Journal of paediatrics and child health最新文献

{"title":"Educational Outcomes at 7, 11 and 16 Years of Age for Children Born Small for Gestational Age: Results From the Auckland Birthweight Collaborative Study.","authors":"Alexia K Searchfield, Barry Milne, Karen E Waldie, Rebecca F Slykerman, Rinki Murphy, Edwin A Mitchell, John M D Thompson","doi":"10.1111/jpc.70630","DOIUrl":"https://doi.org/10.1111/jpc.70630","url":null,"abstract":"<p><strong>Aim: </strong>Small for gestational age (SGA) has been linked to lower school achievement in childhood. However, this association has only been shown consistently in preterm-SGA cohorts. This paper aims to determine whether being born SGA at term is associated with school performance at 7, 11 and 16 years of age.</p><p><strong>Methods: </strong>n = 871 children born at term (n = 433 small-for-gestational-age [SGA] and n = 438 appropriate for gestational age [AGA]) had education outcomes analysed at age 7 (n = 265 SGA, n = 304 AGA), 11 (n = 200 SGA, n = 218 AGA) and 16 (n = 152 SGA, n = 185 AGA). The outcomes studied were the risk of below-average achievement in oral comprehension, written comprehension and mathematics at 7 and 11 years of age, and the risk of not achieving final secondary school qualifications at 16. Binary and multinomial logistic regression were performed.</p><p><strong>Results: </strong>SGA children score below-average in written comprehension at 7 (OR 1.71, CI 1.04-2.80) and oral comprehension at 11 (OR 2.10, CI 1.22-3.62). These associations were not statistically significant once adjusted for confounders (written comprehension at 7 aOR 1.54, CI 0.89-2.69; oral comprehension at 11 aOR 1.79, CI 0.99-3.25). There was no statistically significant difference in secondary school achievement (OR 0.80, 95% CI 0.45-1.42) between SGA and AGA children.</p><p><strong>Conclusions: </strong>Our results show that being born SGA at term does not independently increase the risk of below-average performance at ages 7, 11 or 16 after adjusting for known social and environmental confounders. However, clinicians should maintain active surveillance for term SGA infants, particularly when co-occurring environmental or maternal risk factors are present.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Severe Steroid-Induced Myopathy in a Child With a Pharmacogenetic Predisposition: A Case Report and Systematic Review of the Literature.","authors":"Giada Caiffa, Carolina Carraro, Gabriele Stocco, Antonella Muzzo, Marianna Lucafò, Erika Cecchin, Egidio Barbi, Luisa Zupin","doi":"10.1111/jpc.70628","DOIUrl":"https://doi.org/10.1111/jpc.70628","url":null,"abstract":"<p><strong>Background: </strong>Glucocorticoids (GCs) are essential in paediatric inflammatory and immune-mediated diseases but are associated with dose- and duration-dependent toxicity. Pharmacogenetic variability in metabolic and transporter pathways may contribute to inter-individual differences in GC adverse effects.</p><p><strong>Case presentation: </strong>A 7-year-old girl with recurrent IgA vasculitis required prolonged corticosteroid therapy. During treatment, she developed marked Cushingoid features, progressive proximal muscle weakness, and severe fatigability consistent with steroid-induced myopathy. Pharmacogenetic analysis revealed a CYP3A4 intermediate metabolizer genotype and CYP3A5 poor metabolizer genotype, without relevant variants in ABCB1 or ABCG2. NLRP3 methylation analysis was normal. Gradual steroid tapering combined with intravenous immunoglobulin therapy resulted in rapid clinical improvement and sustained remission.</p><p><strong>Methods and results: </strong>A systematic review of PubMed, Embase, and Scopus up to March 2026 identified seven eligible studies. Evidence on associations between CYP3A4, CYP3A5, ABCB1, and ABCG2 polymorphisms and GC-related adverse effects in children was limited and inconsistent, without strong genotype-phenotype correlations.</p><p><strong>Conclusions: </strong>This case suggests that combined CYP variants may contribute to increased glucocorticoid exposure and side effects. Although current evidence remains insufficient for routine clinical use, pharmacogenetic testing may be considered in selected cases with unexpected GC adverse effects.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which Children Count? The Ethics of Selective Advocacy.","authors":"Monica S Cooper","doi":"10.1111/jpc.70626","DOIUrl":"https://doi.org/10.1111/jpc.70626","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Lipid Profile and Atherogenic Indices With Dietary Adherence in Paediatric Coeliac Disease.","authors":"Saniye Başak Oktay, Sibel Yavuz, İsmail Gürkan Çikim","doi":"10.1111/jpc.70632","DOIUrl":"https://doi.org/10.1111/jpc.70632","url":null,"abstract":"<p><strong>Aim: </strong>The association of adherence to a gluten-free diet (GFD) on lipid metabolism and cardiovascular risk markers in paediatric coeliac disease (CD) remains incompletely understood. This study aimed to evaluate lipid profile parameters and atherogenic indices according to dietary adherence in children with CD.