Document Detail


Physiologic and clinical benefits of noninvasive ventilation in infants with Pierre Robin sequence.
MedLine Citation:
PMID:  20956415     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of the study was to determine the clinical and physiologic benefits of noninvasive respiratory support (NRS) (continuous positive airway pressure or noninvasive positive pressure ventilation) for infants with a Pierre Robin sequence (PRS).
METHODS: Breathing patterns, respiratory efforts, and gas exchange were analyzed for 7 infants with a PRS during spontaneous breathing and during NRS. Clinical outcomes with duration of NRS and need for a tracheotomy and/or nutritional support was evaluated.
RESULTS: Compared with spontaneous breathing, breathing patterns, respiratory efforts, and transcutaneous carbon dioxide pressures improved during NRS; the mean respiratory rate decreased from 55 ± 9 to 37 ± 7 breaths per minute (P = .063), the mean inspiratory time/total duty cycle decreased from 59 ± 9% to 40 ± 7% (P = .018), the mean esophageal pressure swing decreased from 29 ± 13 to 9 ± 4 cm H(2)O (P = .017), the diaphragmatic pressure-time product decreased from 844 ± 308 to 245 ± 126 cm H(2)O-second per minute (P = .018), and the mean transcutaneous carbon dioxide pressure during sleep decreased from 57 ± 7 to 31 ± 7 mm Hg (P = .043). All of the patients could be discharged successfully from the hospital with NRS. The mean duration of NRS was 16.7 ± 12.2 months. Six patients could be weaned from nutritional support, and none required a tracheotomy.
CONCLUSIONS: NRS is able to improve breathing patterns and respiratory outcomes for infants with severe upper airway obstruction attributable to a PRS, which supports its use as a first-line treatment.
Authors:
Nicolas Leboulanger; Arnaud Picard; Véronique Soupre; Guillaume Aubertin; Françoise Denoyelle; Eva Galliani; Gilles Roger; Eréa-Noël Garabedian; Brigitte Fauroux
Related Documents :
10499065 - Measuring in situ central airway resistance in patients with laryngotracheal stenosis.
9156965 - The non-invasive acetylene rebreathing method for estimation of cardiac output: influen...
8332995 - Central and peripheral cardio-respiratory effects of saxitoxin (stx) in urethane-anesth...
7999865 - Measurement of hydrostatic intraperitoneal pressure. altir nursing team.
2499195 - Pathophysiology of pressure changes during intrauterine transfusion.
16507195 - Comparison of haemodynamic responses to orotracheal intubation with glidescope videolar...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-10-18
Journal Detail:
Title:  Pediatrics     Volume:  126     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-02     Completed Date:  2010-11-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1056-63     Citation Subset:  AIM; IM    
Affiliation:
Pierre and Marie Curie University, Paris, France.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Airway Obstruction / physiopathology,  therapy*
Carbon Dioxide / blood
Continuous Positive Airway Pressure / instrumentation*
Enteral Nutrition
Female
Follow-Up Studies
Home Care Services
Humans
Infant
Infant, Newborn
Male
Oxygen / blood
Pierre Robin Syndrome / physiopathology,  therapy*
Positive-Pressure Respiration / instrumentation*
Pulmonary Gas Exchange / physiology
Respiratory Function Tests
Work of Breathing / physiology
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Vision of Pediatrics 2020: the AAP's role in maintaining focus and creating the future.
Next Document:  Vision of Pediatrics 2020: lessons learned from a Christmas Carol.