The Experts below are selected from a list of 126 Experts worldwide ranked by ideXlab platform
Ann R. Stark - One of the best experts on this subject based on the ideXlab platform.
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Changes in the contribution of the rib cage to tidal breathing during infancy.
The American review of respiratory disease, 1990Co-Authors: M. B. Hershenson, Andrew A. Colin, Mary Ellen B. Wohl, Ann R. StarkAbstract:As the shape, compliance, and deformability of the rib cage (RC) change during infancy, RC participation in quiet breathing may increase. We used respiratory inductive plethysmography (RIP) to determine the relative contributions of the RC and abdomen (AB) to tidal volume (Vt) in 20 studies in 14 healthy infants 1 to 26 months of age during quiet natural sleep. RIP was calibrated with simultaneous flow measurements (Anesthesia Mask and pneumotachograph) by the least squares method of statistical analysis. We analyzed segments of breathing with and without flow measurement for RIP-derived Vt, change in RC volume (Vrc) and AB volume (Vab) with each breath and the RC contribution to tidal breathing (%RC = Vrc/Vrc + Vab). The %RC increased with age: %RC = 1.4 age (months) + 33 (r = 0.69, p < 0.01). After 9 months of age, %RC resembled that found in quietly sleeping adolescents. Mask placement increased Vt in all but one subject (mean increase, 29 ± 23% of baseline ± SD; p < 0.001, paired t test). In infants y...
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Changes in the contribution of the rib cage to tidal breathing during infancy.
The American review of respiratory disease, 1990Co-Authors: M. B. Hershenson, Andrew A. Colin, Mary Ellen B. Wohl, Ann R. StarkAbstract:As the shape, compliance, and deformability of the rib cage (RC) change during infancy, RC participation in quiet breathing may increase. We used respiratory inductive plethysmography (RIP) to determine the relative contributions of the RC and abdomen (AB) to tidal volume (VT) in 20 studies in 14 healthy infants 1 to 26 months of age during quiet natural sleep. RIP was calibrated with simultaneous flow measurements (Anesthesia Mask and pneumotachograph) by the least squares method of statistical analysis. We analyzed segments of breathing with and without flow measurement for RIP-derived VT, change in RC volume (Vrc) and AB volume (Vab) with each breath and the RC contribution to tidal breathing (%RC = Vrc/Vrc + Vab). The %RC increased with age: %RC = 1.4 age (months) + 33 (r = 0.69, p less than 0.01). After 9 months of age, %RC resembled that found in quietly sleeping adolescents. Mask placement increased VT in all but one subject (mean increase, 29 +/- 23% of baseline +/- SD; p less than 0.001, paired t test). In infants younger than 10 months of age, Mask placement also increased %RC (without Mask, 40 +/- 9%; with Mask, 46 +/- 10% p less than 0.02). We conclude that by 1 yr of age, the RC contribution to tidal breathing during quiet sleep is similar to that of the adolescent, suggesting that major developmental changes in RC shape, compliance, and deformability take place during infancy.
Christopher Randolph - One of the best experts on this subject based on the ideXlab platform.
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Aerosol Therapy with Valved Holding Chambers in Young Children, Importance of a Face Mask Seal
Pediatrics, 2002Co-Authors: Christopher RandolphAbstract:Purpose of the Study. The purpose of this study was to determine the relative ability of 3 different spacers with Masks to obtain a tight seal. The Nebuchamber (Astra Draco AB, Lund, Sweden), the AeroChamber (Trudell Medical, London, Ontario, Canada), and the Babyhaler (Glaxo GmbH, Germany) were compared with the Hans Rudolph Anesthesia Mask in infants and young children. Masks are viewed as a critical interface between the valved holding chamber and the small child for providing aerosol treatments. Study Population. The study population included 30 children with …
Michael T. Newhouse - One of the best experts on this subject based on the ideXlab platform.
