Brigitte Fauroux - Academia.edu (original) (raw)

Papers by Brigitte Fauroux

Research paper thumbnail of Lower respiratory tract infection caused by respiratory syncytial virus: current management and new therapeutics

The Lancet. Respiratory medicine, Jan 24, 2015

Respiratory syncytial virus (RSV) is a major worldwide cause of morbidity and mortality in childr... more Respiratory syncytial virus (RSV) is a major worldwide cause of morbidity and mortality in children under five years of age. Evidence-based management guidelines suggest that there is no effective treatment for RSV lower respiratory tract infection (LRTI) and that supportive care, ie, hydration and oxygenation, remains the cornerstone of clinical management. However, RSV treatments in development in the past decade include 10 vaccines and 11 therapeutic agents in active clinical trials. Maternal vaccination is particularly relevant because the most severe disease occurs within the first 6 months of life, when children are unlikely to benefit from active immunisation. We must optimise the implementation of novel RSV therapeutics by understanding the target populations, showing safety, and striving for acceptable pricing in the context of this worldwide health problem. In this Review, we outline the limitations of RSV LRTI management, the drugs in development, and the remaining challe...

Research paper thumbnail of Practice of Noninvasive Ventilation for Cystic Fibrosis: A Nationwide Survey in France

BACKGROUND: No guidelines are available for noninvasive ventilation (NIV) for cystic fibrosis (CF... more BACKGROUND: No guidelines are available for noninvasive ventilation (NIV) for cystic fibrosis (CF). OBJECTIVE: To survey and evaluate the use of NIV for CF in France. METHODS: We surveyed the coordinator physicians of every accredited CF center in France. RESULTS: The respondents represented 36 centers (15 pediatric centers, 13 adult centers, and 8 centers that see both pediatric and adult

Research paper thumbnail of Short-term effect of winter air pollution on respiratory health of asthmatic children in Paris

The European respiratory journal, 1998

There is controversy as to whether low levels of air pollution affect the symptoms and lung funct... more There is controversy as to whether low levels of air pollution affect the symptoms and lung function in asthma. We addressed this by examining the short-term effects of winter air pollution on childhood asthma in Paris. We performed a 6 month follow-up of 84 medically diagnosed asthmatic children classified into two groups of severity. The outcomes included incidence and prevalence of asthma attacks, symptoms and use of supplementary beta2-agonists, peak expiratory flow (PEF) value and its variability. The statistical analysis controlled the lack of independence between daily health outcomes, trends and meteorology. Air pollution was associated with an increase in reports and duration of asthma attacks and asthma-like symptoms in mild asthmatic children. The strongest association was the risk of asthma attack for an increase of 50 microg x m(-3) of sulphur dioxide (SO2) on the same day (odds ratio (OR)=2.86). Maximum reduction in morning peak expiratory flow (PEF) (5%) and maximum i...

Research paper thumbnail of Chylothorax idiopathique chez l’enfant : prise en charge et évolution

Revue des Maladies Respiratoires, 2006

Research paper thumbnail of Multiple-Locus Variable-Number Tandem-Repeat Analysis for Longitudinal Survey of Sources of Pseudomonas aeruginosa Infection in Cystic Fibrosis Patients

Journal of Clinical Microbiology, 2007

Research paper thumbnail of Comparing Mycobacterium massiliense and Mycobacterium abscessus lung infections in cystic fibrosis patients

Journal of Cystic Fibrosis, 2015

Mycobacterium massiliense is closely related to Mycobacterium abscessus and is also a frequent ca... more Mycobacterium massiliense is closely related to Mycobacterium abscessus and is also a frequent cause of mycobacterial lung disease in patients with cystic fibrosis (CF). There has been no previous investigation of possible differences between M. massiliense and M. abscessus infections in the setting of CF. We studied a prospective cohort of 16 M. massiliense and 27 M. abscessus lung infection cases with CF, with a mean follow-up of 6 years. M. massiliense cases were younger than M. abscessus cases (mean age: 12.8 vs 17.1 years; p=0.02) at the time of the first mycobacterial isolation and also had lower body mass index values (mean: 16.4 vs 19.3 kg/m(2), p=0.002). All M. massiliense cases, except one, had negative BMI Z-score values at the time of the first mycobacterial isolation (11/12 vs 16/23 M. abscessus cases, p=0.04). Clarithromycin-based combination therapies led to mycobacterial eradication in 100% of M. massiliense cases but only in 27% of M. abscessus cases (p=0.009). Our data show a particular link between M. massiliense and malnutrition specifically in CF patients. Unlike M. abscessus, the bacteriological response of M. massiliense to combination antibiotic therapies containing clarithromycin was excellent. Distinguishing between M. massiliense and M. abscessus has major clinical implications for CF patients.

