Frontiers in Pediatrics最新文献

{"title":"Application of the intelligent interactive system to promote the full course care of very low birth weight infants.","authors":"Namei Xie, Ruming Ye, Yuying Chen, Ying Lin, Xianghui Huang, Deyi Zhuang","doi":"10.3389/fped.2025.1516969","DOIUrl":"10.3389/fped.2025.1516969","url":null,"abstract":"<p><strong>Aim: </strong>To explore the effects of full course care with an intelligent interactive system on the growth, neurodevelopment and follow up adherence of very low birth weight infants (VLBW), as well as parental satisfaction.</p><p><strong>Methods: </strong>The preterm infants admitted between January 2022 and December 2022 were designated as the experimental group, while those admitted from January 2021 to December 2021 constituted the control group. The experimental group received a full course of care through an intelligent interactive system, whereas the control group received inpatient and follow-up care from primary and clinic nurses, respectively. We compared the two groups' parental satisfaction at discharge, infants' anthropometric assessments, follow-up adherence, and infant's neurodevelopment.</p><p><strong>Results: </strong>From January 1, 2021, to December 31, 2022, 171 VLBWI and their parents were enrolled at a tertiary hospital, with 89 infants in the experimental group and 82 in the control group. Parental satisfaction in the experimental group was significantly higher than in the control group (<i>P</i> < 0.05). At the corrected ages of 1, 3, and 6 months, the height and weight of the preterm infants in the experimental group were also superior to those of the control group (<i>P</i> < 0.05). Additionally, the follow-up adherence rate of the experimental group exceeded that of the control group at the corrected ages of 3 and 6 months (<i>P</i> < 0.05). Furthermore, at the corrected age of 6 months, the scores for fine motor skills, adaptability, and social interaction of infants in the experimental group were higher than those in the control group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>An intelligent interactive system can facilitate comprehensive management of VLBWI by integrating inpatient care and follow-up. This approach has significant clinical value as it promotes the physical and cognitive development of infants while enhancing parent satisfaction and adherence.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1516969"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractory agitation in the NICU: challenges in prevention, diagnosis, and treatment.","authors":"Kim Beatty, Eunsung Cho, Jessica Biggs, Shawnee Daniel-McCalla, Johana Diaz","doi":"10.3389/fped.2025.1504619","DOIUrl":"10.3389/fped.2025.1504619","url":null,"abstract":"<p><p>In this paper we explore refractory agitation in the neonatal population, focusing on the limitations of existing evidence on appropriate prevention, diagnosis, and treatment options. We highlight seven patients identified in an urban single-center level IV NICU with agitation unresponsive to standard non-pharmacologic interventions and escalation of standard neurosedative medications. We analyzed baseline characteristics and clinical courses of these patients with the aim to identify the NICU subpopulation at greatest risk for development of refractory agitation and to gain insight into the potential benefits of alternative medical management of agitation on later neurodevelopment. Based on these experiences we propose a practical approach to infants at increased risk for refractory agitation including standardized screening guidelines and a clinical pathway for developmentally appropriate non-pharmacologic and pharmacologic management.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1504619"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factor analysis of plastic bronchitis among 126 children with macrolide-resistant <i>Mycoplasma pneumoniae</i> pneumonia with mutations at the <i>A2063G</i> site after bronchoscopy examination: a nomogram prediction model.","authors":"Ran Ma, Ting Bai, Bo Yuan, Li Zhang, Shanshan Li, Lanhua Ma, Wei Zhang","doi":"10.3389/fped.2025.1521954","DOIUrl":"10.3389/fped.2025.1521954","url":null,"abstract":"<p><strong>Objective: </strong>To determine the risk factors for plastic bronchitis (PB) in children diagnosed with macrolide-resistant <i>Mycoplasma pneumoniae</i> (MRMP) pneumonia associated with the <i>A2064G</i> variant.