March 2011

Nominate a Fellow Section Member for Our Specialty Practitioner of the Year Award
Every year we honor one of our own with a Specialty Practitioner of the Year award at the AARC International Respiratory Congress. Since this year’s Congress will take place a month earlier than usual (it’s Nov. 5–8, in Tampa, FL), we need to begin gathering nominations for our 2011 award now. Take a few moments to brainstorm deserving candidates, then visit the section website to fill out our ONLINE NOMINATION FORM.

Sepsis Protocol Involving RTs Reduces Time to Treatment
A protocol aimed at improving the recognition and treatment of septic shock in children successfully reduced the time from triage to first bolus from a median of 56 minutes to a median of 22 minutes and the time from triage to first antibiotics from a median of 130 minutes to a median of 38 minutes. Baylor College of Medicine investigators implemented the protocol after root-cause analyses and morbidity and mortality conferences identified system problems with sepsis recognition and management. The protocol includes a computerized triage system that alarms on abnormal vital signs and required recruitment of additional nursing, respiratory therapy, and pharmacy personnel to monitor and treat the children in a special resuscitation room. The study compared 191 encounters in 167 patients with suspected sepsis who were treated after implementation of the protocol to data on children with suspected sepsis who were treated before the protocol was put into place. The authors published their findings in this month’s Pediatrics. READ ABSTRACT

Oxygen Sats Similar in Sleeping, Waking Infants with CNLD
British researchers question the common practice of withdrawing supplemental oxygen from infants with chronic neonatal lung disease (CNLD) during the day but maintaining it at night due to concerns that oxygen saturation is lower at night. Noting that the strategy did not correspond to their clinical observations, they decided to measure oxygen saturation in 13 infants while they were awake and asleep during the day. Due to a markedly low SpO2 in one infant, final data were reported for 12 infants. The mean SpO2 was 97.6% during sleep and 97.0% when the infants were awake. The authors conclude, “There is no physiological justification for increasing oxygen during sleep, or withdrawing selectively during the daytime, although larger studies are needed to confirm this finding.” The study was published ahead of print by Acta Paediatrica on Mar. 1. READ ABSTRACT

Evidence of PH Predicts Death in BPD Patients on PPV
A new study out of Cincinnati Children’s Hospital Medical Center links pulmonary hypertension (PH) with risk of death in infants with bronchopulmonary dysplasia (BPD) requiring prolonged positive pressure ventilation (PPV). The research was conducted among 216 patients with BPD requiring prolonged PPV who were identified from a pool of 1156 extremely low birth weight infants. Among the 41% who received echocardiography after four weeks of life, evidence of PH was seen in 37%. These infants were four times more likely to die than infants without evidence of PH on echocardiography. The study was published ahead of print by the Journal of Perinatology on Feb. 10. READ ABSTRACT

TRACK Excels at Tracking Asthma in Kids
California researchers add to the evidence that the 5-item, caregiver-completed Test for Respiratory and Asthma Control in Kids (TRACK) is a valid and reliable method for gauging changes in respiratory control status among preschool children with asthma symptoms. Noting that TRACK had been previously tested mainly in asthma specialist practices, these investigators measured its ability to track changes among children being treated by pediatricians. The study involved 438 children whose caregivers completed TRACK at two clinic visits about four to six weeks apart. Results showed mean changes in TRACK scores differed according to asthma control, with lower scores seen in children classified as very poorly controlled, in those who required a step-up in therapy, and in those with four or more episodes of wheezing, coughing, or shortness of breath per week over the past three months. The study appears in this month’s Pediatrics. READ ABSTRACT