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Chapter-21 Pediatric Pulmonology

BOOK TITLE: The Short Textbook of Pediatrics

Author
1. Singh Daljit
2. Gupte Suraj
ISBN
9788184484694
DOI
10.5005/jp/books/10983_21
Edition
11/e
Publishing Year
2009
Pages
34
Author Affiliations
1. Amritsar, India, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India, G B Pant Institute of Postgraduate Medical Education and Research, New Delhi, India, GB Pant Hospital, Maulana Azad Medical College, New Delhi, India, Sri Guru Ram Das University of Health Sciences, Amritsar, Punjab, India, Govind Ballabh Pant Institute of Postgraduate, Medical Education and Research, Govind Ballabh Pant Hospital, New Delhi, India, Dr Daljit Singh Eye Hospital, 57, Joshi Colony, Amritsar-143001, India, Maulana Azad Medical College and Associated GB Pant Hospital, New Delhi, India, Dr Daljit Singh Eye Hospital, Radhaswami Road, Amritsar, India, Air Force Hospital, Kanpur, Uttar Pradesh, India, Dayanand Medical College and Hospital, Ludhiana, Punjab, India; Royal College of Paediatrics and Child Health (RCPCH), London, UK, Command Hospital (SC), Pune, Maharashtra, India, Command Hospital, Pune, Maharashtra, India, Dayanand Medical College and Hospital, Ludhiana, Punjab, e-ma
2. Mamata Medical College and General and Super Specialty Hospitals, Khammam, Telangana, India, Mamata Medical College/Mamata General and Superspeciality Hospitals, Khammam, Telangana, South India, Mamata Medical College/Mamata, General and Superspecialty Hospitals, Khammam, Telangana, India, Postgraduate Department of Pediatrics Mamata Medical College and Hospital Khammam, Andhra Pradesh, India, Mamata Medical College/Mamata General and Superspecialty Hospitals, Khammam 507002, Andhra Pradesh, India, Mamata Medical College/Mamata General and Superspecialty Hospitals, Khammam, Andhra Pradesh, India, Mamata Medical College and Hospitals, Khammam, Andhra Pradesh, India, Narayana Medical College/Narayana General and Superspeciality Hospitals, Nellore 524002, AP, South India, Narayana Medical College and Hospital, Nellore, AP, India, Narayana Medical College/Narayana General and Superspeciality Hospitals, Nellore, Andhra Pradesh (India), Children’s Health Centre, Jammu, India, Children’s Health Center, Jammu, Ja
Chapter keywords

Abstract

Indian infants and children demonstrate patterns of clinical presentation of respiratory disease. That is at variance with that seen in the west. Such factors as considerable delay in reporting to the hospital and high frequency of infestations and associated malnutrition collectively or individually result in a rather changed clinical profile. The chapter starts off with salient features of special diagnostic procedures in pediatric pulmonology, including arterial blood gas (ABG) analysis, bronchoscopy, lung biopsy and polygraphic monitoring. The last-named comprises monitoring of the heart rate, ECG, movements of chest and abdomen, arterial PCO2, and SaO2 in case of obstructive apnea and upper airway obstruction. Then follows accounts of upper respiratory infection, foreign body in lower respiratory tract, acute/adult respiratory distress syndrome, respiratory syncytial virus infections, and acute bronchitis. The common problem of acute bronchiolitis is discussed in details, touching upon such controversial issues as role of bronchodilators and steroids. There is an assertion pinpointing the probability of acute bronchiolitis as the first attack of asthma. Then follows the severe acute respiratory syndrome (SARS) which first originated from China and is a relatively mild disease in pediatric subjects compared to adults. The topic of pneumonias is dealt with in considerable details, including various classifications and therapeutic approach in nosocomial (hospital;-acquired) pneumonias. Having dealt with bronchiectasis, pleural effusion empyema thoracis and lung abscess, the text moves on to bronchial asthma. Amongst its different aspects, inhalation therapy receives special treatment. Tuberculosis is dealt with in details with special emphasis on the recommendations of the Indian Academy of Pediatrics as regards its modern treatment as also the Directly Observed Therapy DOT. Finally are given short descriptions on recurrent respiratory infections, wheezy chest, cystic fibrosis, legionellosis and drowning and near-drowning.

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