Respiratory

Overall, chronic lung disease accounts for more than six per cent of annual health-care costs in Canada, and COPD is the leading cause of hospitalization. A large number of Canadians with COPD and asthma, and other lung diseases such as cystic fibrosis and neonatal lung disease need to be further researched

Research Projects

The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia-tracheoesophageal fistula
07/06/2023

Dramatic improvement in neonatal care and paediatric surgery has been observed over the past 20 years, enabling most patients with EA-TEF to survive through adulthood. EA-TEF is no more a paediatric disease but an adult disease with chronic problems. Severe complications that were not observed in the past because only a few patients reached adulthood are now a concern. The transition from adolescence to adult medicine is, therefore, a new challenge. Transition is a critical period where the risk of poor compliance and loss of follow-up is high. This risk should be anticipated, and a good transition requires training and preparation of the adolescent and family and a multidisciplinary team.
First reports of primary ciliary dyskinesia caused by a shared DNAH11 allele in Canadian Inuit
23/04/2023

The discovery of this homozygous DNAH11 variant in widely disparate parts of the Nunangat (Inuit homelands) suggests this is a founder mutation that may be widespread in Inuit. Thus, PCD may be an important cause of chronic lung, sinus, and middle ear disease in this population. Inuit with chronic lung disease, including bronchiectasis or laterality defects, should undergo genetic testing for PCD. Consideration of including PCD genetic analysis in routine newborn screening should be considered in Inuit regions.
Thrombospondin-1 Plays a Major Pathogenic Role in Experimental and Human Bronchopulmonary Dysplasia
15/03/2022

TSP-1 inhibits alveologenesis in neonatal rats, in part via the upregulated activity of TGF-β1. Observations in human lungs suggest a similar pathogenic role for TSP-1 in infants at risk for BPD.
Housing conditions and respiratory morbidity in Indigenous children in remote communities in Northwestern Ontario, Canada
24/01/2022

Many houses in these FN communities had substantial IEQ problems. Presence of endotoxin was associated with wheezing with colds and tended to be associated with LRTI in young children. Surface area of visible mould tended to be associated with URTI visits. Urgent collective action is needed to respond to historically damaging impacts of colonization, including systemic indifference.
Aerosol SARS-CoV-2 in hospitals and long-term care homes during the COVID-19 pandemic
04/06/2021

Although a subset of aerosol samples exhibited detectable SARS-CoV-2 RNA at low titres, the presence of viable SARS-CoV-2 virus in aerosols appears to be infrequent at >2m distance.
Intermittent vs Continuous Pulse Oximetry in Hospitalized Infants With Stabilized Bronchiolitis
01/03/2021

In this randomized clinical trial, among infants hospitalized with stabilized bronchiolitis with and without hypoxia and managed using an oxygen saturation target of 90% or higher, clinical outcomes, including length of hospital stay and safety, were similar with intermittent vs continuous pulse oximetry. Nursing satisfaction was greater with intermittent monitoring. Given that other important clinical practice considerations favor less intense monitoring, these findings support the standard use of intermittent pulse oximetry in stable infants hospitalized with bronchiolitis.
Decontamination Interventions for the Reuse of Surgical Mask Personal Protective Equipment: A Systematic Review
10/08/2020

There is limited evidence on the safety or efficacy of surgical mask decontamination. Given the heterogeneous methods used in studies to date, we are unable to draw conclusions on the most efficacious and safe intervention for decontaminating surgical masks.
Care recommendations for the respiratory complications of esophageal atresia-tracheoesophageal fistula
27/07/2020

Tracheoesophageal fistula (TEF) with esophageal atresia (EA) is a common congenital anomaly that is associated with significant respiratory morbidity throughout life. The objective of this document is to provide a framework for the diagnosis and management of the respiratory complications that are associated with the condition.
Paediatric adenotonsillectomy, part 1: surgical perspectives relevant to the anesthetist
01/06/2020

Obstructive sleep apnoea is a systemic inflammatory disease with multiple end-organ effects, increased sensitivity to opioids and reported pain. The anaesthetic technique should be adjusted accordingly and can be informed by preoperative overnight oximetry, an increasingly accepted diagnostic tool for OSA. Residual symptoms of oSDB/OSA after AT imply severe baseline disease and/or an underlying medical complexity.
Characterization of the innate immune response in a novel murine model mimicking bronchopulmonary dysplasia
01/05/2020

