Respiratory Function In Children Research Articles

Effectiveness of balloon therapy versus incentive spirometry in promotion of respiratory function in children with lower respiratory tract diseases in selected hospitals Lucknow, Uttar Pradesh

Background: Lower respiratory tract infections (LRTIs) are one of the most common infections that affect children’s respiratory systems it develops when the lung, specifically the lower airways become infected. The present study aims that breathing exercise helps to strengthen the children’s lungs and help to reduce the severity of respiratory sign and symptoms. So, balloon breathing exercises will be more acceptable among children. Methods: A quasi-experimental study was conducted among 60 children diagnosed with LRTI at selected hospitals, Lucknow by using a convenient sampling technique. The clinical respiratory score scale (CRS), PedsQL (Multidimensional fatigue scale) was used to measure respiratory parameter and level of fatigue. Written permission was obtained from the authorities of Balrampur hospital and Vivekananda polyclinic and institute of medical sciences, Lucknow where the study was conducted. Results: Data were analyzed by using descriptive and inferential statistics. All p values less than 0.05 were treated as significant.0.83±0.61 of the children in the experimental group and 0.93±0.88 in the control group and a p=0.536. This illustrates that overall CRS had no significant difference and results of comparison of the experimental and control group -4.0625±6.86765, -4.0517±3.93027 respectively. P=0.994 which is not statistically different. Conclusions: The study concluded that as per the present research study data, balloon therapy was found to be effective. Hence, the present research hypothesis (H1, H2, H3) is accepted.

Retracted: Influences of Airway Obstruction Caused by Adenoid Hypertrophy on Growth and Development of Craniomaxillofacial Structure and Respiratory Function in Children

Retracted: Influences of Airway Obstruction Caused by Adenoid Hypertrophy on Growth and Development of Craniomaxillofacial Structure and Respiratory Function in Children

The Effect of Family-Centered Smoking Cessation Counseling on the Respiratory Function of Asthmatic Children With a Smoker in the Family Referred to Besat Hospital Children’s Clinic, Sanandaj in 2019

Background: Asthma is the most prevalent allergic respiratory condition and may be triggered by tobacco smoke. The aim of the present study was to investigate the effect of family-centered counseling on the respiratory function of children with asthma referred to the pediatric clinic of Besat hospital, Sanandaj in 2019. Materials and Methods: The present randomized quasi-experimental study was performed on 60 children with asthma from a smoking family who were referred to the pediatric clinic of Besat hospital in Sanandaj. The participants were placed into comparison and intervention groups (30 per group). No intervention was performed in the comparison group, and they only received general education by a specialist doctor. The intervention group received family-centered smoking cessation counseling. The child’s forced expiratory volume in the first second (FEV1) level was measured before and three months after the intervention, and clinical symptoms, including daily cough, night cough, sputum production, wheezing, and dyspnea, were determined before, one, and three months after the intervention in both groups. Finally, the results were compared between the two groups. Results: The results showed that clinical symptoms (daily cough, wheezing, and dyspnea) decreased, while FEV1 increased in the intervention group compared to the comparison group, and the difference was significant (P<0.05). The amount of sputum production and night cough decreased in both groups, and the decrease was higher in the intervention group, but it was not statistically significant. Conclusion: According to the results, it is recommended that intervention strategies such as family-centered counseling be adopted to stop smoking and improve clinical symptoms in children with asthma.

Influences of Airway Obstruction Caused by Adenoid Hypertrophy on Growth and Development of Craniomaxillofacial Structure and Respiratory Function in Children.

