Publications by authors named "Robin McKinney"
Article Synopsis
- - The study focuses on bronchopulmonary dysplasia (BPD), a common chronic respiratory issue in infants, particularly those born preterm, highlighting the lack of consistent clinical care guidelines.
- - A survey of 27 BPD programs revealed significant variability in outpatient care, including referral processes, services offered, follow-up echocardiograms, and discharge criteria.
- - The authors advocate for the creation of comprehensive clinical guidelines for BPD, similar to those for asthma and cystic fibrosis, to standardize care and potentially improve long-term health outcomes.
Article Synopsis
- The study focused on ventilator-dependent infants and children with bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) to assess their health outcomes.
- Approximately 60% of the 154 subjects had pulmonary hypertension, with many requiring specific medications; those with PH tended to transition to home ventilation and discharge at older ages.
- Despite the challenges, most subjects improved over time, successfully weaning off oxygen and ventilators by age 5, with a low mortality rate after discharge.
Article Synopsis
- The study aimed to identify factors affecting when infants with severe bronchopulmonary dysplasia (sBPD) can be liberated from ventilators and successfully decannulated.
- Results showed that on average, ventilation liberation occurred at 27 months and decannulation at 49 months, with factors like age at discharge, ventilator pressure, and respiratory readmissions influencing these timings.
- Conclusions highlighted that individual factors predominantly drive the differences in timing, while aggressive management of gastroesophageal reflux affected decannulation timelines.
Article Synopsis
- - This research investigates different mechanical ventilation strategies for infants with severe bronchopulmonary dysplasia (BPD) to improve care and clinical trial design.
- - A secondary analysis of data from 78 infants across 14 centers used clustering techniques to categorize ventilator settings into three distinct approaches based on specific physiological measures.
- - The findings show significant differences in ventilation settings among the identified clusters, suggesting a need for further studies to link these practices to BPD clinical outcomes.
As the population of ventilator-dependent children (VDC) with tracheostomies due to underlying severe bronchopulmonary dysplasia grows, there is an increasing need to shift the care of these children from hospital to home. Transitioning the ventilator-dependent child from the hospital to home is a complex process that requires coordination between the medical team and the family. One crucial step in the process is transitioning from an Intensive care unit (ICU) ventilator to a portable home ventilator (PHV).
View Article and Find Full Text PDFArticle Synopsis
- The study investigated the prevalence of severe bronchopulmonary dysplasia (BPD) in infants, focusing on their ventilatory support types and settings.
- A total of 187 infants were included, with 51% receiving invasive positive-pressure ventilation (IPPV) across 15 different medical centers.
- Results showed significant variations in the types of ventilator modes used, depending on the specific center.
Different types of patient triggered ventilator modes have become the mainstay of ventilation in term and preterm newborn infants. Maintaining spontaneous breathing has allowed for earlier weaning and the additive effects of respiratory efforts combined with pre-set mechanical inflations have reduced mean airway pressures, both of which are important components in trying to avoid lung injury and promote normal lung development. New sophisticated modes of assisted ventilation have been developed during the last decades where the control of ventilator support is turned over to the patient.
View Article and Find Full Text PDFObjective: Severe bronchopulmonary dysplasia (sBPD) can lead to long term morbidity. We created a sBPD multidisciplinary team in 2011 to optimize care and improve outcomes.
Study Design: Retrospective chart review of three groups between 2008 and 2016: patients with sBPD born before 2011, patients with sBPD born after 2011, and patients with moderate BPD born after 2011.
Article Synopsis
- The study investigates how neurally adjusted ventilatory assist (NAVA) is used for preterm infants with severe bronchopulmonary dysplasia (sBPD) across different centers in a collaborative effort.
- Only 31% of the participating centers utilized NAVA for managing these patients, with varying rates of successful outcomes: 67% achieved respiratory stability and 87% survived until discharge.
- The findings suggest that while NAVA can be effective and safe for selective infants with sBPD, its application is inconsistent, highlighting the need for more standardized clinical studies to establish best practices.
Bronchopulmonary dysplasia (BPD) is a major cause of morbidity and mortality in surviving extremely preterm infants, with long-term morbidity disproportionately affecting children with severe BPD (sBPD). Infants with sBPD experience multiple organ system dysfunction. To best treat these complicated patients, we created a multidisciplinary team in 2011 consisting of multiple pediatric subspecialists with a specific interest in sBPD.
View Article and Find Full Text PDFAdministration of adenovirus (Ad) vectors to animals induces innate immune responses, typified by elevated interleukin-6 (IL-6). To assess innate responses to Ad vectors in humans, we evaluated serum IL-6 following administration of E1(-) E3(-) Ad vectors to different human hosts and the relationship among peak IL-6 and peak anti-Ad neutralizing antibodies. We administered: 1) Ad(GV)CFTR.
View Article and Find Full Text PDF