This is the first report of in-depth characterization of the lung injury and recovery describing the evolution of the innate immune response in a standardized mouse model for experimental BPD with postnatal LPS and hyperoxia exposure.
Predictors of postoperative respiratory complications in children undergoing adenotonsillectomy
15/01/2020

Prediction modeling concurrently evaluating comorbidities and polysomnography metrics identified cardiac disease, airway anomaly, and young age as independent predictors of PRAEs. These findings suggest that medical comorbidity and age are more important factors in predicting PRAEs than PSG metrics in a medically complex population.
Tuberculosis among First Nations, Inuit and Métis children and youth in Canada: Beyond medical management
14/01/2020

Historical TB control practices in Canada have contributed to stigma and discrimination toward those with the disease, as well as fear and mistrust of the health system.
Autophagy is required for lung development and morphogenesis
04/06/2019

The current study aimed to investigate the occurrence of autophagy in the developing mouse lung and its regulatory role in airway branching and terminal sacculi formation. We found 2 windows of epithelial autophagy activation in the developing mouse lung, both resulting from AMPK activation.
Oral aspiration, type 1 laryngeal cleft, and respiratory tract infections in canadian inuit children
01/06/2019

We conclude that swallowing dysfunction is not only prevalent amongst Canadian Inuit but clinically significant. This is the first study to demonstrate an association between swallowing dysfunction and respiratory morbidity in this population.
Understanding parent perceptions of healthy physical activity for their child with a chronic medical condition: A cross-sectional study
01/06/2019

Over one-third of parents reported having questions about physical activity for their child with a chronic medical condition, suggesting substantial uncertainty even among children reported as active. Presence of parent uncertainty is associated with parent reports of the child being unwell or a history of cardiac arrhythmia
Acid Sphingomyelinase Inhibition Attenuates Cell Death in Mechanically Ventilated Newborn Rat Lung
12/10/2018

Ventilation-induced ceramides promote autophagy-mediated cell death, and identifies SMPD1 as a potential therapeutic target for the treatment of ventilation-induced lung injury in newborns.
Sodium nitrite augments lung S-nitrosylation and reverses chronic hypoxic pulmonary hypertension in juvenile rats
10/10/2018

Chronic PHT heralds a greatly increased risk of death and severe morbidity, and no therapies yet exist that are proven to modify the disease course.
Insulin Resistance and Hypertension in Obese Youth With Sleep-Disordered Breathing Treated With Positive Airway Pressure: A Prospective Multicenter Study
01/09/2017

In youth with obesity and SDB, metabolic dysfunction and hypertension were highly prevalent. Larger, longer-term studies are needed to determine whether PAP improves cardiometabolic outcomes in obese youth.
Long-Term Effects of Lung Volume Recruitment on Maximal Inspiratory Capacity and Vital Capacity in Duchenne Muscular Dystrophy
08/07/2015

With lung volume recruitment therapy, MIC–VC differences were stable over time, indicating that respiratory system compliance remains stable, despite a loss in VC, in individuals with Duchenne muscular dystrophy.
Bronchiectasis in children from Qikiqtani (Baffin) Region, Nunavut, Canada
01/01/2015

Previous researchers have reported that Canadian Inuit children have markedly elevated rates of LRTI early in life. Our study suggests that this may lead to long-term pulmonary sequelae.
Existence, Functional Impairment, and Lung Repair Potential of Endothelial Colony-Forming Cells in Oxygen-Induced Arrested Alveolar Growth
01/05/2014

We show for the first time that ECFCs exist in the distal vasculature of the developing mammalian lung, and their functional capacity is impaired in oxygen-induced lung damage. We also show that therapeutic supplementation with human umbilical cord blood–derived ECFCs is feasible, efficacious, and apparently safe in this experimental O2-induced model of BPD in neonatal mice.
Long-term respiratory complications of congenital esophageal atresia with or without tracheoesophageal fistula: an update
03/06/2013

Recent studies suggest that in older patients, respiratory symptoms tend to be associated with atopy, but abnormal lung function tends to be associated with gastroesophageal reflux and with chest wall abnormalities.
Airway Delivery of Mesenchymal Stem Cells Prevents Arrested Alveolar Growth in Neonatal Lung Injury in Rats
01/12/2009

MSC treatment preserved alveolar structure in a model of chronic lung disease in newborn rats caused by severe hyperoxia, which may be due to a paracrine effect on lung cells. MSCs may have therapeutic potential for preventing neonatal lung diseases characterized by alveolar damage.