Adenoid hypertrophy (AH) is a common disease in otorhinolaryngology. Children with chronic snoring and hypoxia are susceptible to long-term nasal obstruction, while long-term open-mouth breathing may cause craniofacial bone development disorders and dull facial expressions, the so-called adenoid face. The purpose of this work is to analyze the influence of AH-induced airway obstruction (AO) on the growth and development of craniomaxillofacial structure and respiratory function (RF) in children. The clinical data of 56 AH children (observation group) and 42 healthy children with physical examination (control group) who visited the Hebei Eye Hospital during the same period were retrospectively analyzed. All children received acoustic rhinometry and X-ray cephalometric measurements. The upper airway structure, sleep disorder score, and A/N value of nasopharyngeal lateral X-ray images were compared between cases and controls. For AH children, sleep tests were also performed to assess their RF. X-ray cephalometric measurements of facial morphology showed obvious vertical growth, mandibular retrognathia, and enlarged mandibular angle in AH children. AH mainly affects the size of the nasopharyngeal and oropharyngeal airway. AH children presented with higher nasal airway resistance (5.11 ± 1.95 cmH2O/L min) and lower nasopharyngeal volume (NPV) (16.86 ± 3.93 cm3) than controls. Of the AH children, 45 had abnormal RF, including 4 with obstructive sleep apnea syndrome. The A/N value of nasopharyngeal lateral X-ray images was significantly higher in AH children than in controls. Besides, worse sleep quality was found in AH children. The above differences were all of statistical significance. The above indicates that AH can affect the size of the nasopharyngeal and oropharyngeal airway, change children's respiratory mode and RF, increase nasal resistance, and decrease NPV, resulting in upper respiratory tract stenosis, as well as craniomaxillofacial and oral malformations, which affects children's normal growth and development.

Nasal respiratory function in children with bronchial asthma and obesity

Nasal respiratory function in children with bronchial asthma and obesity

Changes in Respiratory Function in Asthma Patients using Respiratory Inspiration Muscle Exercise: Literature Review

Asthma is characterized by narrowing and inflammation of the bronchi, with symptoms of dyspnea, fatigue, and limited activity. This study aims to explain the effect of respiratory inspiratory muscle training on changes in respiratory function based on the results of previous studies. This study was compiled based on a literature review that came from the databases: PubMed, springer link, and google scholar which were selected based on the inclusion criteria that have been set. From 272 articles found, only 6 articles deserve to be reviewed. The results of the review stated that respiratory inspiratory muscle exercise had an effect on changes in respiratory function in asthmatic patients with a very significant significance value. Changes provided by inspiratory muscle training are related to respiratory muscle strengthening which reduces respiratory stimulus and ventilation requirements for a given workload, contributing to more efficient breathing patterns and decreased perception of dyspnea. Inspiratory respiratory muscle exercise, either done alone or in combination with other respiratory rehabilitation programs, can increase the strength of the respiratory muscles so as to have an improved impact on the respiratory function of children with asthma from children to adults.

Lung-Adapted Staphylococcus aureus Isolates With Dysfunctional Agr System Trigger a Proinflammatory Response.

Staphylococcus aureus dominates the lung microbiota of children with cystic fibrosis (CF) and persistent clones are able to establish chronic infection for years, having a direct deleterious impact on lung function. However, in this context, the exact contribution of S. aureus to the decline in respiratory function in children with CF is not elucidated. To investigate the contribution of persistent S. aureus clones in CF disease, we undertook the analysis of sequential isogenic isolates recovered from 15 young CF patients. Using an air-liquid infection model, we observed a strong correlation between S. aureus adaption in the lung (late isolates), low toxicity, and proinflammatory cytokine secretion. Conversely, early isolates appeared to be highly cytotoxic but did not promote cytokine secretion. We found that cytokine secretion was dependent on staphylococcal protein A (Spa), which was selectively expressed in late compared to early isolates as a consequence of dysfunctional agr quorum-sensing system. Finally, we demonstrated the involvement of TNF-α receptor 1 signaling in the inflammatory response of airway epithelial cells to these lung-adapted S. aureus isolates. Our results suggest an unexpected direct role of bacterial lung adaptation in the progression of chronic lung disease by promoting a proinflammatory response through acquired agr dysfunction.

Respiratory Oscillometry in Newborn Infants: Conventional and Intra-Breath Approaches.