</p><p><strong>Methods: </strong>Children aged 3-18 years with CD were retrospectively evaluated. GFD adherence was assessed using clinical findings, serology, and patient and/or parental reports. Lipid parameters and atherogenic indices were compared according to GFD adherence. Multivariable linear regression analysis was performed to evaluate the association between GFD adherence and high-density lipoprotein cholesterol (HDL-C) after adjustment for age, sex, and BMI.</p><p><strong>Results: </strong>A total of 149 children included in the study; 106 (71.1%) were classified as diet-adherent and 43 (28.9%) as diet-nonadherent. HDL-C levels were significantly higher in children adhering to a GFD (55.3 vs. 46 mg/dL, p < 0.001), whereas total cholesterol, low-density-lipoprotein-cholesterol, triglyceride, and glucose levels were similar between groups. Castelli-Risk-Index-I, Castelli-Risk-Index-II, Atherogenic-Coefficient, and Atherogenic-Index-of-Plasma were significantly lower in children adhering to a GFD (all p < 0.05). Triglyceride-Glucose-Index did not differ between groups (p = 0.430). Dietary adherence remained an independent predictor of higher HDL-C levels after adjustment for age, sex, and body-mass-index (B = 8.253, 95% CI: 3.972-12.534, p < 0.001).</p><p><strong>Conclusions: </strong>GFD adherence was associated with higher HDL-C levels and a more favourable profile of lipid-derived atherogenic indices in children with CD. These findings suggest an association between adherence to a GFD and HDL-C-related lipid parameters; however, prospective studies are needed to determine the temporal and causal relationships between dietary adherence and metabolic outcomes.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validating a Wearable Bluetooth Oximeter for Infants in the Neonatal Intensive Care Unit.","authors":"Amy Courtney, Ju Lee Oei","doi":"10.1111/jpc.70622","DOIUrl":"https://doi.org/10.1111/jpc.70622","url":null,"abstract":"<p><strong>Introduction: </strong>Oxygen is vital for life but the wrong amount of oxygen can lead to significant risk of morbidity and mortality. Preterm infants are at particular risk from both too little (hypoxia) and excess (hyperoxia) oxygen. In the neonatal intensive care unit (NICU), oxygen treatment is guided by oximetry derived from wired oximeters which are difficult to use outside of the hospital environment. We aimed to validate Bluetooth wireless oximeters in newborn infants to determine the accuracy of devices that would be more suitable for out of hospital use.</p><p><strong>Methods: </strong>Three 20 min sets of measurements including oxygen saturations (SpO₂), heart rate (HR) and perfusion index (PI) from the post-ductal regions (left arm and lower limbs) were conducted in 21 spontaneously ventilating infants using the Masimo (1) SafetyNet and (2) Radical 7 oximeters. The wired Radical 7 oximeter was the reference. Data were downloaded onto CSV files and analysed for agreement.</p><p><strong>Results: </strong>Twenty-one (eight male) infants were recruited between July to September 2023. Median gestations and ages were 36 weeks and 3 days. Neither Bluetooth device (SafetyNet and wireless Radical 7) met International Organization for Standardization (ISO) standard (ARMSE ≤ 3%), Score 3.624 (wireless Rad-7) and 3.884 (SafetyNet). Both wearables consistently overestimated SpO₂, with mean biases (wired-wearable) of -1.802 (Rad-7) and -1.803 (SafetyNet), that increased at lower SpO₂ levels. Linear regression, ICC, Pearson's correlation analyses showed poor consistency.</p><p><strong>Conclusion: </strong>Wireless oximeters have poor correlation with wired oximeters especially at lower SpO₂ levels but ease of use, especially in the home environment in less acutely ill patients, requires further evaluation.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management Strategies for Paediatric Pleural Empyema: A Systematic Review.","authors":"Atheer I Shahar, Maryam Mohammed Alghamdi, Zainab Ahmed Athwani, Lama Hassan Ayoub, Afraa Hashim Mutahar, Ayed Mohammed Alenazi, Alnashmi S Alanazi","doi":"10.1111/jpc.70617","DOIUrl":"https://doi.org/10.1111/jpc.70617","url":null,"abstract":"<p><strong>Aim: </strong>To examine and compare management strategies for paediatric pleural empyema with respect to efficacy, safety, length of hospital stays, complications and long-term outcomes.</p><p><strong>Methods: </strong>Database searches across PubMed, Web of Science, Cochrane Library and ScienceDirect (January 2005-May 2025) were conducted following PRISMA guidelines. After exclusions, 22 studies (RCTs and observational) were included. Quality was assessed using the Newcastle-Ottawa Scale and Cochrane Risk of Bias tool. Because studies defined success inconsistently, effectiveness was also expressed as single-procedure success: resolution without a further drainage procedure. Other outcomes included reintervention, hospital stay, complications and mortality.