{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T03:04:29Z","timestamp":1769915069638,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,6,12]],"date-time":"2021-06-12T00:00:00Z","timestamp":1623456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Continuous negative extra\u2010thoracic pressure (CNEP) can prevent children with apnea developing severe respiratory infection with endotracheal intubation. Little is known about children with mild acute respiratory disease, especially with a focus on clinical respiratory symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a prospective, observational study between July 2014 and July 2017 to evaluate the safety of a modified setting of CNEP in hospitalized children with symptoms of chest\u2010wall retraction or nasal alar breathing without the requirement for immediate intubation therapy in a single center. A modified setting of CNEP was defined as 4\u00a0h of treatment comprising 3 consecutive hours of CNEP followed by 1\u00a0h of rest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We studied 19 hospitalized children with retraction or nasal breathing but no possible state of endotracheal intubation. The median age at admission was 0.9\u00a0years and the duration of CNEP was 6\u00a0days. No sedative drugs were used. The percentage of children with retraction or nasal breathing after 24\u00a0h from initiation of CNEP was significantly decreased compared with that just before CNEP (68% vs 100%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). Logistic regression showed no statistical evidence of contributing factors for pulmonary symptoms. No patients were transferred to receive intubation, but one boy reinitiated respiratory support within 6\u00a0months after discharge. No children had adverse events of upper airway obstruction, skin injury, interfering with access, hypothermia, discomfort from fitting a cuirass, and neck excoriation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results suggest that a modified setting of CNEP management can be tolerated and continued without concern of adverse events.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.14560","type":"journal-article","created":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T03:21:01Z","timestamp":1606706461000},"page":"838-844","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Modified setting of negative pressure in children with mild respiratory disease"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3863-2743","authenticated-orcid":false,"given":"Shingo","family":"Ishimori","sequence":"first","affiliation":[{"name":"Department of Pediatrics Kakogawa Central City Hospital Kakogawa Japan"},{"name":"Department of Pediatrics Takatsuki General Hospital Takatsuki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shizuka","family":"Nagase","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kakogawa Central City Hospital Kakogawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsuko","family":"Kanagawa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kakogawa Central City Hospital Kakogawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoshi","family":"Nakajiri","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kakogawa Central City Hospital Kakogawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sora","family":"Okita","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kakogawa Central City Hospital Kakogawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinobu","family":"Oyazato","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kakogawa Central City Hospital Kakogawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Nishiyama","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kakogawa Central City Hospital Kakogawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiko","family":"Yonetani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kakogawa Central City Hospital Kakogawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e318184989f"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/1025448x.00041008"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.113.5_Supplement.289S"},{"key":"e_1_2_8_5_1","first-page":"22","article-title":"Cuirass ventilation: A review and uptake","volume":"7","author":"Linton DM","year":"2005","journal-title":"Crit. 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