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Neurally adjusted ventilatory assist (NAVA) allows patient-ventilator synchrony during pediatric noninvasive ventilation: a crossover physiological study

IntroductionThe need for intubation after a noninvasive ventilation (NIV) failure is frequent in the pediatric intensive care unit (PICU). One reason is patient-ventilator asynchrony during NIV. Neurally adjusted ventilatory assist (NAVA) is a mode of ventilation controlled by the patient’s neural respiratory drive. The aim of this study was to assess the feasibility and tolerance of NIV-NAVA in children and to evaluate its impact on synchrony and respiratory effort. Methods: This prospective, physiologic, crossover study included 13 patients requiring NIV in the PICU of Sainte-Justine’s Hospital from October 2011 to May 2013. Patients were successively ventilated in conventional NIV as prescribed by the physician in charge (30 minutes), in NIV NAVA (60 minutes), and again in convent...

Effect of Corticosteroids on Treatment Failure Among Hospitalized Patients With Severe Community-Acquired Pneumonia and High Inflammatory Response A Randomized Clinical Trial

Conclusions and RelevanceAmong patients with severe community-acquired pneumonia and high initial inflammatory response, the acute use of methylprednisolone compared with placebo decreased treatment failure. If replicated, these findings would support the use of corticosteroids as adjunctive treatment in this clinical population.Trial Registrationclinicaltrials.gov Identifier: NCT00908713 (Source: JAMA)

French Hajj pilgrims’ experience with pneumococcal infection and vaccination: A knowledge, attitudes and practice (KAP) evaluation

Transmission of respiratory infections poses a major public health challenge during the Hajj and Umrah in the Kingdom of Saudi Arabia. Acquisition of Streptococcus pneumoniae during Hajj has been studied in the past and recommendations for vaccination against Streptococcus pneumonia have been made for high risk groups. (Source: Travel Medicine and Infectious Disease)

Cough-variant asthma: a diagnostic dilemma in the occupational setting

Conclusions Clinical symptoms, post-challenge BHR and increased NL eosinophil counts confirmed a positive response to SICT and validated the diagnosis of cough-variant occupational asthma. SICT may be useful in cases where history and clinical data suggest cough-variant asthma and spirometric indices are negative. (Source: Occupational Medicine)

Lung Ultrasound in Critically Ill Infants and Children

Lung ultrasound is emerging as a versatile and important imaging modality for infants and children at the point-of-care whether in the emergency department, NICU or PICU. This brief talk will cover pneumothorax, lung contusion, pneumonia (bacterial vs. viral), acute respiratory distress syndrome, and neonatal respiratory disorders including transient tachypnea of the newborn and hyaline membrane disease. (Source: Ultrasound in Medicine and Biology)

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