refresher training good marks for effectiveness.
The investigators published their findings in the May 19 Epub edition
of Resuscitation. READ
ABSTRACT
Computerized Survey Can Identify
Undiagnosed, Uncontrolled Asthma
Could a computerized health
risk assessment (HRA) help identify undiagnosed and uncontrolled asthma
in children? Yes, report California researchers publishing in the June
issue of the Journal of Asthma. They installed the system in an urban
pediatric hospital-based outpatient teaching clinic, asking parents of
children age two and older to take the survey on the touch screen before
seeing their physician. The survey predicted probable asthma in 26% of
the group, with 51% classified as controlled asthma with parental reporting
of a previous diagnosis and 14% controlled asthma without parental reporting
of a previous diagnosis. Twenty-five percent of the group with probable
asthma was deemed uncontrolled with parental reporting of a previous diagnosis
and 10% uncontrolled without parental reporting of a previous diagnosis.
The authors conclude, “A previously validated HRA system can consistently
identify a high rate of undiagnosed and poorly controlled asthma in an
urban pediatric hospital-based teaching clinic. The utility of such a
system would be to reduce missed opportunities for delivery of care and
morbidity for the patients who currently have undiagnosed and/or uncontrolled
asthma in the pediatric primary care outpatient setting.” READ
ABSTRACT
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