BackgroundOscillometry has been employed widely as a non-invasive and standardized measurement of respiratory function in children and adults; however, limited information is available on infants.AimsTo establish the within-session variability of respiratory impedance (Zrs), to characterize the degree and profile of intra-breath changes in Zrs and to assess their impact on conventional oscillometry in newborns.Methods109 healthy newborns were enrolled in the study conducted in the first 5 postpartum days during natural sleep. A custom-made wave-tube oscillometry setup was used, with an 8–48 Hz pseudorandom and a 16 Hz sinusoidal signal used for spectral and intra-breath oscillometry, respectively. A resistance-compliance-inertance (R-C-L) model was fitted to average Zrs spectra obtained from successive 30-s recordings. Intra-breath measures, such as resistance (Rrs) and reactance (Xrs) at the end-expiratory, end-inspiratory and maximum-flow points were estimated from three 90-s recordings. All natural and artifact-free breaths were included in the analysis.ResultsWithin-session changes in the mean R, C and L values, respectively, were large (mean coefficients of variation: 10.3, 20.3, and 26.6%); the fluctuations of the intra-breath measures were of similar degree (20–24%). Intra-breath analysis also revealed large swings in Rrs and Xrs within the breathing cycle: the peak-to-peak changes amounted to 93% (range: 32–218%) and 41% (9–212%), respectively, of the zero-flow Zrs magnitude.DiscussionIntra-breath tracking of Zrs provides new insight into the determinants of the dynamics of respiratory system, and highlights the biasing effects of mechanical non-linearities on the average Zrs data obtained from the conventional spectral oscillometry.

Randomised controlled trial of nebulised gentamicin in children with bronchiectasis.

AimFollowing trials of inhaled antibiotics in adults, this study investigates the efficacy of nebulised gentamicin to improve respiratory function in children with bronchiectasis.MethodsThis is a randomised, double‐blind, placebo‐controlled, crossover trial of 12‐week nebulised placebo/gentamicin, 6‐week washout, 12‐week gentamicin/placebo. Participants were children (5–15 years) with bronchiectasis, chronic infection (any pathogen), and able to perform spirometry from a hospital bronchiectasis clinic. Primary outcomes were change in forced expiratory volume in 1 s (FEV1) and hospitalisation days. Secondary outcomes included sputum bacterial density, sputum inflammatory markers, additional antibiotics and symptom severity. Analyses were on an intention‐to‐treat basis.ResultsFifteen children (mean 11.7‐years‐old) completed the study. There was no significant change in mean FEV1 (56%/55%, P = 0.38) or annual rate of hospital admissions (1.1/0, P = 0.12) between gentamicin and placebo, respectively. However, Haemophilus influenzae sputum growth (27% vs. 80%, P = 0.002) and bacterial density (2.4 log10 cfu/mL lower P < 0.001) improved with gentamicin. Sputum inflammatory markers interleukin‐1β (P < 0.001), interleukin‐8 (P < 0.001) and tumour necrosis factor‐α (P = 0.003) were lower with gentamicin. Poor recruitment limited study power and treatment adherence was challenging for this cohort.ConclusionsIn this crossover study of nebulised gentamicin in children with bronchiectasis, there was a reduction in sputum bacterial density and inflammation. However, there were no major improvements in clinical outcomes and adherence was a challenge.

Effects of additional inspiratory muscle training on mobility capacity and respiratory strength for school-children and adolescents with cerebral palsy: a randomized controlled trial

BackgroundChildren and adolescents with cerebral palsy often have poor respiratory function, which is often not addressed. ObjectiveTo examine if adding inspiratory muscle training to sensorimotor exercises would improve mobility capacity and respiratory function in children and adolescents with cerebral palsy. MethodsForty school-children and adolescents with cerebral palsy aged 8–15 years with Gross Motor Function Classification System I–III, participated in this randomized controlled trial. The experimental group received 45 min of sensorimotor physical therapy in addition to 15 min of inspiratory muscle training for 18 sessions over six weeks. In contrast, the control group received 45 min of sensorimotor training session, three times a week over six weeks. The primary outcome measure was the six-minute walk test. The secondary outcome measures were maximal inspiratory and maximal expiratory pressure, as well as pulmonary function tests. ResultsTime by group interaction showed no statistical significance between the groups in any outcome measures except for peak expiratory flow. The mean difference of 9.6 cm H2O (95% CI: 2.3, 16.8) in the MIP from baseline to 2-month follow-up supports the experimental intervention. Post-training, the between-group mean difference was 19.8 (95% CI: -18.0, 57.6) meter in the six-minute walk test. ConclusionAdding inspiratory muscle training to sensorimotor physical therapy did not impact mobility capacity in children and adolescents with cerebral palsy.

