Objective: To evaluate the feasibility and effects of noninvasive pressure support ventilation (NIV) on the breathing pattern in infants developing respiratory failure after extubation. Design: Prospective pilot clinical study; each patient served as their own control. Setting: A nine-bed paediatric intensive care unit of a tertiary university hospital. Patients: Six patients (median age 5 months, range 0.5-7 months; median weight 4.2 kg, range 3.8-5
The purpose of this case report is to illustrate food intoxication in infants as a consequence of fennel ingestion. Four cases of methemoglobinemia (MetHb) are presented here. Each patient ate homemade fennel purée a few hours prior to arriving to the emergency department with cyanosis unresponsive to oxygen, in the absence of suspected cyanotic heart disease. All 4 patients received treatment with methylene blue and fully recovered. Our cases emphasize that improper handling and storing of vegetables can lead to life-threatening MetHb.
Heliox has been shown to be beneficial in the management of different obstructive pulmonary disorders. High-frequency percussive ventilation has recently been advocated to treat lung injury in children with reduced lung compliance. We report our experience of combining heliox with noninvasive high-frequency percussive ventilation in a 5-yr-old boy with severe acute respiratory failure resulting from advanced cystic fibrosis lung disease. The dramatic improvement allowed stabilization and withholding of endotracheal intubation. We hypothesize that this approach improved gas exchange by enhancing molecular diffusion and by favoring laminar flow throughout the upper and lower airways. Further investigations should study the mechanisms of this noninvasive bimodal therapy.
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