Deposition studies of aerosol delivery by nasal cannula to infants.

Aim: Nasal cannulas are used to provide oxygen support for infants and have been considered as a means for delivering aerosols to the lungs. To measure mucociliary clearance in the lungs of infants with congenital heart defects, we delivered radiopharmaceutical aerosols via a nasal cannula. Here we report on the pulmonary and nasal deposition of these aerosols.

Inhaled Pulmonary Vasodilators: Are There Indications Within the Pediatric ICU?

Inhaled nitric oxide (INO) is only FDA-cleared for neonates (> 34 weeks gestation) with hypoxic respiratory failure-associated pulmonary hypertension. Off-label use of INO is common in the pediatric population despite a lack of evidence regarding survival benefit, questioning whether the therapy should be considered outside the neonatal period. A lack of definitive evidence combined with increasing health-care costs has led to the use of less costly inhaled prostacyclin as an alternative to INO, presenting unique patient safety concerns.

Reflexive orienting in response to short- and long-duration gaze cues in young, young-old, and old-old adults.

Shifting visual focus on the basis of the perceived gaze direction of another person is one form of joint attention. In the present study, we investigated whether this socially relevant form of orienting is reflexive and whether it is influenced by age. Green and Woldorff (Cognition 122:96-101, 2012) argued that rapid cueing effects (i.

Helium-oxygen therapy for infants with bronchiolitis: a randomized controlled trial.

Objective: To compare nebulized racemic epinephrine delivered by 70% helium and 30% oxygen or 100% oxygen followed by helium-oxygen inhalation therapy via high-flow nasal cannula (HFNC) vs oxygen inhalation via HFNC in the treatment of bronchiolitis.

Design: Prospective, randomized, controlled, single-blind trial.

Setting: This study was conducted from October 1, 2004, through May 31, 2008, in the emergency department of an urban, tertiary care children's hospital.

Timing of reflexive visuospatial orienting in young, young-old, and old-old adults.

This study examined adult age differences in reflexive orienting to two types of uninformative spatial cues: central arrows and peripheral onsets. In two experiments using a Posner cuing task, young adults (ages 18-28 years), young-old adults (60-74 years), and old-old adults (75-92 years) responded to targets that were preceded 100-1,000 ms earlier by a central arrow or a peripheral abrupt onset. In Experiment 1, the cue remained present upon target onset.

Spatial distribution of attentional inhibition is not altered in healthy aging.

Inhibition of return (IOR) is a phenomenon of attentional orienting that is indexed by slower responses to targets presented at previously attended locations. The purpose of this study was to examine adult age differences in the distribution of IOR to multiple locations. In three experiments, young adults (ages 18-30 years) and older adults (ages 60-87 years) completed an IOR task that varied in the number of simultaneous onset cues (one to seven) and the number of display locations (four or eight).

The emotional blink: adult age differences in visual attention to emotional information.

To assess age differences in attention-emotion interactions, the authors asked young adults (ages 18-33 years) and older adults (ages 60-80 years) to identify target words in a rapid serial visual presentation (RSVP) task. The second of two target words was neutral or emotional in content (positive in Experiment 1, negative in Experiment 2). In general, the ability to identify targets from a word stream declined with age.

Adult age differences in attention to semantic context.

In three experiments age differences in attention to semantic context were examined. The performance of younger adults (ages 18-29 years) and older adults (ages 60-79 years) on a semantic priming task indicated that both age groups could use information regarding the probability that a prime and target would be related to flexibly anticipate the target category given the prime word (Experiment 1). The timing by which target expectancies were reflected in reaction time performance was delayed for older adults as compared to younger adults, but only when the target was expected to be semantically unrelated to the prime word (Experiment 2).

Aerosol delivery through nasal cannulas: an in vitro study.

In most circumstances, a nasal route for the delivery of pulmonary aerosol medications is rarely considered; however, in specific instances, this route may be quite useful. Consider, for example, the delivery of aerosol treatments during humidified high-flow nasal cannula use in pediatric critical care, or continuous aerosol delivery via cannula for medications with short durations of action. The goal of this study was to evaluate the potential for delivering aerosols via nasal cannula through in vitro studies of aerosol output and size.

Aging and temporal patterns of inhibition of return.

Inhibition of return (IOR), an inhibitory component of spatial attention that is thought to bias visual search toward novel locations, is considered relatively well preserved with normal aging. We conducted two experiments to assess age-related changes in the temporal pattern of IOR. Inhibitory effects, which were strongly reflected in the performance of both younger adults (ages 18-34 years) and older adults (ages 60-79 years), diminished over a period of 5 s.

Heliox-driven albuterol nebulization for asthma exacerbations: an overview.

Our understanding of albuterol nebulization driven by helium-oxygen mixture (heliox) has matured with recent advances in clinical therapy, delivery systems, and understanding of dosing; this has led to substantial improvements in delivery as well as refinements of research protocols for asthma exacerbations. This review begins with heliox inhalation therapy and then addresses heliox as a driving gas for nebulization. Technical considerations are reviewed, including optimal gas mixtures, flow-rate adjustment factors, and nebulizer setup.

Helium/oxygen-driven albuterol nebulization in the treatment of children with moderate to severe asthma exacerbations: a randomized, controlled trial.

Background: Helium and oxygen mixtures (heliox) increase both pulmonary aerosol delivery and gas delivery relative to oxygen. We aimed to compare the effectiveness of a 70%:30% helium/oxygen (heliox)-driven continuous aerosol delivery versus 100% oxygen-driven delivery in the treatment of asthmatic children with moderate to severe exacerbations.

Methods: We enrolled 30 children aged 2 to 18 years who presented to an urban, pediatric emergency department (ED) with moderate to severe asthma as defined by a pulmonary index (PI) score of > or =8.

Continuous vs intermittent nebulized albuterol for emergency management of asthma.

Objective: To compare the efficacy and safety of continuous nebulized (CN) albuterol therapy with those of intermittent nebulized (IN) albuterol therapy in the ED treatment of children with moderate to severe asthma exacerbations.

Methods: A prospective, randomized, single-blind study was conducted at a children's hospital ED. Patients aged 2 to 18 years with a moderate to severe asthma exacerbation (asthma score > or = 8) were enrolled.

Validity of a disposable end-tidal CO2 detector in verifying endotracheal tube placement in infants and children.

Study Objective: To examine the validity of a disposable, colorimetric end-tidal CO2 detector in verifying endotracheal tube (ETT) placement in infants and children.

Design: The detector was studied prospectively in 151 intubations.

Setting: Operating room, ICU, and emergency department of a children's hospital.

Accuracy of expiratory carbon dioxide measurements using the coaxial and circle breathing circuits in small subjects.

Mass spectrometry is widely used to measure the end-tidal concentrations of inhalation anesthetics and other gases during surgery in order to estimate their arterial concentrations. When certain breathing circuits are used in newborns, however, fresh gas or ambient air may contaminate the expired sample, introducing a systematic error in the measurement of any end-tidal gas concentration. We estimated this error in newborn piglets using carbon dioxide as an indicator substance of expired gas.