Особенности функции внешнего дыхания у детей с внебольничной пневмонией

Актуальность. Новые возможности улучшения функции внешнего дыхания (ФВД) связаны с применением высокочастотной осцилляции грудной клетки (ВЧОГК), которая позволяет восстановить дренаж бронхиального дерева и оптимизировать легочную вентиляцию. Цель исследования — изучение и оценка ФВД у детей с внебольничной пневмонией (ВП). Материалы и методы. Проведено обследование 107 детей (основная группа (ОГ) — 55 человек и контрольная группа (КГ) — 52 человека) в возрасте 6–17 лет с ВП с острым и неосложненным течением. Дети ОГ получали базисную терапию (БТ) с проведением процедур ВЧОГК, тогда как дети КГ получали исключительно БТ. Исследовали ФВД в динамике лечения, применяя спирометрию. Результаты. В начале терапии ВП показатели ФВД в исследуемых группах имели несущественные различия. При анализе параметров ФВД у детей ОГ на 10-й день БТ отмечено повышение объема форсированного выдоха за 1-ю секунду (ОФВ1) (88,36 ± 1,55 %, p = 0,02), жизненной емкости легких (ЖЕЛ) (88,18 ± 1,53 %, p = 0,02), форсированной жизненной емкости легких (ФЖЕЛ) (86,77 ± 1,37 %, p = 0,03), максимальной объемной скорости воздуха на уровне выдоха 25 % (МОШ25) (90,10 ± 2,99 %, p = 0,02) и максимальной вентиляции легких (МВЛ) (88,31 ± 1,70 %, p = 0,04). Сравнивая показатели ФВД детей КГ, выявили менее выраженную динамику, в частности, ОФВ1 (81,65 ± 2,44 %), ЖЕЛ (82,95 ± 2,56), ФЖЕЛ (80,85 ± 2,09), МОШ25 (82,63 ± 3,08 %) и МВЛ (85,65 ± 1,99 %). При проведении ROC-анализа динамика восстановления ФВД у детей ОГ более заметна за счет улучшения МВЛ, о чем свидетельствует самая большая площадь под кривой ROC (ППК) — 0,99, ОФВ1 — ППК 0,94 и ОФВ1/ФЖЕЛ — ППК 0,94. У детей КГ была менее выражена динамика исследуемых параметров ФВД, что подтверждается МВЛ — ППК 0,63, ОФВ1 — ППК 0,79 и ОФВ1/ФЖЕЛ — ППК 0,89. Выводы. Для улучшения вентиляционной функции легких у детей с ВП необходимо проводить процедуры бронходренажа, используя ВЧОГК в составе БТ, о чем свидетельствуют полученные положительные результаты спирометрии.

Respiratory function in children with nephrotic syndrome: Comparative evaluation of impulse oscillometry and spirometry.

To evaluate the respiratory functions of children with nephrotic syndrome (NS) by impulse oscillometry (IOS) and its correlation with spirometry. Fifty-five NS patients aged 3-18 years were included as the study group and 40 healthy children of the same age formed the control group. Patients were divided into nephrotic phase (first attack and relapse) and remission. Demographic, anthropometric, and laboratory data of the children were recorded. Respiratory functions were evaluated by IOS and spirometry. Children over 6-years old performed both IOS and spirometry while children under 6 years performed only IOS. The R (R5%, R10%, R5-20), AX and Z5% values of IOS in patients with nephrotic phase were higher than remission patients and control group while spirometry indices of PEF% and MEF25-75% were lower. Z scores of MEF25-75 were significantly negatively correlated with z scores of R5, R10, Z5, and Fres while they were significantly positively correlated with z scores of X values (5, 10, 15, and 20 Hz). Z scores of forced expiratory volume in 1 /forced vital capacity significantly negatively correlated with z scores of R values (R5, R10), Z5 and AX and positively correlated with z scores of X values (X5, X10, X15 Hz). Our study demonstrated that respiratory functions measured by IOS and spirometry were affected at the time of nephrotic phase in NS patients. IOS, a novel method easily applicable even in small children, is a potentially valuable tool to detect this condition; given its good correlation with spirometry.

