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- Holmgren, Daniel, 1945, et al.
(författare)
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Histamine provocation in young, awake children with bronchial asthma, using a fall in oxygenation as the only indicator of a bronchial reaction.
- 1999
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - 0803-5253. ; 88:5, s. 545-9
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Tidskriftsartikel (refereegranskat)abstract
- Bronchial provocation with histamine was performed in 11 boys and 6 girls, age range 2.7-7.4 y, with unspecific respiratory symptoms or bronchial asthma, using a fall in oxygenation as the only indicator of a bronchial reaction. In addition to transcutaneous oxygen tension (tcPO2), transcutaneous carbon dioxide tension (tcPCO2) was continuously monitored during the provocation procedure in order to identify possible changes in ventilation. A fall of 20% or more in the tcPO2 below a "floating" baseline value, defined as the highest tcPO2 value between the inhalations of histamine up to that point, was regarded as indicating a significant bronchial reaction. One child was excluded from the study because of an "early, false-positive" reaction due to hyperventilation during the inhalation, verified by a decrease in the tcPCO2 followed by a compensatory period of hypoventilation, resulting in a fall of more than 15% in the tcPO2 after the inhalation of saline. In the vast majority of the children, however, the tcPO2 values remained stable during the first dose stages of saline and histamine, with either a gradual fall immediately before or a distinct fall in conjunction with the reaction. The mean reaction concentration was significantly lower in the group of children with clinical asthma, 0.74 mg/ml, compared with the group of children with unspecific respiratory symptoms, 2.00 mg/ml (p = 0.03). In conclusion, a 20% fall in the tcPO2 can be used as the only indicator of a bronchial reaction during bronchial provocation tests in young, awake children. Changes in ventilation evaluated by monitoring tcPCO2, makes it possible to distinguish between a fall in oxygen tension due to an early, "false" reaction as a result of hypoventilation and a "true" bronchial reaction.
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- Holmgren, Daniel, 1945, et al.
(författare)
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Transcutaneous blood gas monitoring during salbutamol inhalations in young children with acute asthmatic symptoms.
- 1992
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Ingår i: Pediatric pulmonology. - 8755-6863. ; 14:2, s. 75-9
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Tidskriftsartikel (refereegranskat)abstract
- The effect of salbutamol inhalations on transcutaneous blood gases was investigated in 23 children (aged 11 months-2.5 years) with asthmatic symptoms. After one salbutamol inhalation there was a mean increase in transcutaneous PO2 (tcPO2) of 0.5 kPa (P less than 0.01); after a second dose given 30 minutes later, the mean increase was 1.2 kPa (P less than 0.001). The increase in tcPO2 after only one dose of salbutamol was significantly correlated to age (P less than 0.01). No such correlation was observed after a second dose. The overall increase in tcPO2 after two salbutamol inhalations showed a negative correlation to the duration of the current symptomatic period (P less than 0.05). We conclude that salbutamol inhalations have beneficial effects in young children with acute asthmatic symptoms, even below the age of 18 months, provided that an adequate dose reaches the lung and preferably at an early stage of obstruction.
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- Lagerkvist, Anna-Lena, 1956, et al.
(författare)
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Immediate changes in blood-gas tensions during chest physiotherapy with positive expiratory pressure and oscillating positive expiratory pressure in patients with cystic fibrosis.
- 2006
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Ingår i: Respiratory care. - 0020-1324. ; 51:10, s. 1154-61
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess and compare immediate effects of chest physiotherapy with positive expiratory pressure (PEP) versus oscillating PEP on transcutaneously measured blood-gas tensions in patients with cystic fibrosis. METHODS: Fifteen patients (mean age 12.5 y, range 6.9-21.5 y) participated. The treatments were randomized and performed on 2 separate occasions, 8 weeks apart. Spirometry was conducted before and after each treatment. We transcutaneously measured oxygen tension (P(tO2). RESULTS: There were no changes in spirometry values. During PEP, different trends in blood-gas tension were seen, and there were no consistent changes. During oscillating PEP, P(tO2) increased and P(tCO2) decreased. During oscillating PEP, P(tCO2) was lower and the intra-individual change in P(tCO2) was more pronounced than during PEP. The results obtained immediately after oscillating PEP showed a higher P(tO2) and a lower P(tCO2) than with PEP. CONCLUSION: PEP and oscillating PEP can both cause transitory effects on blood gases in patients with cystic fibrosis. However, oscillating PEP alters blood-gas tensions more than does PEP, and hyperventilation during oscillating PEP may reduce treatment time.
