University of Oulu

Strodthoff, C., Kähkönen, T., Bayford, R. H., Becher, T., Frerichs, I., & Kallio, M. (2022). Bronchodilator effect on regional lung function in pediatric viral lower respiratory tract infections. Physiological Measurement, 43(10), 104001. https://doi.org/10.1088/1361-6579/ac9450

Bronchodilator effect on regional lung function in pediatric viral lower respiratory tract infections

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Author: Strodthoff, Claas1; Kähkönen, Toni2; Bayford, Richard H3;
Organizations: 1Department of Anaesthesiology and Intensive Care Medicine, University Medical Centre Schlewig-Holstein, Kiel, Germany
2PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu, Oulu, Finland
3Department of Natural Sciences, Middlesex University, London, United Kingdom
4Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 1.1 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2023030329560
Language: English
Published: IOP Publishing, 2022
Publish Date: 2023-10-18
Description:

Abstract

Objective: Viral lower respiratory tract infections (LRTI) are the leading cause for acute admission to the intensive care unit in infants and young children. Nebulized bronchodilators are often used when treating the most severe cases. The aim of this study was to investigate the bronchodilator effect on respiratory mechanics during intensive care with electrical impedance tomography (EIT) and to assess the feasibility of EIT in this context.

Approach: We continuously monitored the children with chest EIT for up to 72 h in an observational study design. The treatment decisions were done by clinical assessment, as the clinicians were blinded to the EIT information during data collection. In a retrospective analysis, clinical parameters and regional expiratory time constants determined by EIT were used to assess the effects of bronchodilator administration, especially regarding airway resistance.

Main results: We included six children from 11 to 27 months of age requiring intensive care due to viral LRTI and receiving bronchodilator agents. Altogether 131 bronchodilator administrations were identified during EIT monitoring. After validation of the exact timing of events and EIT data quality, 77 administrations were included in the final analysis. Fifty-five bronchodilator events occurred during invasive ventilation and 22 during high-flow nasal cannulae treatment. Only 17% of the bronchodilator administrations resulted in a relevant decrease in calculated expiratory time constants.

Significance: Continuous monitoring with EIT might help to optimize the treatment of LRTI in pediatric intensive care units. In particular, EIT-based regional expiratory time constants would allow objective assessment of the effects of bronchodilators and other respiratory therapies.

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Series: Physiological measurement
ISSN: 0967-3334
ISSN-E: 1361-6579
ISSN-L: 0967-3334
Volume: 43
Issue: 10
Article number: 104001
DOI: 10.1088/1361-6579/ac9450
OADOI: https://oadoi.org/10.1088/1361-6579/ac9450
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Subjects:
Copyright information: © 2022 Institute of Physics and Engineering in Medicine. This Accepted Manuscript is available for reuse under a CC BY-NC-ND licence after the 12 month embargo period provided that all the terms of the licence are adhered to.
  https://creativecommons.org/licenses/by-nc-nd/4.0/