АНАЛИЗ АССОЦИАЦИИ ПОЛИМОРФИЗМА ADRB2 ГЕНА И ФУНКЦИИ ВНЕШНЕГО ДЫХАНИЯ У ДЕТЕЙ С БРОНХИАЛЬНОЙ АСТМОЙ

Objectives. To study the role of the ADRB2 gene polymorphism (rs1042713) in the impaired external respiratory function in children with bronchial asthma (BA). Material and methods. The study group included 60 children aged 3-17 years with allergic (n=37) and mixed form of BA (n=23). The genotyping of the investigated gene locus was performed by PCR-RFLP (polymerase chain reaction - restriction fragment length polymorphism), BA control was exercised using the Asthma Control Test (ACT). Results. The analysis of allele frequencies showed an association of allele A with normal spirogram parameters in patients with BA (p=0.042). In children under 12 years, there were statistically significant differences in spirogram indices when comparing patients with genotypes AA and GG (p=0.045). An association of allele A with the absence of pathological changes was revealed when evaluating the results of spirometry (p=0.021). There was a moderate positive correlation (r=0.615, p=0.011) between the assessment of nocturnal symptoms (Asthma Control Test) and the genotype of the ADRB2 gene polymorphism in children aged 12 years and older. Conclusions. An association of the ADRΒ2 gene polymorphism (rs1042713) with the external respiratory function was revealed in an objective study by spirometry and a subjective assessment of this indicator by the patient himself/herself or by his/her parents. This gene locus can be included in the BA target panel in order to determine the likelihood of uncontrolled course development of the disease with impaired external respiratory function and in the future to develop an individual program for dispensary observation of the patient.

SMA - CLINICAL: P.92 Comparing motor and respiratory function in SMA Type1 treated with Nusinersen using CHOP INTEND(CHOP) & Great Ormond Street Respiratory Score(GSR)

There is limited data comparing motor and respiratory function in children with SMA1 on Nusinersen (NUS). As NUS is becoming available for a wider SMA population, more information on the correlation between these two crucial aspects of patient response is needed. Aim of the study: to correlate respiratory and motor function of SMA1 children on NUS SMA1 patients were assessed using the CHOP functional assessment, a monitoring tool for motor function, and the GSR, an objective respiratory assessment tool for children with SMA1, at 0, 2 and 22 months into treatment.

Особливості терапії секреторно-евакуаторних порушень при гострих бронхітах у дітей з порушенням функції зовнішнього дихання

Objective: to increase the efficiency and safety of the treatment of the bronchi secretory-evacuation disorders in acute bronchitis with impaired respiratory function in children by using a medication with minimal effect on the cardiovascular system. Materials and methods. Under observation were 60 children aged 6 to 11 years. 2 observation groups were formed (30 children in each group): 1st group — children receiving the Bronchipret® for 10 days with acute bronchitis with impaired respiratory function; 2nd group — children who do not receive the Bronchipret in acute bronchitis with impaired respiratory function. Results. In the group of patients taking Bronchipret®, in addition to faster clinical dynamics, according to spirography, there was an improvement in the parameters of the external respiration function, characterizing the obstructive component of the obstruction of the air flow. After therapy with Bronchipret®, normalization of the functioning of the autonomic nervous system and the predominance of eutonia were observed against the background of a decrease in the number of registration of parasympathicotonia. Conclusion. The good tolerance and safety of Bronchipret® during 7-day use in patients aged 6–11 years allows us to recommend this drug as a highly effective treatment for bronchi secretory-evacuation disorders in acute bronchitis in children. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: children, bronchitis, spirography, treatment, thyme, ivy.

Assessment of the Efficacy and Safety of Ivy Leaf (Hedera helix) Cough Syrup Compared with Acetylcysteine in Adults and Children with Acute Bronchitis.