Research paper thumbnail of Sevrage de la ventilation mécanique (à l’exclusion du nouveau-né et du réveil d’anesthésie)

Research paper thumbnail of Sniff and Muller manoeuvres to measure diaphragmatic muscle strength

Respiratory Medicine, 2008

a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w... more a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / r m e d Respiratory Medicine (2008) 102, 1737e1743

Research paper thumbnail of Les paramètres fonctionnels respiratoires sont-ils pertinents pour prédire les anomalies des échanges gazeux nocturnes dans la mucoviscidose?

Revue Française d'Allergologie et d'Immunologie Clinique, 2006

Research paper thumbnail of Temporal Dynamics of Interferon Gamma Responses in Children Evaluated for Tuberculosis

PLoS ONE, 2009

Background: Development of T-cells based-Interferon gamma (IFNc) assays has offered new possibili... more Background: Development of T-cells based-Interferon gamma (IFNc) assays has offered new possibilities for the diagnosis of latent tuberculosis infection (LTBI) and active disease in adults. Few studies have been performed in children, none in France. With reference to the published data on childhood TB epidemiology in the Paris and Ile de France Region, we considered it important to evaluate the performance of IGRA (QuantiFERON TB Gold In TubeH, QF-TB-IT) in the diagnosis and the follow-up through treatment of LTBI and active TB in a cohort of French children.

Research paper thumbnail of Influence des polymorphismes du gène TGF- ɛ1 sur la fonction pulmonaire des patients atteints de mucoviscidose

Revue des Maladies Respiratoires, 2005

Introduction : La dégradation de la fonction respiratoire est le facteur de morbidité et de morta... more Introduction : La dégradation de la fonction respiratoire est le facteur de morbidité et de mortalité le plus important dans la mucoviscidose. L'hétérogénéité phénotypique de cette maladie suggère l'intervention de gènes modificateurs situés en dehors du locus CFTR. Étant donné le rôle clé du TGF-β dans le remodelage tissulaire, nous avons recherché une association entre des variations de production de TGF-β 1 secondaires à des polymorphismes et la variabilité de l'évolution clinique chez des patients atteints de mucoviscidose. Matériel : La population étudiée comprend 374 patients atteints de mucoviscidose. Les données phénotypiques ont été recueillies à partir des dossiers des patients. Deux polymorphismes fonctionnels du gène TGF-1 en position + 869 et -509 ont été étudiés. Méthodes : Le génotype des patients a été déterminé en utilisant une technique de discrimination allélique par méthode de fluorescence. Les taux plasmatiques de TGF-β 1 ont été déterminés par dosage ELISA chez 56 patients. Résultats : Nous avons observé des taux plasmatiques de TGF-β 1 significativement plus élevés chez les patients de génotype + 869TT par rapport aux patients + 869CT et + 869 cm 3 (p = 0,05). Ce génotype « haut producteur » + 869TT était également associé à un déclin significativement plus rapide de la fonction respiratoire avec un déclin annuel moyen du VEMS (± SD) de : -1,8 % (± 0,5) pour les patients + 869 cm 3 vs. -1 % (± 0,6) pour les patients + 869CT et -2,5 % (± 0,6) pour les patients + 869TT (p = 0,03). Aucune association significative n'a été retrouvée entre les données cliniques, les taux de TGF-β 1 et le polymorphisme en position -509. Discussion : Ces résultats démontrent une association entre la progression de l'atteinte respiratoire dans la mucoviscidose, la production de TGF-β 1 et le polymorphisme en position + 869 T/C. Dans la littérature, ce polymorphisme, décrit comme « fonctionnel » car associé à des taux variables de TGF-β 1 , a également été associé à une majoration de la fibrose pulmonaire ou à un déclin de la fonction respiratoire dans des pathologies respiratoires chroniques. Conclusion : Cette étude génétique et fonctionnelle suggère que le polymorphisme du gène TGF-1 en position + 869 influence le taux de TGF-β 1 plasmatique et prédispose à un déclin accéléré de la fonction respiratoire chez les patients atteints de mucoviscidose.

