{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T05:10:47Z","timestamp":1696569047093},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,2,8]],"date-time":"2013-02-08T00:00:00Z","timestamp":1360281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label \/><jats:p>A 4\u2010year\u2010old girl with bilateral vocal fold palsy was successfully decannulated from tracheotomy after seven laryngeal procedures. But an important stridor and dyspnea recurred 13 months after decannulation. Nocturnal gas exchange was normal but her daytime work of breathing was increased by fourfold, without any beneficial effect of nasal noninvasive continuous positive airway pressure ventilation (CPAP), reflecting a severe fixed airway obstruction. Endoscopic examination confirmed the work of breathing findings showing glottic and supraglottic stenosis. This upper airway obstruction was successfully treated with a recannulation. In conclusion, the major message of this case report is that measurement of the work of breathing was able to document the \u201cfixed\u201d nature of the airway obstruction, by showing no improvement even with highest tolerated levels of nasal CPAP. As such, the work of breathing may be proposed as a screening tool to quantify and assess the reversibility of severe upper airway obstruction in children. <jats:bold>Pediatr Pulmonol. 2014; 49:E35\u2013E39.<\/jats:bold> \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.22772","type":"journal-article","created":{"date-parts":[[2013,2,8]],"date-time":"2013-02-08T15:34:40Z","timestamp":1360337680000},"source":"Crossref","is-referenced-by-count":4,"title":["Work of breathing as a tool to diagnose severe fixed upper airway obstruction"],"prefix":"10.1002","volume":"49","author":[{"given":"S.","family":"Khirani","sequence":"first","affiliation":[{"name":"S2A Sant\u00e9 Ivry\u2010sur\u2010Seine France"},{"name":"AP\u2010HP, H\u00f4pital Armand Trousseau, Pediatric Pulmonary Department Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Pierrot","sequence":"additional","affiliation":[{"name":"AP\u2010HP, H\u00f4pital 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