</p><p><strong>Methods: </strong>The clinical data of 126 children diagnosed with MRMP pneumonia (all with mutations at the <i>A2063G</i> site) who underwent bronchoscopy from May 2023 to April 2024 were retrospectively collected. Based on bronchoscopic findings, patients were classified into the PB and non-PB groups. The study compared the general and clinical features, laboratory indicators, imaging features, bronchoscopic manifestations, treatment, and prognosis between the two groups. A nomogram model, based on logistic regression, was developed to estimate the risks of developing PB in children with MRMP pneumonia caused by mutations at the <i>A2063G</i> site.</p><p><strong>Results: </strong>We included 68 boys and 58 girls in this study, with 32 (25.4%) belonging to the PB group. The nomogram model constructed in this study indicated that three risk factors-Atelectasis, <i>Mycoplasma pneumoniae</i> genome copies (throat swab) >10⁵, and D-dimer levels-could be used for the early identification of MRMP pneumonia-induced PB. The area under the receiver operating characteristic curve for the predictive model was 0.832 (95% confidence interval: 0.743-0.922). The Hosmer-Lemeshow goodness-of-fit test demonstrated good calibration of the nomogram (<i>P</i> = 0.227, R² = 0.403). Decision curve analyses revealed that the model has clinical value. Regarding treatment, second-line drugs and the frequency of bronchoscopy were significantly higher in the PB group than in the non-PB group.</p><p><strong>Conclusions: </strong>Early risk factor identification and bronchoscopy can improve the outcomes of children with PB associated with MRMP pneumonia caused by mutations at the <i>A2063G</i> site.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1521954"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Anti-interferon-γ autoantibodies in an adolescent with disseminated <i>Talaromyces marneffei</i> and mycobacterial co-infections.","authors":"Bingkun Li, Tiantian Li, Qihua Huang, Nanfang Mo, Xiaojuan He, Zhiwen Jiang, Xiuying Li, Xiaolu Huang, Xinyu Zhang, Cunwei Cao","doi":"10.3389/fped.2025.1552469","DOIUrl":"10.3389/fped.2025.1552469","url":null,"abstract":"<p><strong>Background: </strong>Anti-interferon-γ autoantibodies (AIGAs) are associated with adult-onset immunodeficiency syndrome, which makes individuals susceptible to intracellular pathogen infections. However, AIGAs are rarely reported in adolescents.</p><p><strong>Case presentation: </strong>We report a 13-year-old Chinese boy who presented with fever, cough, and enlarged cervical lymph nodes. Blood cultures yielded <i>Mycobacterium abscessus</i>, and <i>Talaromyces marneffei</i> (TM) was cultured from pericardial effusion. Whole exome sequencing revealed no pathogenic variants. Notably, high levels of neutralizing AIGAs were detected in the patient's serum. After receiving treatment for <i>Mycobacterium abscessus</i> and antifungal therapy for TM, the patient showed significant improvement. However, at the 19-month follow-up, the patient developed a <i>Mycobacterium asiaticum</i> infection.</p><p><strong>Conclusion: </strong>This case highlights the importance of screening for AIGAs in pediatric patients with disseminated TM or NTM infections. Prolonged treatment and continuous follow-up remains crucial for managing pediatric patients with AIGAs.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1552469"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wheelchair use confidence scale for Arab pediatric manual wheelchair users: preliminary evaluation of its measurement properties.","authors":"Hassan Izzeddin Sarsak, Paula W Rushton","doi":"10.3389/fped.2025.1522475","DOIUrl":"10.3389/fped.2025.1522475","url":null,"abstract":"<p><strong>Introduction: </strong>This study translated the pediatric Wheelchair Use Confidence Scale for Manual Wheelchair Users (WheelCon-M-P) into Arabic (WheelCon-M-A-P) and evaluated whether the translation produced scores similar to the original English version.</p><p><strong>Methods: </strong>The English version was first translated into Arabic and then verified by back translation method by expert committee in the field of rehabilitation and wheelchair service provision. The final versions were administered to assess confidence with manual wheelchair use among children. Each participant was asked to complete both the WheelCon-M-P English version and the WheelCon-M-A-P Arabic version in a random sequence. Kappa statistics were used to quantify the level of agreement between scores obtained from both versions.</p><p><strong>Results: </strong>Participants (<i>n</i> = 48) had an average age of 14.2 years, were all bilingual, and 54% were male. Kappa agreement obtained was 0.54 (95% confidence interval, 0.49-0.62) indicating significant moderate agreement between the two versions (<i>p</i> < 0.000).