Research paper thumbnail of EMLA Cream and Nitrous Oxide to Alleviate Pain Induced by Palivizumab (Synagis) Intramuscular Injections in Infants and Young Children

PEDIATRICS, 2008

Synagis) Intramuscular Injections in Infants and Young Children EMLA Cream and Nitrous Oxide to A... more Synagis) Intramuscular Injections in Infants and Young Children EMLA Cream and Nitrous Oxide to Alleviate Pain Induced by Palivizumab http://pediatrics.aappublications.org/content/121/6/e1591.full.html located on the World Wide Web at:

Research paper thumbnail of Influence des polymorphismes du gène TGF-béta 1 sur la fonction pulmonaire des patients atteints de mucoviscidose

Revue des Maladies Respiratoires, 2006

Research paper thumbnail of Prevalence of asthma or respiratory symptoms among children attending primary schools in Paris

Pediatric Pulmonology, 1998

The objectives of this study were to determine the prevalence of chronic respiratory symptoms and... more The objectives of this study were to determine the prevalence of chronic respiratory symptoms and asthma in 8-to 9-year-old children in Paris, and to analyze their medical management. This cross-sectional study was carried out in 1994 on a randomized sample of 3,756 pupils attending Paris public primary schools.

Research paper thumbnail of A Comparison of Transcutaneous and End-tidal Measurements of CO 2 in One Lung Ventilation

Korean Journal of Anesthesiology, 2008

Research paper thumbnail of Long-term noninvasive mechanical ventilation for children at home: A national survey

Pediatric Pulmonology, 2003

Experience with domiciliary noninvasive mechanical ventilation (NIMV) in children is limited. The... more Experience with domiciliary noninvasive mechanical ventilation (NIMV) in children is limited. The aim of this study was to determine the number of patients and categorize the use of domiciliary NIMV in children in France. An anonymous cross-sectional national study was performed, using a postal questionnaire sent to all specialist centers utilizing domiciliary NIMV for chronic respiratory failure. Patients aged <18 years and receiving home NIMV were included in the study. Detailed information was obtained from 102 patients from 15 centers: 4/15 centers cared for 84% of patients; 7% of patients were under 3 years old; 35% were between 4-11 years old; and 58% were older than 12 years. Underlying diagnoses included neuromuscular disease (34%), obstructive sleep apnea (OSA) and/or cranio-facial abnormalities (30%), cystic fibrosis (17%), congenital hypoventilation (9%), scoliosis (8%), and other disorders (2%). NIMV was started because of nocturnal hypoventilation (67%), acute exacerbation (28%), and/or failure to thrive (21%). Volume-targeted ventilation was preferred in restrictive disorders (56%) and central hypoventilation (56%), while pressure support ventilation (PSV) was preferred in cystic fibrosis (71%). Patients with OSA and/or cranio-facial abnormalities were ventilated with continuous positive airway pressure (45%) or bilevel PSV (52%). In conclusion, NIMV is currently used in France for the domiciliary management of children with a variety of conditions causing chronic respiratory failure. However, NIMV in children is still performed on a small scale, and combined with the heterogeneity of the patient population, its application would best be served by centers specializing in the initiation and long-term follow-up of these patients.

Research paper thumbnail of Measurement of maximal pressures and the sniff manoeuvre in children

Paediatric respiratory reviews, 2007

Maximal static inspiratory and expiratory pressures are simple, noninvasive tests that evaluate g... more Maximal static inspiratory and expiratory pressures are simple, noninvasive tests that evaluate global inspiratory and expiratory muscle strength. But these tests may be difficult or impossible to perform in young children. The sniff is a natural maneuver which many children find easier to perform than maximal pressures. The measurement of the nasal inspiratory pressure represents a valuable inspiratory muscle test which allows the extension of inspiratory muscle testing to a younger and larger paediatric population.

Research paper thumbnail of Retrospective French nationwide survey of childhood aggressive vascular anomalies of bone, 1988-2009

Orphanet Journal of Rare Diseases, 2010

Objective: To document the epidemiological, clinical, histological and radiological characteristi... more Objective: To document the epidemiological, clinical, histological and radiological characteristics of aggressive vascular abnormalities of bone in children.

