January 2013
Join. Renew. Win.
The AARC has launched a new membership drive for 2013, so CLICK OVER NOW to see what it’s all about and then share the link with your colleagues who are not yet members of the Association. They’ll be eligible for some great prizes if they join–and you will be too when you renew your membership in your professional organization. There’s a little friendly competition going on between the states to see who can grow by the most members and largest percentage of members from now through Oct. 31 too.
Experienced RT Can Achieve Stable Pulse Oximetry within 120 Seconds of Life
A new study out of the University of San Diego Medical Center finds an experienced respiratory therapist is capable of applying a pulse oximeter and achieving reliable SpO2 values within the first 120 seconds of life, as recommended by current Neonatal Resuscitation Program guidelines. Researchers arrived at that conclusion after conducting a retrospective review of data on the resuscitation of 50 very low birth weight infants at their hospital. The resuscitation team consisted of a physician, nurse, and RT, with the RT taking responsibility for applying the pulse oximeter on the right hand or wrist of the infant immediately following birth. The time at which a reliable pulse oximetry signal was obtained was determined from the analog tracing from a data acquisition system. Mean time to achieve a reliable pulse oximetry was 79±42 seconds, median time was 67 seconds, and 86% of the infants had a reliable SpO2 value before 120 seconds of life. The study was published ahead of print in Resuscitation on Dec. 10. READ ABSTRACT
NCPAP Does Not Raise Risk for Hearing Loss When Compared to Mechanical Ventilation
Preterm infants are at higher risk for hearing loss and that risk can be increased by exposure to environmental noise from life support equipment. Researchers from Maimonides Medical Center in Brooklyn decided to find out whether treatment with the relatively noisier NCPAP leads to greater hearing loss than treatment with mechanical ventilation. They looked at 344 neonates, 61 of whom failed a hearing screen. Failure of the hearing screen was associated with gestational age, birth weight, ventilation, intrauterine growth retardation, necrotizing enterocolitis (NEC), apnea, and use of vancomycin and furosemide. Ventilation, apnea, and NEC were predictors of a failed hearing screen on multivariate analysis, but no difference was seen between treatment with NCPAP and mechanical ventilation. Forty-two of the infants who failed the hearing screen were reevaluated at age two, and 19 had confirmed hearing loss. Again, no differences were noted between infants who received NCPAP and those who received mechanical ventilation. The authors conclude, “There is no increase in the hearing loss in preterm neonates treated with NCPAP as compared to mechanical ventilation despite being exposed to higher environmental noise generated by the NCPAP.” The study was published ahead of print by the International Journal of Pediatric Otorhinolaryngology on Dec. 27. READ ABSTRACT
PRAM Adds Value to Spirometry Assessment for Asthma in the ED
The Pediatric Respiratory Assessment Measure (PRAM) score adds important information to spirometry measures during treatment for an acute exacerbation of asthma in the emergency department, report researchers from Vanderbilt University Medical Center. They conducted a prospective study of 503 children age 5-17 who came to the ED with asthma exacerbations. Percent predicted FEV1 and PRAM were recorded during pretreatment and then again at two and four hours. While a significant mean change was only seen for %FEV1 after the first two hours of treatment, significant and meaningful changes in PRAM scores were still apparent at four hours. The authors conclude that “spirometry and clinical severity scores do not have similar trajectories and that clinical severity scores may be more sensitive to clinical change of acute asthma severity than spirometry.” The study was published ahead of print by the Journal of Asthma on Dec. 21. READ ABSTRACT
Impaired Immune Response Linked to More Severe RSV
Researchers have long believed that children who develop severe cases of respiratory syncytial virus (RSV) have higher concentrations of innate immunity cytokines. A new study from investigators at Nationwide Children’s Hospital finds the opposite is true. They evaluated 66 previously healthy children under age two who were hospitalized with a first episode of RSV bronchiolitis during the 2010-2011 respiratory season. Nasal wash and blood samples were obtained from each patient within 24 hours of admission to confirm RSV infection and measure cytokine concentrations before and after LPS stimulation. The RSV patients were compared to healthy infants and those with less severe RSV bronchiolitis who were also hospitalized in the infectious diseases unit. A significantly lower production capacity of innate cytokines was seen in the severe RSV group compared with healthy controls and infants with less severe RSV. The authors aren’t sure whether children who develop more severe RSV are born with an impaired immune system or not, but they believe these findings clearly show a link between an inadequate functional innate immune response and severity of RSV. The study was published in a recent issue of the Journal of Infectious Diseases. READ PRESS RELEASE
