Respiratory function during infancy in survivors of the INNOVO trial.

Rationale: Despite encouraging reports suggesting that inhaled nitric oxide (iNO) appear to improve outcome in hypoxemic term and near term infants by improving oxygenation and reducing need for ECMO, the long-term benefits of iNO remain unclear. This study aimed to compare lung function at approximately 1 year in infants who were and were not randomly allocated to iNO as part of their neonatal management for severe respiratory failure at birth. Furthermore, results were compared to lung function of healthy infants.

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

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).

Early detection of cystic fibrosis lung disease: multiple-breath washout versus raised volume tests.

Background: Lung clearance index (LCI), a measure of ventilation inhomogeneity derived from the multiple-breath inert gas washout (MBW) technique, has been shown to detect abnormal lung function more readily than spirometry in preschool children with cystic fibrosis, but whether this holds true during infancy is unknown.

Objectives: To compare the extent to which parameters derived from the MBW and the raised lung volume rapid thoraco-abdominal compression (RVRTC) techniques identify diminished airway function in infants with cystic fibrosis when compared with healthy controls.

Methods: Measurements were performed during quiet sleep, with the tidal breathing MBW technique being performed before the forced expiratory manoeuvres.

Development of lung function in early life: influence of birth weight in infants of nonsmokers.

This study aimed to compare lung growth and development during the first year of life in healthy term infants of low or appropriate birth weight for gestation. Paired measurements of forced expiratory volume in 0.4 second, FVC, and forced expiratory flow when 75% of FVC has been exhaled were obtained, using the raised volume technique, at about 7 weeks and 9 months of age in 80 infants (32 low and 48 appropriate birth weight for gestation) of white, nonsmoking mothers.

Respiratory physiotherapy vs. suction: the effects on respiratory function in ventilated infants and children.

Objective: To assess and compare the effects of physiotherapy and suction on expired tidal volume (V(TE)), respiratory compliance (C(rs)), resistance (R(rs)) and arterial blood gases.

Design: Randomised cross-over study comparing outcomes after both treatments on the same day.

Setting: Intensive tertiary care units, Great Ormond Street Hospital, London.

Quality control for spirometry in preschool children with and without lung disease.

The reliability of spirometry is dependent on strict quality control. We examined whether quality control criteria recommended for adults could be applied to children aged 2-5 years. Forty-two children with cystic fibrosis and 37 healthy children attempted spirometry during their first visit to our laboratory.

The evolution of airway function in early childhood following clinical diagnosis of cystic fibrosis.

This study aimed to investigate the evolution of airway function in infants newly diagnosed with cystic fibrosis (CF). FEV(0.5) was measured soon after diagnosis (median age of 28 weeks) and 6 months later in subjects with CF and on two occasions 6 months apart (median ages of 7.

Accuracy of displayed values of tidal volume in the pediatric intensive care unit.

Objectives: To assess the accuracy of the expired tidal volumes (VT(E)) displayed by one of the most frequently used ventilators that measures exhaled volume at the expiratory valve.

Design: Prospective study.

Setting: The intensive care units of a pediatric tertiary referral center in London, UK.