Research paper thumbnail of Optimization of aerosol deposition by pressure support in children with cystic fibrosis: an experimental and clinical study

American journal of respiratory and critical care medicine, 2000

Nebulized aerosols are commonly used to deliver drugs into the lungs of patients with cystic fibr... more Nebulized aerosols are commonly used to deliver drugs into the lungs of patients with cystic fibrosis (CF). The aim of this study was to assess the effectiveness of pressure-support (PS) ventilation in increasing aerosol deposition within the lungs of children with CF. An in vitro study demonstrated the feasibility of coupling a breath-actuated nebulizer to a PS device. An in vivo study was done with 18 children (ages 6 to 21 yr) with clinically stable CF, each of whom underwent both a standard and a PS-driven ventilation scan (control session and PS session, respectively). In addition, a perfusion scan was used to determine lung outlines and to construct a geometric model for quantifying aerosol deposition by radioactivity counting in MBq. Homogeneity of nebulization was evaluated from the four first-order moments of aerosol distribution in the peripheral and central lung regions. The time-activity nebulization curve was linear in all patients, with higher slopes during the PS than...

Research paper thumbnail of Assessing Inspiratory Muscle Strength by Sniff Nasal Inspiratory Pressure

Neurocritical Care, 2004

The sniff nasal inspiratory pressure (SNIP) consists in the measurement of pressure through an oc... more The sniff nasal inspiratory pressure (SNIP) consists in the measurement of pressure through an occluded nostril during sniffs performed through the controlateral nostril. It is an accurate and noninvasive approximation of esophageal pressure swing during sniff maneuvers. However SNIP can underestimate esophageal pressure swing in subjects with nasal obstruction, patients with chronic obstructive pulmonary disease and severe neuromuscular patients. Nevertheless, since SNIP maneuver has predicted normal values, is noninvasive and is easier to perform than maximal inspiratory pressure (MIP) maneuver, it could be considered as the first simple test to use in order to assess inspiratory muscle weakness. In addition, because it is as reproducible as MIP, it can be suitable to follow inspiratory muscle function in chronic neuromuscular patients. Because, of the important limit of agreement between SNIP and MIP, these two methods are not interchangeable but complementary.

Research paper thumbnail of Lower respiratory tract infection caused by respiratory syncytial virus: current management and new therapeutics

The Lancet. Respiratory medicine, Jan 24, 2015

Respiratory syncytial virus (RSV) is a major worldwide cause of morbidity and mortality in childr... more Respiratory syncytial virus (RSV) is a major worldwide cause of morbidity and mortality in children under five years of age. Evidence-based management guidelines suggest that there is no effective treatment for RSV lower respiratory tract infection (LRTI) and that supportive care, ie, hydration and oxygenation, remains the cornerstone of clinical management. However, RSV treatments in development in the past decade include 10 vaccines and 11 therapeutic agents in active clinical trials. Maternal vaccination is particularly relevant because the most severe disease occurs within the first 6 months of life, when children are unlikely to benefit from active immunisation. We must optimise the implementation of novel RSV therapeutics by understanding the target populations, showing safety, and striving for acceptable pricing in the context of this worldwide health problem. In this Review, we outline the limitations of RSV LRTI management, the drugs in development, and the remaining challe...

Research paper thumbnail of Practice of Noninvasive Ventilation for Cystic Fibrosis: A Nationwide Survey in France

BACKGROUND: No guidelines are available for noninvasive ventilation (NIV) for cystic fibrosis (CF... more BACKGROUND: No guidelines are available for noninvasive ventilation (NIV) for cystic fibrosis (CF). OBJECTIVE: To survey and evaluate the use of NIV for CF in France. METHODS: We surveyed the coordinator physicians of every accredited CF center in France. RESULTS: The respondents represented 36 centers (15 pediatric centers, 13 adult centers, and 8 centers that see both pediatric and adult

Research paper thumbnail of Short-term effect of winter air pollution on respiratory health of asthmatic children in Paris

The European respiratory journal, 1998

There is controversy as to whether low levels of air pollution affect the symptoms and lung funct... more There is controversy as to whether low levels of air pollution affect the symptoms and lung function in asthma. We addressed this by examining the short-term effects of winter air pollution on childhood asthma in Paris. We performed a 6 month follow-up of 84 medically diagnosed asthmatic children classified into two groups of severity. The outcomes included incidence and prevalence of asthma attacks, symptoms and use of supplementary beta2-agonists, peak expiratory flow (PEF) value and its variability. The statistical analysis controlled the lack of independence between daily health outcomes, trends and meteorology. Air pollution was associated with an increase in reports and duration of asthma attacks and asthma-like symptoms in mild asthmatic children. The strongest association was the risk of asthma attack for an increase of 50 microg x m(-3) of sulphur dioxide (SO2) on the same day (odds ratio (OR)=2.86). Maximum reduction in morning peak expiratory flow (PEF) (5%) and maximum i...

