CHEST 2008: New research in pediatric chest medicine

October 28, 2008


(Monday, October 27, 2:30 PM EST)

Health-care utilization for children with asthma changes with the seasons, peaking in the fall. Using data from the United Healthcare database, researchers from the University of North Carolina reviewed health-care utilization patterns and asthma medication usage in children aged 2 to 5 years and 6 to 12 years from 2002 to 2004. Results showed that health-care utilization was minimal in the summer; however, September consistently served as a point of inflection for health-care utilization for both age groups. In October and November, peak emergency department visits for the two age groups were approximately 2.4 to 2.8 times higher than in July; outpatient visits were approximately 3.1 to 3.3 times higher; and hospitalizations were approximately 3.7 to 5.6 times higher. Asthma controller and reliever medications claims increased beginning in September and peaked in December. Rates for health-care use and claims for asthma medications also were elevated in February.


(Tuesday, October 28, 1:00 PM EST)

Swimming may be an effective intervention for children with asthma. Taiwanese researchers followed 30 children with asthma to investigate the effects of a 6-week swimming intervention on pulmonary function testing (PFT), peak expiratory flow monitoring (PEFM), and the severity of asthma (SOA). Twenty boys and 10 girls were randomly assigned to receive regular asthma treatment combined with a 6-week swimming training (experimental group) or regular asthma treatment alone (control group). Compared with the control group, the experimental group showed significant improvements in PEFM and SOA. These results suggest that swimming may be an effective nonpharmacologic intervention for children with asthma.


(Wednesday, October 29, 1:00 PM EST)

New research shows that virgin coconut oil (VCO) may be an effective adjunct therapy for treating pediatric community-acquired pneumonia (CAP). Researchers from the Philippines divided 40 children with CAP into two treatment groups. Group A (VCO group) received IV ampicillin plus 2 mL/kg/day of VCO orally, taken for a maximum period of 3 days, and group B (control group) received IV ampicillin alone. The respiratory rate of the VCO group normalized significantly earlier than the control group. In addition, after 72 hours, more patients in the control group were still noted to have crackles compared with the VCO group. VCO supplementation also resulted in a quicker time to normalize temperature and oxygen saturation, and a shorter time of hospitalization, than in the group receiving IV ampicillin alone.


(Wednesday, October 29, 1:00 PM EST)

Physicians may be reluctant to order overnight polysomnography studies in children because of the high cost of the examination or the anxiety that is induced by separating the child from his or her family. New research shows that body mass index (BMI) in children may predict whether they have obstructive sleep apnea (OSA), which would then warrant overnight polysomnography. Researchers from East Tennessee State University performed a retrospective review of 158 pediatric patients who were tested for OSA in a pediatric sleep lab. Of the patients, 129 had a positive test result for OSA. Of the 129 patients who were positive for OSA, 117 fell in the <5th percentile for bmi or>95th percentile for BMI. Researchers speculate that for children in these two percentile groupings, overnight polysomnography may be warranted to diagnose OSA.

American College of Chest Physicians

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