To the editor: Eradication of Mycobacterium abscessus in a chronically infected patient with cystic fibrosis
✍ Scribed by Andrew A. Colin
- Publisher
- John Wiley and Sons
- Year
- 2000
- Tongue
- English
- Weight
- 25 KB
- Volume
- 30
- Category
- Article
- ISSN
- 8755-6863
No coin nor oath required. For personal study only.
✦ Synopsis
Evaluation of pulmonary mechanics in the pediatric intensive care unit can be helpful in assessing the response to therapy, facilitating optimal adjustment of ventilator settings, 1 and predicting prognosis. 2 A variety of techniques have been employed. [3][4][5] Children may be supported either by volume-limited or pressure-limited ventilation. We determined whether ventilatory mode influenced the performance or results of pulmonary mechanics measurements and whether the results from different techniques correlated.
Nine children (median age: 9.5 years; range: 5-17 years) were studied on Servo 900c ventilators; their primary diagnoses were hepatic transplantation (n ס 3); craniotomy (n ס 1); head injuries sustained during road traffic accidents (n ס 3); intracranial hemorrhage (n ס 1); and hepatic encephalopathy due to acetaminophen ingestion (n ס 1). The children were sedated, and none were making spontaneous respiratory efforts during positive pressure inflations. The study was approved by the Research Ethics Committee of King's Healthcare National Health Service Trust, and parents gave informed written consent. Children were studied first on volumelimited and then pressure-limited ventilation. Ventilator rate and inflation time were not changed on transfer to the alternate ventilatory modes, but inspiratory pressure changes of between 2-4 cmH 2 O were required to ensure that the delivered volume remained constant. Four techniques were assessed on each ventilator mode: