Browsing by Author "Namboodiripad, Aparna"
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Publication High flow nasal cannula therapy in Children with Acute Respiratory Distress – A Prospective Observational study(Perinatal Society of Nepal (PESON), 2025) Ajith, Divya; Namboodiripad, AparnaAbstract: Introduction: Acute respiratory distress (ARD) is one of the most common causes for PICU admission among children. Though invasive mechanical ventilation is an effective respiratory support, it has many adverse effects. Hence newer modes of less invasive methods have been studied. High Flow Nasal Cannula therapy (HFNC) is a new mode of respiratory support which can efficiently deliver heated and humidified gas at very high flow rates. The studies on HFNC therapy in paediatric population is limited, but it is being used in many PICUs effectively for various indications. The aim of this study is to elucidate the clinical profile and outcome of HFNC therapy as a primary modality of treatment in children with ARD. Methods: Children aged one month to 14 years with ARD requiring HFNC respiratory support during PICU admission were recruited for the study. Demographics, clinical parameters, HFNC setting and outcome of HFNC therapy was documented in a proforma. Results: 144 children with ARD were assessed, of which 130 (90.3%) responded successfully to HFNC therapy, and 14 (9.7%) required more invasive support. Indications that required HFNC support included pneumonia (43.1%), bronchiolitis (31.2%), reactive airway disease (25%) and tracheal web (0.69%). Most HFNC failures happened in children with pneumonia (16.1% of all pneumonia cases). Conclusions: For children experiencing respiratory distress, HFNC is a primary respiratory support method that is both safe and effective. Children who respond well to HFNC exhibit a positive clinical response in the first few Correspondence hours.Publication Validation of the Paediatric Asthma Score (PAS) in Evaluation of Acute Exacerbation of Asthma in Children(Nepal Paediatric Society (JNPS), 2023) Jose, Joswin K; Namboodiripad, AparnaAbstract: Introduction: Assessing the severity of acute asthma objectively is important to guide treatment. Peak Expiratory Flow Rate (PEFR) is used for this. Paediatric Asthma Score (PAS) is a user-friendly asthma score in children. Our aim was to validate the efficacy of PAS in comparison with PEFR for assessing severity of acute asthma. Methods: The study included 32 children in the age group of five to 14 years, with mild to moderate asthma exacerbation. The PEFR and the PAS were measured before treatment, 15 min, 30 min, and one hour after treatment, and at discharge. Paired t-test was used to establish construct validity by comparing pre-and post-treatment PEFR and PAS. The criterion validity was calculated by correlating pre-and post-treatment PASs with PEFRs. Results: The mean predicted PEFR improved with treatment by 22.35% (p < 0.001) by one hour. Pre- and post-treatment PASs significantly correlated with PEFRs. The correlation of pre-treatment PEFR and PAS was r = -0.491 (p = 0.004), that for post-treatment at 1hour was r = -0.505 (p = 0.003). Conclusions: The study validities the PAS as a measure of severity of asthma. The PAS is thus a simple alternative to the PEFR to estimate airway obstruction in children within the age group to five to 14 years with acute asthma exacerbations.