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

Strodthoff, Claas ORCID logoORCID: https://orcid.org/0000-0001-7987-818X, Kähkönen, Toni, Bayford, Richard ORCID logoORCID: https://orcid.org/0000-0001-8863-6385, Becher, Tobias ORCID logoORCID: https://orcid.org/0000-0003-2026-7629, Frerichs, Inez ORCID logoORCID: https://orcid.org/0000-0002-7712-6539 and Kallio, Merja ORCID logoORCID: https://orcid.org/0000-0003-0799-344X (2022) Bronchodilator effect on regional lung function in pediatric viral lower respiratory tract infections. Physiological Measurement, 43 (10) , 104001. ISSN 0967-3334 [Article] (Published online first) (doi:10.1088/1361-6579/ac9450)

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Abstract

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. 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. We continuously monitored the children with chest EIT for up to 72h 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. 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. Continuous monitoring with EIT might help to optimize the treatment of LRTI in pediatric intensive care units. Especially EIT-based regional expiratory time constants would allow objective assessment of the effects of bronchodilators and other respiratory therapies. [Abstract copyright: © 2022 Institute of Physics and Engineering in Medicine.]

Item Type: Article
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Keywords (uncontrolled): Airway Resistance, Electrical Impedance Tomography, Pediatric Intensive Care Units, Respiratory Tract Infections, Bronchodilator Agents
Research Areas: A. > School of Science and Technology > Natural Sciences
Item ID: 36476
Notes on copyright: This Accepted Manuscript is © 2022 Institute of Physics and Engineering in Medicine
This is the Accepted Manuscript version of an article accepted for publication in Physiological Measurement. IOP Publishing Ltd is not responsible for any errors or omissions in this version of the manuscript or any version derived from it. The Version of Record is available online at https://doi.org/10.1088/1361-6579/ac9450
As the Version of Record of this article has been published on a subscription basis, this Accepted Manuscript is available for reuse under a CC BY-NC-ND 3.0 licence https://creativecommons.org/licences/by-nc-nd/3.0 after the 12 month embargo period.
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Depositing User: Jisc Publications Router
Date Deposited: 06 Oct 2022 14:03
Last Modified: 25 Jan 2023 04:32
URI: https://eprints.mdx.ac.uk/id/eprint/36476

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