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- Lagerkvist, Anna-Lena, 1956, et al.
(författare)
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Repeated blood gas monitoring in healthy children and adolescents by the transcutaneous route.
- 2003
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Ingår i: Pediatric pulmonology. - : Wiley. - 8755-6863 .- 1099-0496. ; 35:4, s. 274-9
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to establish transcutaneous oxygen tension (tcPO(2)), carbon dioxide tension (tcPCO(2)), and oxygen saturation (tcSO(2)) values and to investigate the intra- and interindividual variation in these values in healthy children and adolescents. Forty-one healthy children/adolescents (21 girls; mean age, 12.1 years; SD, 3.5; range, 5.0-19.0 years) participated. Continuous recordings of tcPO(2), tcPCO(2), tcSO(2), and heart rate (HR) were made for 30 min on two occasions, with a mean interval of 10.3 days, with the child/adolescent in a sitting position. The respiratory rate (RR) was counted manually during the last 5 min of each recording. The mean values of tcPO(2), tcPCO(2), tcSO(2), HR, and RR during the last 5 min of the recordings were reported. At the first recording, the mean value for tcPO(2) was 10.8 kPa (SD 1.0), for tcPCO(2) 5.1 kPa (0.4), for tcSO(2) 97.4% (1.1), for HR 82.2 min(-1) (9.9), and for RR 19.0 min(-1) (2.8). The coefficient of variation for tcPO(2) was 9.3%, for tcPCO(2) 7.8%, for tcSO(2) 1.1%, for HR 12.0%, and for RR 14.7%. The mean intraindividual variation in tcPO(2) was 0.3 kPa (SD 1.0), tcPCO(2) 0.0 kPa (0.5), tcSO(2) 0.1% (1.3), HR 0.1 min(-1) (7.7), and RR 0.5 min(-1) (2.7). No significant differences were observed in tcPO(2), tcPCO(2), tcSO(2), HR, or RR between the two recordings. In conclusion, the reproducibility of tcPO(2), tcPCO(2), and tcSO(2) monitoring during 30 min in healthy children and adolescents was good. This indicates that transcutaneous blood gas monitoring may be used to document significant changes in blood gas tensions and oxygen saturation over time.
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- Wennergren, Göran, 1947, et al.
(författare)
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Wheezing bronchitis reinvestigated at the age of 10 years.
- 1997
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - 0803-5253. ; 86:4, s. 351-5
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Tidskriftsartikel (refereegranskat)abstract
- We have reinvestigated 92/101 children aged 10, who before the age of 2 years were admitted to a paediatric ward due to wheezing bronchitis. At the present time, 70% are symptom-free without medication, 20% have mild asthma, 8% moderate and 2% severe asthma. Persistent asthma correlated significantly to the presence of some other atopic disease in recent years, to early start of wheezing during infancy and to intense obstructive disease as a young child, while initial respiratory syncytial virus infection did not. A clear-cut relationship between smoking in the home in infancy and persistent asthma emerged (not visible at a preschool follow-up). The histamine challenge results correlated to the clinical picture. A normal histamine challenge was seen in 63%, mild hyperresponsiveness in 19%, moderate in 12% and pronounced hyperresponsiveness in 6%. The figures for persistent asthma and bronchial hyperresponsiveness are high compared with the prevalence of asthma in the overall population of schoolchildren.
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