In current asthma guidelines, dosage regimens for inhalation therapy in children are based on adult doses and are generally titrated per kilogram of bodyweight or per square metre of body surface area. However, these recommendations do not correspond well with current knowledge of aerosol therapy in childhood. Lung deposition of the aerosolised drug is the key determinant for clinical efficacy and for systemic side effects of inhalation therapy. Lung deposition increases with age, whereas lung deposition expressed as a percentage per kilogram bodyweight is age-independent. This finding is explained by the self-regulating effect of age-dependent airway anatomy on lung deposition. Therefore, it is more likely that adult doses translate into paediatric doses only by virtue of the differences in self-limiting pulmonary deposition when using the same absolute nominal doses of the medication. Adapting the adult dose to a paediatric dose calculated on body size might be unnecessary and could lead to insufficient pulmonary deposition of medication. These findings suggest that dosage regimens for inhalation therapy for children may have to be reconsidered, and should be determined from dose-ranging studies rather than calculated from adult doses based on body size.
The mean cerebral blood flow velocity is significantly decreased in children during inhaled anesthesia with sevoflurane than during halothane. This might be relevant for the choice of anesthetic in children with risk of increased intracranial pressure, neurosurgery, or craniofacial osteotomies.
Le but de ces recommandations est de prévenir et de traiter les hypoglycémies chez les nouveau-nés à terme ou faiblement prématurés dès la 35e semaine de gestation dans les salles d’accouchements ou les maternités, c’est-à-dire les centres de niveau I offrant des soins néonataux de base selon la classification des degrés de prise en charge néonatale en Suisse1). Ces recommandations ne s’appliquent pas aux prématurés < 35 semaines de gestations et aux nouveau-nés malades qui doivent être admis dans des centres de niveaux supérieurs offrant une prise en charge ciblée, des soins intermédiaires ou intensifs (niveaux de soins IIa, IIb et III en Suisse selon les critères du CANU).
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