Research paper thumbnail of Chylothorax idiopathique chez l’enfant : prise en charge et évolution

Revue des Maladies Respiratoires, 2006

Research paper thumbnail of Multiple-Locus Variable-Number Tandem-Repeat Analysis for Longitudinal Survey of Sources of Pseudomonas aeruginosa Infection in Cystic Fibrosis Patients

Journal of Clinical Microbiology, 2007

Research paper thumbnail of Comparing Mycobacterium massiliense and Mycobacterium abscessus lung infections in cystic fibrosis patients

Journal of Cystic Fibrosis, 2015

Mycobacterium massiliense is closely related to Mycobacterium abscessus and is also a frequent ca... more Mycobacterium massiliense is closely related to Mycobacterium abscessus and is also a frequent cause of mycobacterial lung disease in patients with cystic fibrosis (CF). There has been no previous investigation of possible differences between M. massiliense and M. abscessus infections in the setting of CF. We studied a prospective cohort of 16 M. massiliense and 27 M. abscessus lung infection cases with CF, with a mean follow-up of 6 years. M. massiliense cases were younger than M. abscessus cases (mean age: 12.8 vs 17.1 years; p=0.02) at the time of the first mycobacterial isolation and also had lower body mass index values (mean: 16.4 vs 19.3 kg/m(2), p=0.002). All M. massiliense cases, except one, had negative BMI Z-score values at the time of the first mycobacterial isolation (11/12 vs 16/23 M. abscessus cases, p=0.04). Clarithromycin-based combination therapies led to mycobacterial eradication in 100% of M. massiliense cases but only in 27% of M. abscessus cases (p=0.009). Our data show a particular link between M. massiliense and malnutrition specifically in CF patients. Unlike M. abscessus, the bacteriological response of M. massiliense to combination antibiotic therapies containing clarithromycin was excellent. Distinguishing between M. massiliense and M. abscessus has major clinical implications for CF patients.

Research paper thumbnail of Sevrage de la ventilation mécanique (à l’exclusion du nouveau-né et du réveil d’anesthésie)

Research paper thumbnail of Sniff and Muller manoeuvres to measure diaphragmatic muscle strength

Respiratory Medicine, 2008

a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w... more a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / r m e d Respiratory Medicine (2008) 102, 1737e1743

Research paper thumbnail of Les paramètres fonctionnels respiratoires sont-ils pertinents pour prédire les anomalies des échanges gazeux nocturnes dans la mucoviscidose?

Revue Française d'Allergologie et d'Immunologie Clinique, 2006

Research paper thumbnail of Temporal Dynamics of Interferon Gamma Responses in Children Evaluated for Tuberculosis

PLoS ONE, 2009

Background: Development of T-cells based-Interferon gamma (IFNc) assays has offered new possibili... more Background: Development of T-cells based-Interferon gamma (IFNc) assays has offered new possibilities for the diagnosis of latent tuberculosis infection (LTBI) and active disease in adults. Few studies have been performed in children, none in France. With reference to the published data on childhood TB epidemiology in the Paris and Ile de France Region, we considered it important to evaluate the performance of IGRA (QuantiFERON TB Gold In TubeH, QF-TB-IT) in the diagnosis and the follow-up through treatment of LTBI and active TB in a cohort of French children.

