Abstract | OBJECTIVE: DESIGN: Prospective, randomized, monocentric study carried out in the pediatric intensive care unit (PICU) of a university hospital. PATIENTS: Infants <6 months old, admitted to the PICU with severe respiratory syncytial virus bronchiolitis. INTERVENTION: The patients were randomized into two groups for 6 hr. The nCPAP group (n = 10) received 6 cmH(2)O pressure support delivered by a jet flow generator and the control group (n = 9) received an air/ oxygen mixture from a heated humidifier. Respiratory distress was assessed by the modified Wood's clinical asthma score (m-WCAS), and inspiratory muscle work was evaluated by calculating the pressure-time product per breath (PTP(insp) /breath) and per minute (PTP(insp) /min) from the esophageal pressure (Pes) recordings. MEASUREMENTS AND MAIN RESULTS: Compared with control condition, nCPAP decreased m-WCAS [-2.4 (1.05) vs. -0.5 (1.3), P = 0.03], PTPes(insp)/breath [-9.7 (5.7) vs. -1.4 (8.2), P = 0.04], PTPes(insp) /min [-666 (402) vs. -116 (352), P = 0.015], and FiO(2) [-7 (10) vs. +5 (15), P = 0.05]. Significant worsening of m-WCAS was only observed in the control group (4/9 vs. 0/10, P = 0.03). CONCLUSIONS: nCPAP rapidly decreased inspiratory work in young infants with acute bronchiolitis. Improvement in the respiratory distress score at 6 hr was proportional to the initial clinical severity, suggesting the importance of rapid nCPAP initiation in the more severe forms of the disease.
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Authors | Christophe Milési, Stefan Matecki, Samir Jaber, Thibaut Mura, Aurélien Jacquot, Odile Pidoux, Nathalie Chautemps, Aline Rideau Batista Novais, Clémentine Combes, Jean-Charles Picaud, Gilles Cambonie |
Journal | Pediatric pulmonology
(Pediatr Pulmonol)
Vol. 48
Issue 1
Pg. 45-51
(Jan 2013)
ISSN: 1099-0496 [Electronic] United States |
PMID | 22431446
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2012 Wiley Periodicals, Inc. |
Topics |
- Bronchiolitis, Viral
(therapy)
- Continuous Positive Airway Pressure
(methods)
- Humans
- Infant
- Oxygen Inhalation Therapy
- Prospective Studies
- Severity of Illness Index
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