This study aimed to investigate the effects of PM10 concentrations exceeding the Thai national standard (24-hr average, >120 microg/m3) on daily reported respiratory symptoms and peak expiratory flow rate (PEFR) of schoolchildren with and without asthma in Bangkok. The 93 asthmatic and 40 nonasthmatic schoolchildren were randomly recruited from a school located in a highly congested traffic area. Daily respiratory symptoms and PEFR of each child were evaluated and recorded in the diary for 31 successive school days. During the study period, 24-hr average PM10 levels ranged between 46-201 microg/m3. PM10 levels exceeded 120 microg/m3 for 14 days. We found that when PM10 levels were >120 microg/m3, the daily reported nasal irritation of asthmatic children was significantly higher than when PM10 levels were < or =120 microg/m3. In addition, when PM10 levels were >120 microg/m3, nonasthmatic children had a significantly higher daily reported combination of any respiratory symptoms. PEFR did not change with different ambient PM10 levels in both groups. This study suggests that elevated levels of PM10 concentrations in Bangkok affect respiratory symptoms of schoolchildren with and without asthma.

The number of children requiring long-term ventilation support is increasing in many countries around the world. Children benefit from being mechanically ventilated at home rather than staying in the hospital for a longer period of time. Here, we have reviewed the related literatures and guidelines on pediatric home mechanical ventilation and shared our experience in Thailand, where there is no federal or insurance coverage for home care. An economic approach has been taken that includes using less expensive ventilators, training non-professional family caregivers, and seeking funding resources. We also report on the favorable outcome of a program we started in 1995. Of 148 children, 95 (64.2 %) have used noninvasive ventilators, 128 (86.5 %) survive, 20 (13.5 %) were weaned off, only four (2.7 %) died unexpectedly. We hope that this model approach may be useful in some areas with similar difficulties. Keywords Chronic respiratory failure Á Respiratory insufficiency Á Home mechanical ventilation Á Long-term mechanical ventilator Á BPAP Á CPAP

This study was designed to evaluate further the effect of prone positioning on oxygen saturation (SpO2) and respiratory mechanics in spontaneously breathing infants with pneumonia. SpO2 and respiratory mechanics were measured in the supine and prone positions in 17 infants. Prone positioning resulted in statistically significant increases in mean (+/- SD) SpO2 (95.52+/-2.87 to 98.00+/-2.40%, p = 0.0002) and respiratory system compliance (5.99+/-2.52 to 7.93+/-4.30 ml/cm H2O, p = 0.02). This suggests that prone positioning is another beneficial supportive measure for spontaneously breathing infants with pneumonia.

This study was designed to evaluate further the effect of prone positioning on oxygen saturation (SpO2) and respiratory mechanics in spontaneously breathing infants with pneumonia. SpO2 and respiratory mechanics were measured in the supine and prone positions in 17 infants. Prone positioning resulted in statistically significant increases in mean (± SD) SpO2 (95.52 ± 2.87 to 98.00 ± 2.40%, p= 0.0002) and respiratory system compliance (5.99 ± 2.52 to 7.93 ± 4.30 ml/ cmH2O, p= 0.02). This suggests that prone positioning is another beneficial supportive measure for spontaneously breathing infants with pneumonia. □Mechanics, oxygen, pneumonia, prone