Research paper thumbnail of Influence des polymorphismes du gène TGF- ɛ1 sur la fonction pulmonaire des patients atteints de mucoviscidose

Revue des Maladies Respiratoires, 2005

Introduction : La dégradation de la fonction respiratoire est le facteur de morbidité et de morta... more Introduction : La dégradation de la fonction respiratoire est le facteur de morbidité et de mortalité le plus important dans la mucoviscidose. L'hétérogénéité phénotypique de cette maladie suggère l'intervention de gènes modificateurs situés en dehors du locus CFTR. Étant donné le rôle clé du TGF-β dans le remodelage tissulaire, nous avons recherché une association entre des variations de production de TGF-β 1 secondaires à des polymorphismes et la variabilité de l'évolution clinique chez des patients atteints de mucoviscidose. Matériel : La population étudiée comprend 374 patients atteints de mucoviscidose. Les données phénotypiques ont été recueillies à partir des dossiers des patients. Deux polymorphismes fonctionnels du gène TGF-1 en position + 869 et -509 ont été étudiés. Méthodes : Le génotype des patients a été déterminé en utilisant une technique de discrimination allélique par méthode de fluorescence. Les taux plasmatiques de TGF-β 1 ont été déterminés par dosage ELISA chez 56 patients. Résultats : Nous avons observé des taux plasmatiques de TGF-β 1 significativement plus élevés chez les patients de génotype + 869TT par rapport aux patients + 869CT et + 869 cm 3 (p = 0,05). Ce génotype « haut producteur » + 869TT était également associé à un déclin significativement plus rapide de la fonction respiratoire avec un déclin annuel moyen du VEMS (± SD) de : -1,8 % (± 0,5) pour les patients + 869 cm 3 vs. -1 % (± 0,6) pour les patients + 869CT et -2,5 % (± 0,6) pour les patients + 869TT (p = 0,03). Aucune association significative n'a été retrouvée entre les données cliniques, les taux de TGF-β 1 et le polymorphisme en position -509. Discussion : Ces résultats démontrent une association entre la progression de l'atteinte respiratoire dans la mucoviscidose, la production de TGF-β 1 et le polymorphisme en position + 869 T/C. Dans la littérature, ce polymorphisme, décrit comme « fonctionnel » car associé à des taux variables de TGF-β 1 , a également été associé à une majoration de la fibrose pulmonaire ou à un déclin de la fonction respiratoire dans des pathologies respiratoires chroniques. Conclusion : Cette étude génétique et fonctionnelle suggère que le polymorphisme du gène TGF-1 en position + 869 influence le taux de TGF-β 1 plasmatique et prédispose à un déclin accéléré de la fonction respiratoire chez les patients atteints de mucoviscidose.

Research paper thumbnail of EMLA Cream and Nitrous Oxide to Alleviate Pain Induced by Palivizumab (Synagis) Intramuscular Injections in Infants and Young Children

PEDIATRICS, 2008

Synagis) Intramuscular Injections in Infants and Young Children EMLA Cream and Nitrous Oxide to A... more Synagis) Intramuscular Injections in Infants and Young Children EMLA Cream and Nitrous Oxide to Alleviate Pain Induced by Palivizumab http://pediatrics.aappublications.org/content/121/6/e1591.full.html located on the World Wide Web at:

Research paper thumbnail of Influence des polymorphismes du gène TGF-béta 1 sur la fonction pulmonaire des patients atteints de mucoviscidose

Revue des Maladies Respiratoires, 2006

Research paper thumbnail of Prevalence of asthma or respiratory symptoms among children attending primary schools in Paris

Pediatric Pulmonology, 1998

The objectives of this study were to determine the prevalence of chronic respiratory symptoms and... more The objectives of this study were to determine the prevalence of chronic respiratory symptoms and asthma in 8-to 9-year-old children in Paris, and to analyze their medical management. This cross-sectional study was carried out in 1994 on a randomized sample of 3,756 pupils attending Paris public primary schools.

Research paper thumbnail of A Comparison of Transcutaneous and End-tidal Measurements of CO 2 in One Lung Ventilation

Korean Journal of Anesthesiology, 2008

Research paper thumbnail of Long-term noninvasive mechanical ventilation for children at home: A national survey

