May 2012

Section Bulletin Online Now

The Spring edition of our Section Bulletin is ONLINE NOW, so click over to read two informative articles, one on implementing a new ventilator technology and the other on a rare congenital malformation in newborns that effects the respiratory system. Section Chair Cyndi White also brings us up-to-date on section activities in her “Notes” column.

Share Your Research at the 2012 Open Forum

The Open Forum at AARC Congress 2012 presents the perfect opportunity to share clinical research related to neonatal-pediatric respiratory care. If you have a study you’d like to get out to the RT community, consider SUBMITTING AN ABSTRACT by June 1.

Clinical Scoring Systems Go Head to Head

Austrian investigators compared the ability of the Pediatric Risk of Mortality III score, the Organ System Failure score, and the Acute Physiologic Score for Children to assess the severity of bronchiolitis within 24 hours of admission to a PICU, with a particular emphasis on the differences between RSV-positive and RSV-negative infants. Data for the study was collected over an 18 year period. Results showed:

• All three of the scoring systems differed significantly between RSV-positive and RSV-negative cases.
• All scores were significantly higher in the subgroup of patients with mechanical ventilation.
• The mean time of ventilation was significantly higher in the RSV-positive group compared to the RSV-negative group, 6.39 days vs. 2.4 days.
• Infants suffering from RSV-positive bronchiolitis had higher clinical scores corresponding with the severity of bronchiolitis.

The study was published ahead of print by the European Journal of Clinical Microbiology & Infectious Diseases on April 21. READ ABSTRACT

ART Doesn’t Worsen Neonatal Outcomes

Assisted reproductive technologies (ART) don’t appear to worsen neonatal outcomes for infants who are born preterm. That’s the take home message from French investigators who analyzed prospective data on 612 preterm infants, 81 of whom were conceived using ART. Twin pregnancy was significantly higher in the ART group, 69.1% vs. 15.9%, and inborn delivery was also more frequent, 98.8% vs. 90.0%. ART infants also had higher mean gestational ages (29 weeks vs. 28 weeks) and birth weights (1100 grams vs. 1020 grams). Significantly more ART infants survived without severe morbidity, 76.5% vs. 55.2%, with the difference mainly seen in infants born at or before 28 weeks. The authors attribute the differences in morbidity-free survival for the ART infants to pregnancy and neonatal characteristics. The study was published ahead of print by Acta Paediatrica on April 20. READ ABSTRACT

Inhaled Corticosteroids and BPD: More Study Needed

Dutch researchers who conducted a meta-analysis of the literature on the use of inhaled corticosteroids started ≥ 7 days postnatal age but before 36 weeks postmenstrual age in preterm infants considered at risk for bronchopulmonary dysplasia (BPD) conclude the therapy cannot be recommended at this time. Their review included eight trials that randomized 232 ventilated and non-ventilated infants to either inhaled corticosteroids or placebo. Inhaled corticosteroids did not reduce the risk of death or BPD, nor did they have any effect on short term outcomes such as failure to extubate, total duration of mechanical ventilation, or oxygen dependency. The authors note, however, that the total number of randomized patients in their analysis was small and call for further study to establish the efficacy and safety of inhaled corticosteroids in this population. The research appeared in the April 12 edition of the Cochrane Database of Systematic Reviews. READ ABSTRACT

Ventilatory Control in Infants at Risk for SDB: Strategy Matters

Australian researchers find sleep disordered breathing (SDB) in infancy may be associated with an altered ventilatory response to hypoxia. Their study was conducted among 22 infants with cleft lip and/or cleft palate who underwent ventilatory response testing at about 4.4 months of age. These infants were selected for the study due to their higher risk for SDB. Infants with a high apnea-hyponea index (AHI) demonstrated an earlier ventilatory decline and blunted maximal ventilatory response to hypoxia. The investigators attributed these findings to the fact that high AHI infants used a different strategy to augment ventilation in response to hypoxia than low AHI infants. Specifically, low AHI infants initially increased their respiratory rate in response to hypoxia, while in high AHI infants, tidal volume was the first thing to increase. The study was published ahead of print in Pediatric Pulmonology on April 23. READ ABSTRACT