</p><p><strong>Discussion: </strong>This study provides preliminary evidence of a valid WheelCon-M-A-P to assess confidence with manual wheelchair use among Arabic-speaking children. Future studies to further test its psychometric properties are crucial.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1522475"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning-based prediction of mortality in pediatric trauma patients.","authors":"Alex Deleon, Anish Murala, Isabelle Decker, Karthik Rajasekaran, Alvaro Moreira","doi":"10.3389/fped.2025.1522845","DOIUrl":"10.3389/fped.2025.1522845","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop a predictive model for mortality outcomes among pediatric trauma patients using machine learning (ML) algorithms.</p><p><strong>Methods: </strong>We extracted data on a cohort of pediatric trauma patients (18 years and younger) from the National Trauma Data Bank (NTDB). The main aim was to identify clinical and physiologic variables that could serve as predictors for pediatric trauma mortality. Data was split into a development cohort (70%) to build four ML models and then tested in a validation cohort (30%). The area under the receiver operating characteristic curve (AUC) was used to assess each model's performance.</p><p><strong>Results: </strong>In 510,381 children, the gross mortality rate was 1.6% (<i>n</i> = 8,250). Most subjects were male (67%, <i>n</i> = 342,571) and white (62%, <i>n</i> = 315,178). The AUCs of the four models ranged from 92.7 to 97.7 with XGBoost demonstrating the highest AUC. XGBoost demonstrated the highest accuracy of 97.7%.</p><p><strong>Conclusion: </strong>Machine learning algorithms can be effectively utilized to build an accurate pediatric mortality prediction model that leverages variables easily obtained upon trauma admission.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1522845"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum inflammatory factors, vitamin D levels, and asthma severity in children with comorbid asthma and obesity/overweight: a comparative study.","authors":"Wan-Yu Jiang, Rong-Hong Jiao, Su-Li Ma, Jin-Sheng Dai, Hai-Feng Zhu, Meng-Ya Wu, Yan-Ran Che, Lei Zhang, Xiao-Yuan Ding","doi":"10.3389/fped.2025.1439841","DOIUrl":"10.3389/fped.2025.1439841","url":null,"abstract":"<p><strong>Objective: </strong>To investigate serum inflammatory factors, vitamin D levels, and asthma severity in children with comorbid asthma and obesity/overweight, compared with those with asthma or obesity/overweight alone.</p><p><strong>Methods: </strong>This retrospective comparative study included children suffering from asthma alone, asthma combined with obesity/overweight, or obesity/overweight alone at Shanghai Pudong New Area People's Hospital between January 2020 and December 2021.</p><p><strong>Results: </strong>A total of 168 children (mean age: 4.32 ± 1.64 years; 117 males) were included. Compared with children with asthma alone (<i>n</i> = 56), those with comorbid asthma and obesity/overweight (<i>n</i> = 56) exhibited higher levels of serum levels of interleukin 6 (IL-6) (35.75 ± 24.56 vs. 15.40 ± 19.67), TNF-α (15.44 ± 7.35 vs. 12.16 ± 7.24), and leptin (3.89 ± 3.81 vs. 1.27 ± 2.31), and lower levels of 25-hydroxycholecalciferol (25-(OH) D₃) (26.03 ± 10.77 vs. 37.15 ± 13.35), IL-10 (8.69 ± 2.76 vs. 15.32 ± 6.28), and IL-13 (449.40 ± 315.37 vs. 605.27 ± 351.02) (all <i>P</i> < 0.05). Compared with children with obese/overweight alone (<i>n</i> = 56), those with comorbid asthma and obesity/overweight had lower IL-10 (8.69 ± 2.76 vs. 12.29 ± 6.61) and higher IL-6 (35.75 ± 24.56 vs. 20.53 ± 17.07), IL-13 (449.40 ± 315.37 vs. 309.47 ± 257.45), and leptin (3.89 ± 3.81 vs. 2.48 ± 3.52) (all <i>P</i> < 0.05). Children with comorbid asthma and obesity/overweight showed higher Preschool Respiratory Assessment Measure (PRAM) scores (3.14 ± 2.40 vs. 1.93 ± 1.02, <i>P</i> = 0.008) and longer hospital stays (5.96 ± 1.25 vs. 5.29 ± 1.36 days, <i>P</i> = 0.007) compared to those with asthma alone.</p><p><strong>Conclusions: </strong>Significant differences were observed in IL-6, IL-10, IL-13, 25-(OH) D₃ levels, and leptin among children with asthma combined with obesity/overweight and those with asthma or obesity/overweight alone. Children with obesity/overweight alone displayed more severe clinical manifestations and longer hospital stays compared with those with asthma alone.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1439841"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eliglustat substrate reduction therapy in children with Gaucher disease type 1.","authors":"Noor Ul Ain, Armaan Saith, Audrey Ruan, Ruhua Yang, Aaron Burton, Pramod K Mistry","doi":"10.3389/fped.2025.1543136","DOIUrl":"10.3389/fped.2025.1543136","url":null,"abstract":"<p><strong>Importance: </strong>Gaucher disease (GD) is a rare lysosomal storage disorder with limited treatment options for pediatric patients. Oral substrate reduction therapy (SRT) with eliglustat offers a potential alternative, particularly for those with barriers to enzyme replacement therapy (ERT).