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Maximal Expiratory Flow (maximal + expiratory_flow)

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Medical Sciences	100%

Selected Abstracts

Airway function in infants treated with inhaled nitric oxide for persistent pulmonary hypertension

PEDIATRIC PULMONOLOGY, Issue 3 2008
Aparna U. Hoskote MD
Abstract Rationale Inhaled nitric oxide (iNO), used for treatment of persistent pulmonary hypertension of newborn (PPHN), is an oxygen free radical with potential for lung injury. Deferring ECMO with iNO in these neonates could potentially have long-term detrimental effects on lung function. We studied respiratory morbidity (defined as occurrence of respiratory infections requiring treatment, episodes of wheezing, and/or need for ongoing medications following discharge) and airway function at 1 year postnatal age in term neonates treated with iNO but not ECMO for PPHN, and compared data from similar infants recruited to the UK ECMO Trial randomized to receive ECMO or conventional management (CM). Methods Maximal expiratory flow at FRC (V'maxFRC) was measured in infants treated with iNO for PPHN (oxygenation index ,25) at birth. Results V'maxFRC was measured in 23 infants and expressed as z -scores, to adjust for sex and body size and compared to data from 71 (46 ECMO, 25 CM) infants studied at a similar age in the ECMO Trial. Respiratory morbidity was low in iNO group. V'maxFRCz -score was lower than predicted in all groups (P,<,0.001), with no significant difference between those treated with iNO [mean (SD) z -score: ,1.65 (1.2)] and those treated with ECMO [,1.59 (1.2)] or CM [,2.1(1.0)]. Within iNO, ECMO and CM groups; 26%, 37% and 56%, respectively, had V'maxFRCz -scores below normal. Conclusions Respiratory outcome at 1 year in iNO treated neonates with moderately severe PPHN is encouraging, with no apparent increase in respiratory morbidity when compared to the general population. Sub-clinical reductions in airway function are evident at 1 year, suggesting that continuing efforts to minimize lung injury in the neonatal period are warranted to maximize lung health in later life. Pediatr Pulmonol. 2008; 43:224,235. © 2008 Wiley-Liss, Inc. [source]

Nasal administration of albuterol: an alternative route of delivery

JOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 10 2004
Anwar A. Hussain
The use of metered-dose inhalers for the delivery of albuterol, a ,2 -selective adrenergic agonist, is associated with drawbacks, especially in children and the elderly. This investigation was designed to assess the effectiveness of albuterol delivered intranasally and to compare this delivery route with intratracheal and intravenous delivery. Three parameters of pulmonary function (peak maximal expiratory flow, maximal expiratory flow at 50% vital capacity, and total lung capacity) in anaesthetized, artificially ventilated guinea pigs were used to determine the degree of protection produced by albuterol against bronchoconstrictor responses provoked by acetylcholine. The heart rate was also measured. Although intranasal albuterol induced a slower protective action during the very initial phase of absorption, the drug was shown to be equally effective when administered either intranasally or intratracheally. In contrast, despite a significant effect initially in the case of intravenous albuterol, its ability to influence pulmonary function faded rather rapidly. No statistically significant differences in heart rate could be detected among the different treatment groups. In conclusion, intranasal albuterol may offer an alternative to metered-dose inhalers for the treatment of acute bronchospasm and for prevention of exercise-induced asthma, especially for children and the elderly. [source]

Detecting early structural lung damage in cystic fibrosis,,

PEDIATRIC PULMONOLOGY, Issue 3 2002
Harm A.W.M. Tiddens MD
In cystic fibrosis (CF) patients, both severe lung inflammation and severe lung damage occur early and persist throughout life. High-resolution computed tomography (HRCT), a more sensitive method of detecting structural abnormalities than chest X-ray, shows that airways undergo substantial thickening in early CF lung disease. Lung function tests, which are an indirect measure of structural integrity, are insensitive to localized or early damage. Thickening of the peripheral airways causes a reduction in maximal expiratory flow at 25% of forced vital capacity (MEF25) or other measurements of peripheral air flow. Reduced peripheral flows, even in the presence of normal forced expired volume in 1 sec (FEV1) and forced vital capacity (FVC), should be considered an early sign of substantial lung damage and should stimulate aggressive treatment to prevent further deterioration. Pediatr Pulmonol. 2002; 34:228,231. © 2002 Wiley-Liss, Inc. [source]