Introduction Acute bronchitis is defined as a sudden inflammation of the bronchial tubes in the lung mainly caused by viral infection. It is characterized by a persistent cough which can be productive or dry. It is the most common disease in industrialized countries, and thus herbal expectorants enjoy a high popularity in many European countries due to their favorable risk-benefit ratio. Objective The present noninterventional study was intended to gain further data on the application of a cough syrup containing ivy leaf extract EA 575® by evaluating its efficacy and safety in children and adults with symptoms of acute bronchitis. Acetylcysteine (ACC) was chosen as comparator drug (common mono preparations). Material and Methods. The study was conducted at 25 medical practices throughout Switzerland as prospective, open, noninterventional study. Results At entry visit, all clinical assessments including coughing fits, sputum, dyspnoea, rales, severity of the diseases, and coughing quality were rated with moderate intensity in both groups. At the final visit after seven days of treatment, there was a comparable improvement in both groups for all assessments except dyspnoea and number of cough attacks which showed a higher improvement in the EA 575® group compared with ACC. Further, cough-associated sleeping disorders improved more in the EA 575® group. Both, physicians and patients described the efficacy of EA 575® comparable with acetylcysteine. Observations of the tolerability were comparable for both products. The study results indicate that ivy leaf extract might be an effective alternative to acetylcysteine with respect to the improvement of respiratory function in children and adults at a slightly better evaluation of efficacy.

Association between Asian dust exposure and respiratory function in children with bronchial asthma in Nagasaki Prefecture, Japan

BackgroundStudies on the adverse effects of Asian dust (AD) on respiratory function in children are scarce. The objective of this study was to examine the association between AD and respiratory function by measuring peak expiratory flow rates (PEFRs) in asthmatic children.MethodsThe study was carried out from March to May from 2014 through 2016. One hundred ten children with bronchial asthma were recruited from four hospitals in the Goto Islands and south Nagasaki area in Nagasaki prefecture. The parents were asked to record their children’s PEFRs every morning/evening and clinical symptoms in an asthma diary. AD was assessed from light detection and ranging data, and a linear mixed-effects model was used to estimate the effects of AD on daily PEFR. Time-stratified case-crossover analyses were performed to examine the association between AD and asthma attacks defined by reduction levels in PEFR.ResultsAD was detected on 11 days in the Goto Islands, and on 23 days in the south Nagasaki area. After adjusting for age, sex, temperature, and daily oxidants, we found a consistent association between AD and a 1.1% to 1.7% decrease in PEFR in the mornings and a 0.7% to 1.3% decrease in the evenings at a lag of 0 to 5 days. AD was not associated with the number of asthma attacks, respiratory symptoms, or other symptoms at any lag days examined.ConclusionsExposure to AD was associated with reduced PEFR, although the effects were not large enough to induce clinically apparent symptoms, in clinically well-controlled asthmatic children.

Application effect of Omaha system in the whole-path management of childhood asthma

Objective To explore the effect of Omaha system in the whole pathway management of childhood asthma. Methods A total of 120 children with asthma admitted to this hospital from January 2016 to March 2018 were selected and divided into study group and control group with 60 cases each by random number table method.The control group was given basic management, while the research group was given Omaha-based full-path management.The management effect of the two groups was compared. Results The total satisfaction rate of the two groups was significantly higher than that of the control group(P<0.05). The C-ACT score of the study group after intervention(25.82±2.06) was significantly higher than that of the control group, the levels of PEF(82.32±2.32)% and FEV1(87.66±1.74)% were significantly higher than those of the control group, and the difference between the two groups was statistically significant(P<0.05). After intervention, the C-ACT score(25.82±2.06) in the study group was significantly higher than that in the control group, and the levels of PEF(82.32±2.32)% and FEV1(87.66±1.74)% in the study group were significantly higher than those in the control group, with significant differences between the two groups(P<0.05). The scores of quality of life including emotional function(44.25±8.96), activity(25.68±4.17) and symptoms(40.43±9.29) in the study group were significantly higher than those in the control group, with a significant difference between the two groups(P<0.05). Conclusions The application of Omaha system in the whole-path management is beneficial to the control of asthma in children, significantly improve the respiratory function of children, and significantly improve their quality of life, and the management effect is good, worthy of recommendation. Key words: Childhood asthma; Full-path management; Omaha system

Clinical effect of right subaxillary small incision approach on children with congenital heart disease