</p><p><strong>Results: </strong>Included were 18 cohort studies and 4 RCTs (3667 patients; empyema stages 1-3). Evaluated approaches included video-assisted thoracic surgery (VATS), intrapleural fibrinolysis, chest tube drainage and thoracotomy. Study-reported success ranged from 90%-96% with VATS and 70%-95% with fibrinolysis; expressed as single-procedure success, these fell to 67%-100% and 63%-98%, respectively, against 47% for drainage alone. Chest tube duration was often shorter after VATS, although the drain serves a different purpose in each pathway and is not a measure of efficacy. Overall complication rates were low; bronchopleural fistula was reported by only three studies.</p><p><strong>Conclusions: </strong>Both VATS and intrapleural fibrinolysis are safe and effective treatments for paediatric empyema. Both are superior to chest drainage alone. VATS more often achieves resolution with a single procedure, whereas fibrinolysis remains a viable, less-invasive first-line option. Simple parapneumonic effusion requires intravenous antibiotics and supportive care alone. Because allocation was not standardized, differences in reintervention should not be read causally.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abdominal Tics in Children and Adolescents: A Phenomenology-First Diagnostic Framework and Differential Diagnosis.","authors":"İsmail Akaltun, Tayfun Kara, Celil Yılmaz, Enes Turan, Ersin Sayar","doi":"10.1111/jpc.70627","DOIUrl":"https://doi.org/10.1111/jpc.70627","url":null,"abstract":"<p><strong>Aim: </strong>Abdominal tics are a less commonly described axial or tonic tic phenotype in children and adolescents with Tourette syndrome and chronic tic disorders. Their abdominal location and symptom language may create diagnostic uncertainty with gastrointestinal, epileptic, myoclonic, respiratory or functional presentations.</p><p><strong>Methods: </strong>This clinically focused narrative synthesis identified relevant literature through targeted searches of PubMed/MEDLINE, Scopus and Web of Science from database inception through March 2026, supplemented by a targeted PubMed/MEDLINE and citation-chasing update during revision through August 2026 focused on focal abdominal motor seizures, CASPR2-associated movement phenomena, peripheral nerve hyperexcitability and related mimics.</p><p><strong>Results: </strong>Abdominal tics are supported by the same core tic features that apply across body regions: premonitory urge, partial suppressibility, stereotyped recurrence, waxing-and-waning course, sleep attenuation and prior or concurrent tics when present. Key neurological mimics include belly dancer's dyskinesia, propriospinal myoclonus, focal abdominal motor seizures, CASPR2-associated abdominal movement disorders and functional tic-like behaviours. Preserved awareness does not exclude a focal motor seizure. Gastrointestinal mimics include disorders of gut-brain interaction and inflammatory bowel disease. A pattern-directed clinical triage algorithm is proposed alongside management principles derived from established paediatric tic-disorder evidence, including behavioural intervention as first-line treatment and comorbidity-guided pharmacotherapy.</p><p><strong>Conclusions: </strong>A phenomenology-first, red-flag-guided approach can improve diagnostic clarity and help clinicians avoid both reflexive investigation and premature attribution of organic disease to tics. This review provides a practical clinical triage framework for determining when an abdominal movement behaves like a tic, when targeted neurological or gastrointestinal investigation is indicated and when management can follow established tic-disorder principles.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Australian Guideline for the Identification and Management of Hypertension in Children and Adolescents","authors":"N. G. Larkins,&nbsp;T. Medley,&nbsp;A. Black,&nbsp;K. A. Bolton,&nbsp;S. Chaturvedi,&nbsp;M. Clark,&nbsp;G. M. Gabb,&nbsp;J. P. Glenning,&nbsp;C. Grimes,&nbsp;R. C. Huang,&nbsp;A. Hyland,&nbsp;C. Jeffries-Stokes,&nbsp;L. Kalman,&nbsp;S. Kaul,&nbsp;S. Kim,&nbsp;S. McTaggart,&nbsp;R. Kowalski,&nbsp;S. X. Li,&nbsp;S. McNab,&nbsp;D. Metz,&nbsp;A. S. Mihailidou,&nbsp;J. Monin,&nbsp;M. Nelson,&nbsp;M. Pathak,&nbsp;D. Roebuck,&nbsp;M. P. Schlaich,&nbsp;R. Sleaby,&nbsp;C. Quinlan,&nbsp;J. P. Mynard","doi":"10.1111/jpc.70491","DOIUrl":"10.1111/jpc.70491","url":null,"abstract":"&lt;p&gt;Hypertension is among the most important risk factors for chronic disease and avoidable death worldwide [&lt;span&gt;1&lt;/span&gt;]. There is now clear evidence that high blood pressure (BP) should be approached from a life-course perspective, with the identification of early risk factors in time creating opportunity to alter adverse trajectories through early intervention [&lt;span&gt;2&lt;/span&gt;]. In recent years, evidence linking childhood BP to clinical events in later life has expanded, building on prior evidence demonstrating an association between BP in children and surrogate endpoints by