</p><p><strong>Objective: </strong>Evaluate the safety and efficacy of eliglustat SRT in pediatric patients with type 1 Gaucher disease (GD1), both as initial therapy and as a switch from intravenous ERT.</p><p><strong>Design: </strong>A prospective case series was conducted from 2017 to 2024.</p><p><strong>Setting: </strong>Yale's National Gaucher Disease Treatment Center, New Haven, CT, United States.</p><p><strong>Participants: </strong>Fourteen pediatric GD1 patients with significant barriers to receiving ERT.</p><p><strong>Intervention: </strong>Eliglustat SRT was dosed pharmacogenomically based on CYP2D6 metabolizer status.</p><p><strong>Primary outcomes and measures: </strong>Primary outcomes included safety and efficacy in reversing indicators of disease activity. Secondary outcomes involved changes in patient and parent-reported quality of life, assessed using PROMIS questionnaires.</p><p><strong>Results: </strong>Eliglustat was initiated at a mean age of 12.5 years (range: 6-17 years) and administered for a mean duration of 3.6 years (range: 1-7 years). All patients remained on treatment and exhibited sustained reductions in glucosylsphingosine (GlcSph) levels compared to baseline (<i>p</i> = 0.005). Other disease indicators demonstrated corresponding improvements. Adverse effects were limited to transient gastroesophageal reflux in 3/14 patients (21%). Serial electrocardiograms (EKGs) were normal. Growth and developmental milestones were appropriate for age in all patients. Patients and their parents reported a global improvement in quality of life.</p><p><strong>Conclusions: </strong>Eliglustat demonstrated significant clinical benefits in pediatric GD1 patients, as evidenced by reductions in GlcSph levels and other disease indicators. The therapy showed a favorable safety profile comparable to that observed in adults. These findings suggest eliglustat is a promising therapeutic option for pediatric GD1 patients, providing an effective alternative to ERT.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1543136"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of physical exercise interventions on social, behavioral, and motor skills in children with autism: a systematic review and meta-analysis of randomized controlled trials.","authors":"YanAn Wang, Guoping Qian, Sujie Mao, Shikun Zhang","doi":"10.3389/fped.2025.1475019","DOIUrl":"10.3389/fped.2025.1475019","url":null,"abstract":"<p><strong>Background: </strong>Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by social impairments, sensory processing issues, repetitive behavior patterns, motor abnormalities, and executive function impairments.</p><p><strong>Objective: </strong>To systematically review and meta-analyze the effects of various exercise modalities on flexibility and cognitive control, social skills, behavioral problems, motor skills, and coordination in children with ASD, providing scientific evidence for clinical practice to guide effective exercise interventions for children with ASD.</p><p><strong>Methods: </strong>Literature searches were conducted in PubMed, EMbase, Cochrane Library, EBSCOhost, and Web of Science databases, covering the period from database inception to February 15, 2024. Inclusion criteria included studies involving children with ASD, any form of exercise intervention, reporting at least one ASD-related outcome, and designed as randomized controlled trials (RCTs) or quasi-experimental studies. Exclusion criteria included reviews, conference abstracts, commentary articles, and studies lacking sufficient statistical data for meta-analysis. Study quality was assessed using the PEDro scale. Effect sizes were calculated using standardized mean differences (SMD). Heterogeneity was assessed with the <i>I</i> ² statistic. Multiple subgroup analyses were conducted, and publication bias was evaluated using Begg's Test and Egger's Test.</p><p><strong>Results: </strong>23 RCTs were included in this study, showing positive effects of exercise interventions in various domains.Upper grade students showed significant improvement in flexibility and cognitive control (SMD = -0.282, <i>p</i> = 0.161). Lower grade children showed the most significant improvement in motor skills and coordination (SMD = 0.475, <i>p</i> = 0.043). Preschool children showed significant enhancement in social skills (SMD = 0.312, <i>p</i> = 0.041). Behavioral problems improved significantly across all age groups (SMD = -0.674, <i>p <</i> 0.001). Martial arts and ball games were particularly effective in enhancing these domains, and appropriate periodic exercise interventions effectively improved various abilities in children with ASD. Results varied across different ages and intervention types.