Objective To analyze the clinical effect of right subaxillary small incision approach on children with congenital heart disease (CHD). Methods Eighty-six patients with CHD admitted to Henan Children′s Hospital from January 2015 to September 2017 were enrolled in this study.The patients were randomly divided into the control group and the observation group with 43 cases each group.The control group underwent sternal median incision, and the observation group underwent right subaxillary small incision.The total effective rate, incision satisfaction, general conditions of surgery (cardiopulmonary bypass time, operation time, aortic occlusion time, intraoperative blood loss), postoperative related conditions (thoracic drainage volume, postoperative monitoring time, postoperative assisted ventilation time, hospitalization time, hospitalization expenses), Wong-Baker facial expression scale (FPS-R) score, as well as the respiratory function index including the levels of peak inspiratory pressure (PIP) and alveolar-arterial oxygen pressure difference [p(A-a) (O2)]after anesthesia (T1), after operation (T2), at admission to intensive care unit (T3) and before extubation (T4) and complication rate between 2 groups were compared. Results (1)The incision satisfaction in the observation group [90.70% (39/43 cases)] was higher than that in the control group [62.79% (27/43 cases)], and the difference was statistically significant (χ2=9.382, P=0.002). (2)There was no significant difference in the the extracorporeal circulation time, operation time and aortic block time between the two groups [observation group: (68.94±8.26) min, (2.33±0.21) h, (28.79±7.32) min; control group: (67.11±9.11) min, (2.25±0.31) h, (30.02±6.88) min] (P>0.05). (3)The intraoperative blood loss [(89.87±11.25) mL] in the observation group was less than that in the control group [(105.91±31.01) mL], which difference was statistically significant (t=3.189, P=0.002). (4)Also there was significant difference in postoperative monitoring time, postoperative assisted ventilation time, hospitalization time, thoracic drainage volume and hospitalization expenses between the two groups (the observation group: postoperative monitoring time (30.55±10.39) h, postoperative assisted ventilation time [(9.68±2.19) h, hospitalization time (9.61±2.17) d, thoracic drainage volume (90.36±26.14) mL, hospitalization expenses (36 956.15±1 097.84) yuan; the control group: (41.39±9.93) h, (12.72±3.81) h, (12.33±3.15) d, (163.24±29.36) mL and (45 271.97±1 134.55) yuan] (t=4.946, 4.536, 4.663, 12.157, 34.540, all P 0.05). There was no significant difference in the complication rate between the observation group [6.98% (3/43 cases)] and the control group [4.65% (2/43 cases)] (χ2=0.000, P>0.05). Conclusions Right subaxillary small incision approach does not affect the respiratory function of children with CHD, which can improve the satisfaction of incision, reduce the amount of blood loss, accelerate postoperative recovery of children, relieve postoperative pain, and reduce the financial burden of parents.Besides, intra-operative proficient and accurate operations can reduce or avoid the occurrence of related complications and ensure the safety of surgery. Key words: Minimally invasive; Sternal median incision; Congenital heart disease; Small incision in right axillary; Child; Open surgery

Mucoactive therapy for impaired respiratory function in children with acute bronchitis

Purpose of the study. Increasing the efficiency and safety of therapy of the bronchi secretoryevacuation disorders in acute bronchitis with impaired respiratory function in children by using a medication with minimal effect on the cardiovascular system.&#x0D; Materials and methods. The study included 60 children aged 6 to 11 years, suffering from acute bronchitis for 1–2 days. Formed 2 groups of observation (30 children in each group): 1st group (main) – children receiving phytopreparation for 10 days in the complex therapy of the bronchi secretory-evacuation disorders in acute bronchitis with impaired function of external respiration; 2-nd group (comparison) – children receiving ambroxol. The dynamics of the severity of bronchitis was assessed according to the BSS scale (0–20 points).&#x0D; Results. The clinical symptoms of acute bronchitis according to the BSS scale were significantly faster and more effective in the group of children taking the herbal remedy already on the 4-th day of therapy. In the group of patients taking phytopreparation, there was an improvement in objective indicators of respiratory function according to spirography data. In children of the 1st group, the period of recovery is accompanied by the normalization of indicators of the functioning of the autonomic nervous system and the predominance of eutonia against the background of a decrease in the number of registrations of parasympathicotonia.&#x0D; Conclusions. Treatment of acute bronchitis in children using a phytopreparation normalizes the indices of autonomic regulation and functioning of the cardiovascular system, which contributes to a faster and more effective relief of clinical symptoms with the restoration of the function of external respiration.