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Aerosol Therapy With Valved Holding Chambers in Young Children: Importance of the FaceMask Seal
Pediatrics, 2001Co-Authors: Israel Amirav, Michael T. NewhouseAbstract:Objective. Masks are an essential interface between valved holding chambers (VHCs), or spacers, and a small child9s face for providing aerosol therapy. Clinical experience suggests that many young children do not cooperate with the VHC treatment or tolerate a Mask of any kind. This might impair the Mask–face seal and reduce the dose delivered to the child. The objective of this study was to evaluate the ability of parents to provide a good Mask–face seal in infants and toddlers using 3 Masks provided with commonly used pediatric VHCs and compare this with the seal obtained with the Hans Rudolph pediatric Anesthesia Mask. Methods. A preliminary in vitro filter study was conducted to validate the assumption that reduced ventilation as a result of increased faceMask leak reduces the drug aerosol dose delivered to the mouth. FaceMask leak then was studied in vivo for NebuChamber, AeroChamber, BabyHaler, and Hans Rudolph Masks by measuring ventilation with an in-line pneumotachograph while the faceMask was held in place by experienced parents who were asked to demonstrate how they deliver medication to their children without any additional instruction. Thirty children (mean age: 3.2 ± 1.4 years) performed 4 repeat studies with each Mask. The first 10 patients performed the tests once again within 1 month. On the second occasion, the parents were coached continuously and encouraged to hold the Mask tightly against the child9s face. Results. The AeroChamber and Hans Rudolph Masks provided the best seal as reflected in the magnitude of the ventilation measured through them. The NebuChamber provided the poorest seal, with 45% less ventilation than the AeroChamber and Hans Rudolph Masks. There was considerable intraindividual variability for all Masks (24% to 48%); however, the variability with the NebuChamber Mask was 2-fold greater than the other Masks. All ventilatory volumes during the coached session were significantly greater than during the uncoached session. Variability during the coached session was significantly less (except for the BabyHaler, which remained unchanged). Conclusions. VHCs with Masks designed for use with small children may provide a poor seal with the face, leading to reduced or more variable dose delivery. The faceMask seal is critical for efficient aerosol delivery to infants and young children, and this should be stressed to parents.
Zeev N. Kain - One of the best experts on this subject based on the ideXlab platform.
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An evaluation of preoperative anxiety in Spanish-speaking and Latino children in the United States.
Pediatric Anesthesia, 2018Co-Authors: Pragati H. Mamtora, Zeev N. Kain, Robert S. Stevenson, Brenda Golianu, Jeffrey I. Gold, Michelle A. FortierAbstract:BACKGROUND: There is a large body of literature examining factors associated with children's preoperative anxiety; however, cultural variables such as ethnicity and language have not been included. AIMS: The purpose of this investigation was to examine the role of Latino ethnicity and Spanish-speaking families in pediatric preoperative anxiety. METHODS: Participants were 294 children aged 2-15 years of age undergoing outpatient, elective tonsillectomy and/or adenoidectomy surgery and general Anesthesia. Participants were recruited and categorized into 3 groups: English-speaking non-Latino White (n = 139), English-speaking Latino (n = 88), and Spanish-speaking Latino (n = 67). Children's anxiety was rated at 2 time points before surgery: the time the child entered the threshold of the operating room (Induction 1) and the time when the Anesthesia Mask was placed (Induction 2). RESULTS: Results from separate linear regression models at Induction 1 and Induction 2, respectively, showed that being from a Spanish-speaking Latino family was associated with higher levels of preoperative anxiety compared with being from an English-speaking family. In addition, young age and low sociability was associated with higher preoperative anxiety in children. CONCLUSION: Clinicians should be aware that younger, less sociable children of Spanish-speaking Latino parents are at higher risk of developing preoperative anxiety and manage these children based on this increased risk.
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Parental Auricular Acupuncture as an Adjunct for Parental Presence during Induction of Anesthesia
Anesthesiology, 2004Co-Authors: Shu-ming Wang, Inna Maranets, Megan E. Weinberg, Alison A. Caldwell-andrews, Zeev N. KainAbstract:BACKGROUND: The purpose of this study was to determine whether parental auricular acupuncture reduces parental preoperative anxiety and thus allows children to benefit from parental presence during induction of Anesthesia. METHODS: Mothers of children who were scheduled to undergo surgery were randomly assigned to an acupuncture intervention group (auricular press needles at relaxation, tranquilizer point, and master cerebral point) or a sham acupuncture control group (auricular press needles at the shoulder, wrist, and extraneous auricular point). The intervention was performed at least 30 min before the child's induction of Anesthesia. All mothers were present during induction of Anesthesia. The behavioral and physiologic anxiety of mothers and children were rated during the perioperative process. RESULTS: : Multivariable analysis examining maternal anxiety as a function of group found a group-by-time interaction (F1,65 = 4.1, P = 0.04). That is, after induction, maternal anxiety in the acupuncture group was significantly lower (42.9 +/- 10 vs. 49.5 +/- 11; P = 0.014). A multivariate model (F1,65 = 4.8, P =0.031) also showed that children whose mothers received the acupuncture intervention were significantly less anxious on entrance to the operating room (34.9 +/- 20 vs. 47.4 +/- 26; P = 0.03) and during introduction of the Anesthesia Mask (38.6 +/- 25 vs. 55.6 +/- 31; P = 0.016). There were no significant differences in maternal blood pressure and heart rate between the two groups. CONCLUSIONS: : Auricular acupuncture significantly decreased maternal anxiety during the preoperative period. Children of mothers who underwent acupuncture intervention benefitted from the reduction of maternal anxiety during the induction of Anesthesia.
