April 2012
Register for AARC Congress 2012 Now and Save
Earlybird registration is underway now for AARC
CONGRESS 2012, Nov. 10–13 in New Orleans,
LA, through April 30. Don’t miss this great
opportunity to learn the latest in respiratory care
in a city that’s proud to show off its remarkable
recovery from Hurricane Katrina in 2005. The neonatal-pediatric
offerings at the meeting promise to deliver the
state of the art information you need to stay on
the cutting edge of your practice.
Neonatal Lung Function May Predict Asthma at Age Seven
A new study out of Denmark finds children who develop asthma by age seven may have evidence of lung function problems in infancy. The study was conducted among a birth cohort of 411 at-risk children of asthmatic mothers. Ninety-eight percent of the children underwent spirometry at one month of age. Spirometry was repeated in 77% of these children at age seven. Among the 14% of children who developed asthma by age seven, significant neonatal airflow deficits, as measured by forced expiratory flow at 50% of vital capacity and forced expiratory volume after 0.5 seconds, were observed. Bronchial responsiveness to methacholine was also significantly associated with the development of asthma. Neonatal airway reactivity was a stronger predictor of asthma than neonatal lung function. The study was published online ahead of print by the American Journal of Respiratory and Critical Care Medicine in March. READ PRESS RELEASE
Cardiorespiratory Interaction May Measure Infant Maturity
University of Virginia researchers have developed a new analytical method to help determine when premature infants are ready to be discharged from the NICU. The method looks for the interaction between breaths and heartbeats, dubbed “cardiorespiratory interaction,” using individual breaths and heartbeats and relating the two in time. Electrocardiogram waveforms and chest impedance signals were collected from the bedside monitors of 1202 infants born either with very low birth weights or normal birth weights. The two measures were then paired in sliding four minute windows, using software to determine whether patterns in breathing correlated with patterns in heartbeats. Overall, 34,600 breathing and heartbeat records were gathered, corresponding to an average of 13 days of data for each infant. Findings revealed that cardiorespiratory interaction steadily increased with each infant’s postnatal age, but surprisingly, no correlation was seen between cardiorespiratory interaction and either birth weight or gestational age at birth, two measures normally used to determine infant maturity. The study was published in the March issue of the Journal of Applied Physiology. READ PRESS RELEASE
Permissive Hypercapnia Improves Outcomes for Infants with CDH
Another study out of the University of Virginia looked at outcomes of 91 infants treated for congenital diaphragmatic hernia in the extracorporeal membrane oxygenation (ECMO) era, 42 (Group 1) treated before and 49 (Group 2) treated after implementation of permissive hypercapnia. Results showed:
- Survival was higher in Group 2, 85.8% vs. 54.8%.
- Morbidity was lower in Group 2 and approached statistical significance, 65.3% vs. 83.3%.
- Patients in Group 2 were repaired later, had a lower rate of ECMO use, and were extubated earlier.
- No difference was seen in hospital stay.
The authors conclude, “Permissive hypercapnia remains the standard of care for ventilation of infants with CDH at our institution.” The study was published ahead of print by the Journal of the American College of Surgery on Feb. 28. READ ABSTRACT
RSV Vaccine Under Development
Investigators from the University of Saskatchewan are developing a needle-free vaccine for respiratory syncytial virus (RSV). The vaccine, which is delivered through the nose to avoid maternal antibodies acquired during pregnancy and breastfeeding, includes a protein from the surface of RSV that acts as a molecular “lock pick” to allow the virus to gain entry into the cell and establish an infection. In order to get the vaccine past the normal defenses of the respiratory system, the investigators have combined it with other ingredients that help activate the immune system and allow the vaccine to persist long enough to trigger an immune response. So far it has been tested in mice and cotton rats, and the researchers recently received a $740,000 grant from the Canadian Institutes of Health Research to further their studies. READ PRESS RELEASE
