September 2012
OPEN FORUM 2012: Cutting Edge Content for Neonatal-Pediatric RTs
AARC Congress 2012 is coming up Nov. 10–13 in New Orleans, and in addition to great lectures and symposiums, we’ll have 20 Open Forums with original research conducted by your peers. So take a few moments to see what’s on tap for RTs working in the neonatal-pediatric arena and then register today. It’s the best investment you can make in your career this year—and it’s a great investment for your organization too, because attendees are sure to come home with lots of great ideas to improve the care they deliver to their young patients. READ MORE
As you scroll through the Program don’t forget to check out our two great PRE-COURSES. The first addresses patient safety and the second is focused on mechanical ventilation.
Barrier Precautions during Pediatric Resuscitations: Room for Improvement
A new study out of Children’s National Medical Center is shedding some light on the use of barrier precautions during pediatric trauma resuscitations. The researchers videotaped resuscitations involving 1138 trauma team members caring for 128 patients, including physicians, nurses, and respiratory therapists. Results showed an overall compliance with barrier precautions of 81.3%, with higher compliance seen among team members who were primarily stationed at the bedside (90.7% vs. 65.1%). Compliance increased during resuscitations involving penetrating injuries and among patients triaged to the highest activation level. Compliance was also higher among team members who were present before the patient arrived in the facility. The authors call for interventions to better integrate barrier precautions into the workflow of team members taking part in pediatric trauma resuscitations. The study was published ahead of print in Resuscitation on July 24. READ ABSTRACT
Predicting CPAP/Intubation in Kids with Bronchiolitis
A 16-center, prospective cohort study of children under age two who were hospitalized with bronchiolitis over a three year period uncovered several factors that predict the use of CPAP and/or intubation in these patients. Researchers collected clinical data and a nasopharyngeal aspirate from all of the participants; 161 were treated with CPAP and/or intubation. Results linked age <2 months, maternal smoking during pregnancy, birth weight <5 pounds, breathing difficulty that began <1 day prior to admission, presence of apnea, inadequate oral intake, severe retractions, and room air oxygen saturation <85% with a greater need for CPAP/intubation. The study was led by investigators from Children’s Hospital Boston and Harvard Medical School and published ahead of print by Pediatrics on Aug. 7. READ ABSTRACT
Gauging the Pulmonary Effects of HFNC
Researchers from the Children’s Hospital of Philadelphia clarify the pulmonary effects of high flow nasal cannulas (HFNC) on infants in an vitro study that involved the measurement of proximal airway pressures from a HFNC system while varying both the cannula flow and the ratio of nasal prong to simulated nares diameters. Results showed:
- Airway pressure progressively increased with both increasing HFNC flow rate and nasal prong-to-nares ratio.
- At 6 L/min HFNC flow with mouth open, airway pressures remained <1.7 cm H2O for all ratios; they were <10 cm H2O with mouth closed, for ratios <0.9.
- For ratios >0.9 and 50% mouth leak, airway pressures rapidly increased to 18 cm H2O at 2 L/min HFNC flow, followed by a pressure relief valve limited increase to 24 cm H2O at 6 L/min.
The authors conclude, “Safe and effective use of HFNC requires careful selection of an appropriate nasal prong-to-nares ratio even with an integrated pressure relief valve.” The study was published ahead of print by Pediatric Pulmonology on July 23. READ ABSTRACT
Gene Variations Linked to Worse Outcomes for African-American Kids with CAP
Genetic variations in the cystic fibrosis transmembrane conductance regulator may be responsible for more severe community-acquired pneumonia (CAP) in African-American children. That’s the take home message from Medical College of Wisconsin researchers who conducted a prospective cohort genetic association study of lung injury in 304 Caucasian and 474 African-American children diagnosed with CAP. Among the group, 42 Caucasian children required mechanical ventilation and 32 developed acute lung injury (ALI). In the African-American group, 43 required mechanical ventilation and 29 developed ALI. High-risk (TG)mTn alleles known to result in decreased levels of functional cystic fibrosis transmembrane conductance regulator were associated with the need for mechanical ventilation and development of ALI in the African-American children. The study was published ahead of print in Critical Care Medicine on Aug. 10. READ ABSTRACT