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Sensory stimuli and anxiety in children undergoing surgery: a randomized, controlled trial.
Anesthesia & Analgesia, 2001Co-Authors: Zeev N. Kain, Shu-ming Wang, Linda C. Mayes, Dawn M. Krivutza, Barbara A. TeagueAbstract:UNLABELLED: We assessed the effectiveness of a behavioral intervention aimed at reducing the anxiety of children undergoing Anesthesia and surgery. The intervention consisted of dimmed operating room (OR) lights (200 Lx) and soft background music (Bach's "Air on a G String," 50-60 dB). Only one person, the attending anesthesiologist, interacted with the child during the induction of Anesthesia. Children undergoing Anesthesia and surgery were randomly assigned either to a low sensory stimulation group (LSSG, n = 33) or to control group (n = 37). By using validated behavioral measures of anxiety (mYPAS) and compliance (ICC), children were evaluated at the preoperative holding area and during the induction of Anesthesia. On postoperative Days 1, 2, 3, 7, and 14, the behavioral recovery of the children was assessed by using the Post Hospitalization Behavior Questionnaire. We found that the LSSG was significantly less anxious compared with the control group on entrance to the OR (P = 0.03) and on the introduction of the Anesthesia Mask (P = 0.003). Also, the compliance during the induction of Anesthesia was significantly better in children assigned to the LSSG (P = 0.02). The incidence of postoperative behavioral changes, however, did not differ significantly between the two groups (P = ns). We conclude that children who are exposed to low-level sensory stimuli during the induction of Anesthesia and who are exposed to background music exhibit lower levels of anxiety and increased compliance. IMPLICATIONS: Children are less anxious and show increased compliance during induction when exposed to a single care-provider in a dimmed, quiet operating room with background music.
M. B. Hershenson - One of the best experts on this subject based on the ideXlab platform.
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Changes in the contribution of the rib cage to tidal breathing during infancy.
The American review of respiratory disease, 1990Co-Authors: M. B. Hershenson, Andrew A. Colin, Mary Ellen B. Wohl, Ann R. StarkAbstract:As the shape, compliance, and deformability of the rib cage (RC) change during infancy, RC participation in quiet breathing may increase. We used respiratory inductive plethysmography (RIP) to determine the relative contributions of the RC and abdomen (AB) to tidal volume (Vt) in 20 studies in 14 healthy infants 1 to 26 months of age during quiet natural sleep. RIP was calibrated with simultaneous flow measurements (Anesthesia Mask and pneumotachograph) by the least squares method of statistical analysis. We analyzed segments of breathing with and without flow measurement for RIP-derived Vt, change in RC volume (Vrc) and AB volume (Vab) with each breath and the RC contribution to tidal breathing (%RC = Vrc/Vrc + Vab). The %RC increased with age: %RC = 1.4 age (months) + 33 (r = 0.69, p < 0.01). After 9 months of age, %RC resembled that found in quietly sleeping adolescents. Mask placement increased Vt in all but one subject (mean increase, 29 ± 23% of baseline ± SD; p < 0.001, paired t test). In infants y...
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Changes in the contribution of the rib cage to tidal breathing during infancy.
The American review of respiratory disease, 1990Co-Authors: M. B. Hershenson, Andrew A. Colin, Mary Ellen B. Wohl, Ann R. StarkAbstract:As the shape, compliance, and deformability of the rib cage (RC) change during infancy, RC participation in quiet breathing may increase. We used respiratory inductive plethysmography (RIP) to determine the relative contributions of the RC and abdomen (AB) to tidal volume (VT) in 20 studies in 14 healthy infants 1 to 26 months of age during quiet natural sleep. RIP was calibrated with simultaneous flow measurements (Anesthesia Mask and pneumotachograph) by the least squares method of statistical analysis. We analyzed segments of breathing with and without flow measurement for RIP-derived VT, change in RC volume (Vrc) and AB volume (Vab) with each breath and the RC contribution to tidal breathing (%RC = Vrc/Vrc + Vab). The %RC increased with age: %RC = 1.4 age (months) + 33 (r = 0.69, p less than 0.01). After 9 months of age, %RC resembled that found in quietly sleeping adolescents. Mask placement increased VT in all but one subject (mean increase, 29 +/- 23% of baseline +/- SD; p less than 0.001, paired t test). In infants younger than 10 months of age, Mask placement also increased %RC (without Mask, 40 +/- 9%; with Mask, 46 +/- 10% p less than 0.02). We conclude that by 1 yr of age, the RC contribution to tidal breathing during quiet sleep is similar to that of the adolescent, suggesting that major developmental changes in RC shape, compliance, and deformability take place during infancy.