</p><p><strong>Conclusion: </strong>Exercise interventions significantly improve flexibility, cognitive control, motor skills, coordination, social skills, and behavioral problems in children with ASD. This study supports exercise interventions as an effective method to enhance multiple abilities in children with ASD and emphasizes the importance of designing personalized intervention programs tailored to different ages and needs. Future research should focus on larger sample sizes and long-term follow-ups to confirm the sustainability and generalizability of intervention effects.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1475019"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caffeine use in preterm neonates: national insights into Turkish NICU practices.","authors":"Sezin Unal, Serdar Beken, Deniz Anuk Ince, Ozden Turan, Ayse Korkmaz Toygar, Ayse Ecevit, Abdullah Baris Akcan, Mustafa Ali Akın, Selma Aktas, Nukhet Aladag Ciftdemir, Emel Altuncu, Huseyin Altunhan, Baran Cengiz Arcagok, Didem Armangil, Esra Arun Ozer, Banu Aydın, Handan Bezirganoglu, Leyla Bilgin, Erhan Calısıcı, Sebnem Calkavur, Kıymet Celik, Yalcın Celik, Bilin Cetinkaya, Merih Cetinkaya, Atalay Demirel, Gamze Demirel, Nazan Neslihan Dogan, Pelin Doğan, Mehtap Durukan, Defne Engur, Tugba Erener Ercan, Zeynel Gokmen, Ipek Guney Varal, Selvi Gulası, Ayla Gunlemez, Tugba Gursoy, Handan Hakyemez Toptan, Serif Hamitoğlu, Fatih Isleyen, Irem Iyigun, Sebnem Kader, Dilek Kahvecioğlu, Gozdem Kaykı, Murat Kostu, Dilek Kurnaz, Tural Mammadalıyev, Ilke Mungan Akin, Nejat Narlı, Emel Okulu, Nilufer Okur, Ozgur Olukman, Fahri Ovalı, Beyza Ozcan, Ahmet Ozdemir, Ozmert Ozdemir, Hilal Ozkan, Gonca Sandal, Dilek Sarıcı, Cansu Sivrikaya, Betul Siyah Bilgin, Saime Sundus, Ozge Surmeli Onay, Huseyin Simsek, Umit Ayse Tandırcıoğlu, Sema Tanrıverdi, Kadir Serafettin Tekgunduz, Demet Terek, Gaffari Tunc, Turan Tunc, Ercan Tutak, Eda Tufekcioğlu, Funda Tuzun Erdogan, Ersin Ulu, Dilek Ulubas Isik, Nurdan Uras, Sait Ilker Uslu, Irem Unal, Fatma Hilal Yılmaz, Ariorad Moniri","doi":"10.3389/fped.2025.1492716","DOIUrl":"10.3389/fped.2025.1492716","url":null,"abstract":"<p><strong>Objective: </strong>Caffeine is a proven medication used for the prevention and treatment of apnea in premature infants, offering both short- and long-term benefits. International guidelines provide a range of recommendations regarding the preterm population eligible for caffeine prophylaxis, including the timing, dosage, and duration of treatment. Our national guidelines, published prior to the most recent updates of the international guidelines, recommend the use of caffeine citrate starting from the first day after delivery for preterm infants with a gestational age of <28 weeks. For infants up to 32 weeks, if positive pressure ventilation is required, the decision should be made on an individual basis. This study aims to describe the variability in caffeine usage across neonatal intensive care units in our country.</p><p><strong>Methods: </strong>An online survey was sent to neonatologist who are members of the Turkish Neonatology Society to describe the variability in caffeine usage in neonatal intensive care units in our country.</p><p><strong>Results: </strong>We collected responses from 74 units. Prophylactic caffeine usage was observed as; GA ≤27^6/7: 98.6%, GA 28^0/7-28^6/7: 89.0%, GA 29^0/7-29^6/7: 75.3%, GA 30^0/7-31^6/7: 53.4%. 62.2% of units reported administering loading dose within the first two hours. The initial maintenance dose was 5 mg/kg in 64.8% of units, 10 mg/kg in 32.4% of units, and intermediate dose in 5.3% of units. 47.3% of units reported no routine dose adjustment. The postmenstrual age that caffeine treatment was stopped was found to be 34 (min-max; 32-36) weeks for infants without apnea and respiratory support, 36 (min-max; 34-52) weeks for infants without apnea but any respiratory support. The time to discharge after treatment cessation was found as; 1-4 days: 37.8%, 5-7 days: 68.9%. Among the 56 units with multiple responsible physicians, 32.1% reported intra-unit variations.</p><p><strong>Conclusion: </strong>The significant differences in caffeine usage characteristics between and within units highlight the need for clear recommendations provided by standardized guidelines.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1492716"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}