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Drug delivery interfaces:A way to optimize inhalation therapy in spontaneously breathing children

World Journal of Clinical Pediatrics 2016年第3期5卷 281-287页

作者： Arzu Ari Department of Respiratory Therapy Georgia State University

There are several different types of drug delivery interfaces available on the *** the right interface for aerosol drug delivery to children is essential for effective inhalation ***,clinicians usually focus on selecting the right drug-device combination and often overlook the importance of interface selection that lead to suboptimal drug delivery and therapeutic response in neonates and ***,it is necessary to critically assess each interface and understand its advantage and disadvantages in aerosol drug delivery to this patient *** purpose of this paper is to provide a critical assessment of drug delivery interfaces used for the treatment of children with pulmonary diseases by emphasizing advantages and problems associated with their use during inhalation therapy.

关键词： Aerosols Inhalation therapy Children Masks Mouthpiece High flow nasal cannula Blow-by Hood Spacer/valved holding chamber

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Clinical characteristics and outcomes associated with nasal intermittent mandatory ventilation in acute pediatric respiratory failure

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World Journal of Critical Care Medicine 2018年第4期7卷 46-51页

作者： Billy C Wang Theodore Pei Cheryl B Lin Rong Guo David Elashoff James A Lin Carol Pineda Department of Pediatrics Division of Critical Care MedicineLoma Linda University Children’s Hospital Department of Pediatrics Division of Pediatric Critical CareFloating Hospital for Children at Tufts Department of Medicine Biostatistics CoreUCLA David Geffen School of Medicine Department of Pediatrics Mattel Children’s Hospital at UCLA

AIM To characterize the clinical course and outcomes of nasal intermittent mandatory ventilation(NIMV) use in acute pediatric respiratory *** We identified all patients treated with NIMV in the pediatric intensive care unit(PICU) or inpatient general pediatrics between January 2013 and December 2015 at two academic *** who utilized NIMV with other modes of noninvasive ventilation during the same admission were *** included demographics,vital signs on admission and prior to initiation of NIMV,pediatric risk of mortality Ⅲ(PRIsM-Ⅲ) scores,complications,respiratory support characteristics,PICU and hospital length of stays,duration of respiratory support,and *** who did not require escalation to mechanical ventilation were defined as NIMV responders;those who required escalation to mechanical ventilation(MV) were defined as NIMV *** responders were compared to NIMV *** Forty-two patients met study ***(14%) failed treatment and required *** majority of the patients(74%) had a primary diagnosis of *** median age of these 42 patients was 4 mo(range 0.5-28.1 mo,IQR 7,P = 0.69).No significant difference was measured in other baseline demographics and vitals on initiation of NIMV;these included age,temperature,respiratory rate,O2 saturation,heart rate,systolic blood pressure,diastolic blood pressure,and PRIsM-Ⅲ *** duration of NIMV was shorter in the NIMV nonresponder vs NIMV responder group(6.5 h vs 65 h,P < 0.0005).Otherwise,NIMV failure was not associated with significant differences in PICU length of stay(LOs),hospital LOs,or total duration of respiratory *** patients had aspiration pneumonia,pneumothorax,or skin *** Most of our patients responded to *** failure is not associated with differences in hospital LOs,PICU LOs,or duration of respiratory support.

关键词： Continuous positive airway pressure Pediatric Noninvasive positive pressure ventilation Nasal intermittent mandatory ventilation High flow nasal cannula Acute respiratory failure Bilevel positive airway pressure

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