Respiratory failure and mechanical ventilation in severe bronchiolitis

Article Abstract:

For 20 years, mechanical ventilation (use of a respirator) has been an effective, safe and well tolerated method for treating viral bronchiolitis (inflammation of the small airways) in infants. Little attention has been given to factors affecting the need for ventilation among infants with bronchiolitis. Therefore, a retrospective analysis of infants with severe bronchiolitis who needed mechanical ventilation between January 1976 and December 1985 was performed to correlate age, weight and prematurity with the need for ventilation. In addition, comparisons were made with children hospitalized for bronchiolitis who did not require a respirator. The study included 62 infants ranging in age from 14 to 201 days (average 73 days), who did not have congenital heart or lung problems and never had bronchiolitis previously, and had bronchiolitis that required the use of respirator. For comparison, a group of 150 infants ranging in age from 16 to 988 days (average 166 days) was also included. The 62 cases were significantly younger and lighter (average weight of 4.5 vs 6.8 kg). In addition, 40 percent of the ventilated group were premature as compared with 16 percent of the control group. The average ventilation time was 105 hours; infants with a lower gestational age were ventilated for longer periods than other infants. Mechanical ventilation is useful for helping infants with severe bronchiolitis, and factors that indicate the need for ventilation in these cases are age, prematurity and, most importantly, weight. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Artificial respiration, Mechanical ventilation, Bronchiolitis

---

Is routine endotracheal suction justified?

Article Abstract:

The suction of fluids from the trachea helps to prevent blockage of the airways. This procedure can be performed in babies by inserting a catheter (a tube-like device) into the trachea. However, endotracheal suction has various complications, including atelectasis, the collapse of the lungs; bradycardia, or a slow heart rate; decreased lung compliance, or the force required to distend the lungs; hypoxia, or abnormally low blood oxygen; transient increases in blood pressure and blood flow; infection of the blood; and pneumothorax, the collection of gas or air in the lung cavity. Some of these complications may be particularly dangerous in the newborn. Hence, the advisability of endotracheal suction is not always certain. Some infants are given oxygen, physiological salt solutions, or chest physiotherapy before endotracheal suction. Endotracheal suction may be necessary when the inhaled gas is poorly humidified, or has an inadequate moisture content. Poorly humidified air can prevent the clearance of particles from the respiratory tract and can thicken secretion from the trachea and lower airways. A suitable study of endotracheal suction in newborns should focus on whether endotracheal suction and physiotherapy should be routine procedures or used only when there is some indication that the airway is obstructed. The development of pneumothorax; duration of treatment with oxygen and artificial breathing; length of hospital stay; and abnormalities in imaging tests; could be used as measures of outcome. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Complications and side effects, Respiratory therapy, Trachea, editorial, Suction (Medical care), Suction, Trachea intubation

---

High dose pancreatic enzymes in cystic fibrosis

Article Abstract:

A significant number of patients with cystic fibrosis (CF) require supplemental pancreatin (pancreatic enzyme) to aid in fat absorption. The dosage can vary from patient to patient and it is frequently determined by the attending physician to treat each case symptomatically. However, this approach to dosage regulation may result in excess pancreatin supplementation. Seven patients with cystic fibrosis who were taking large doses of pancreatin had persistent abdominal symptoms such as pain, failure to gain weight, or offensive bulky stools. All participants had fat malabsorption, which improved with enzyme supplements. The primary patient concerns were the possibility of abdominal pain and offensive stools that accompanied the reduction of enzyme intake from an average of 45 capsules to 21 capsules a day. Five patients with CF took excessive amounts of pancreatin. Reduction in their intake did not result in deterioration of fat absorption. The other two participants, however, experienced increased malabsorption on the reduced enzyme regimen. This study points out the need for careful the evaluation of each patient's biological needs and physiological responses before scheduling medication regimens. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Physiological aspects, Cystic fibrosis, Intestinal absorption, Cystic fibrosis in children, Digestive enzymes, Pancreatin

Similar abstracts:

• Abstracts: Hepatocellular carcinoma in childhood: clinical manifestations and prognosis. Maternal transmission of hepatitis B virus in childhood hepatocellular carcinoma
• Abstracts: Validity of reported pain as a measure of clinical state in juvenile rheumatoid arthritis. Conspicuous synovial lymphatic capillaries in juvenile idiopathic arthritis synovitis with rice bodies
• Abstracts: Delays in the treatment of acute myocardial infarction: an overview. Effects of relaxation and music therapy on patients in a coronary care unit with presumptive acute myocardial infarction
• Abstracts: Helicobacter pylori and gastric carcinoma: serum antibody prevalence in populations with contrasting cancer risks
• Abstracts: Gastro-oesophageal reflux and the lung. Gastro-oesophageal reflux and respiratory function in infants with respiratory symptoms

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.