Pediatric Pulmonology, 2003

Experience with domiciliary noninvasive mechanical ventilation (NIMV) in children is limited. The... more Experience with domiciliary noninvasive mechanical ventilation (NIMV) in children is limited. The aim of this study was to determine the number of patients and categorize the use of domiciliary NIMV in children in France. An anonymous cross-sectional national study was performed, using a postal questionnaire sent to all specialist centers utilizing domiciliary NIMV for chronic respiratory failure. Patients aged <18 years and receiving home NIMV were included in the study. Detailed information was obtained from 102 patients from 15 centers: 4/15 centers cared for 84% of patients; 7% of patients were under 3 years old; 35% were between 4-11 years old; and 58% were older than 12 years. Underlying diagnoses included neuromuscular disease (34%), obstructive sleep apnea (OSA) and/or cranio-facial abnormalities (30%), cystic fibrosis (17%), congenital hypoventilation (9%), scoliosis (8%), and other disorders (2%). NIMV was started because of nocturnal hypoventilation (67%), acute exacerbation (28%), and/or failure to thrive (21%). Volume-targeted ventilation was preferred in restrictive disorders (56%) and central hypoventilation (56%), while pressure support ventilation (PSV) was preferred in cystic fibrosis (71%). Patients with OSA and/or cranio-facial abnormalities were ventilated with continuous positive airway pressure (45%) or bilevel PSV (52%). In conclusion, NIMV is currently used in France for the domiciliary management of children with a variety of conditions causing chronic respiratory failure. However, NIMV in children is still performed on a small scale, and combined with the heterogeneity of the patient population, its application would best be served by centers specializing in the initiation and long-term follow-up of these patients.

Research paper thumbnail of Measurement of maximal pressures and the sniff manoeuvre in children

Paediatric respiratory reviews, 2007

Maximal static inspiratory and expiratory pressures are simple, noninvasive tests that evaluate g... more Maximal static inspiratory and expiratory pressures are simple, noninvasive tests that evaluate global inspiratory and expiratory muscle strength. But these tests may be difficult or impossible to perform in young children. The sniff is a natural maneuver which many children find easier to perform than maximal pressures. The measurement of the nasal inspiratory pressure represents a valuable inspiratory muscle test which allows the extension of inspiratory muscle testing to a younger and larger paediatric population.

Research paper thumbnail of Retrospective French nationwide survey of childhood aggressive vascular anomalies of bone, 1988-2009

Orphanet Journal of Rare Diseases, 2010

Objective: To document the epidemiological, clinical, histological and radiological characteristi... more Objective: To document the epidemiological, clinical, histological and radiological characteristics of aggressive vascular abnormalities of bone in children.

Research paper thumbnail of Optimization of aerosol deposition by pressure support in children with cystic fibrosis: an experimental and clinical study

American journal of respiratory and critical care medicine, 2000

Nebulized aerosols are commonly used to deliver drugs into the lungs of patients with cystic fibr... more Nebulized aerosols are commonly used to deliver drugs into the lungs of patients with cystic fibrosis (CF). The aim of this study was to assess the effectiveness of pressure-support (PS) ventilation in increasing aerosol deposition within the lungs of children with CF. An in vitro study demonstrated the feasibility of coupling a breath-actuated nebulizer to a PS device. An in vivo study was done with 18 children (ages 6 to 21 yr) with clinically stable CF, each of whom underwent both a standard and a PS-driven ventilation scan (control session and PS session, respectively). In addition, a perfusion scan was used to determine lung outlines and to construct a geometric model for quantifying aerosol deposition by radioactivity counting in MBq. Homogeneity of nebulization was evaluated from the four first-order moments of aerosol distribution in the peripheral and central lung regions. The time-activity nebulization curve was linear in all patients, with higher slopes during the PS than...

Research paper thumbnail of Assessing Inspiratory Muscle Strength by Sniff Nasal Inspiratory Pressure

Neurocritical Care, 2004

The sniff nasal inspiratory pressure (SNIP) consists in the measurement of pressure through an oc... more The sniff nasal inspiratory pressure (SNIP) consists in the measurement of pressure through an occluded nostril during sniffs performed through the controlateral nostril. It is an accurate and noninvasive approximation of esophageal pressure swing during sniff maneuvers. However SNIP can underestimate esophageal pressure swing in subjects with nasal obstruction, patients with chronic obstructive pulmonary disease and severe neuromuscular patients. Nevertheless, since SNIP maneuver has predicted normal values, is noninvasive and is easier to perform than maximal inspiratory pressure (MIP) maneuver, it could be considered as the first simple test to use in order to assess inspiratory muscle weakness. In addition, because it is as reproducible as MIP, it can be suitable to follow inspiratory muscle function in chronic neuromuscular patients. Because, of the important limit of agreement between SNIP and MIP, these two methods are not interchangeable but complementary.