mid-adulthood [&lt;span&gt;3-10&lt;/span&gt;]. This is timely because of the increasing prevalence of hypertension among children and adolescents, concurrent with increasing overweight and obesity [&lt;span&gt;11, 12&lt;/span&gt;]. These trends are equally apparent among the Australian population with the additional observation of a greater prevalence among Aboriginal and Torres Strait Islander children and adolescents consistent with the marked excess of early cardiac and kidney events in young Aboriginal and Torres Strait Islander adults [&lt;span&gt;13-17&lt;/span&gt;]. Yet, in Australia there is no unified guideline for the identification and management of hypertension for children and adolescents less than 18 years of age [&lt;span&gt;18&lt;/span&gt;]. Use of international guidelines may not account for the unique characteristics of the Australian population and healthcare system, including geographic distribution and limited person-level preventative healthcare mechanisms once children commence school. This guideline, facilitated by the BPOzKids Network and Hypertension Australia, aims to address this gap by providing a unified and practical guideline for the identification and management of hypertension in children and adolescents. It is aligned in all practical aspects to Heart Foundation, Stroke Foundation, and Hypertension Australia guidelines for blood pressure and cardiovascular disease risk [&lt;span&gt;19-21&lt;/span&gt;]. Noting that the Heart Foundation Guideline is due for review shortly and amendments will be issued to this guideline if significant changes are required to maintain continuity.&lt;/p&gt;&lt;p&gt;The following organisations provided input during guideline development and endorsed the final version as published: National Heart Foundation of Australia, Hypertension Australia, Royal Australasian College of Physicians, Cardiac Society of Australia and New Zealand, Kidney Health Australia, Australia and New Zealand Paediatric Nephrology Association, and the Australia New Zealand Paediatric Obesity Network.&lt;/p&gt;&lt;p&gt;The Australian Guideline for the Identification and Management of Hypertension in Children and Adolescents (hereafter referred to as the ‘Australian Guideline’) was developed by adapting existing international guidelines to the Australian context using the ADAPTE process [&lt;span&gt;22&lt;/span&gt;]. A multidisciplinary Guideline Steering Committee (GSC) oversaw the process and included subject-matter experts, consumer","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1822-1847"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70491","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148436972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Placebo-Controlled Randomized Trial of Repeated High-Dose Intravenous Magnesium Sulphate and High-Dose Nebulized Budesonide for Severe Asthma in the Paediatric Emergency Department","authors":"Khalid Alansari,&nbsp;Fatin Abou Moussa,&nbsp;Hadi Abu Rasheed,&nbsp;Bruce L. Davidson,&nbsp;Khalid Yousif Ibrahim,&nbsp;Mahmoud Alrifaai","doi":"10.1111/jpc.70530","DOIUrl":"10.1111/jpc.70530","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Determine if high-dose intravenous magnesium with/without nebulized budesonide for children with acute severe asthma is safe and reduces time to medical readiness for discharge compared to standard intravenous magnesium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Either 2 doses of intravenous magnesium or 1 dose and placebo, each with/without high-dose nebulized budesonide, were given in a double-blind randomized trial to study patients in addition to standard-of-care asthma treatment. Time to medical readiness for discharge was the primary outcome. The proportion of patients discharged at 12, 18, and 24 h, asthma severity scores at 4, 8, 12, and 24 h, and safety of high-dose magnesium were secondary outcomes. Follow-up was 1 week.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Covid-19 intervened to stop recuitment at 70% of the estimated 218 children planned. Primary and secondary results were similar for the 4 groups. High-dose magnesium was safe on clinical and laboratory assessment. Exploratory analysis combining IV high-dose magnesium groups compared to standard magnesium showed improvement of discharge ratio at 12 h for the former. 40/78 patients (51.2%) in high-dose magnesium versus 26/75 patients (34.6%) in the standard magnesium arms ready for discharge, <i>p</i> = 0.038, absolute risk reduction 16.6%,95% CI, 0.93% to 31.1%. There was a trend toward improvement of PRAM score at 4 and 8 h in the nebulized budesonide groups compared to placebo and no significant difference in seeking post-discharge outpatient or need for inpatient care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High-dose magnesium appeared safe with only a modest possible benefit of medical readiness for discharge at 12 h. There was a reduction in asthma severity score at 4 and 8 h from nebulized budesonide.</p>\u0000 \u0000 <p>\u0000 <b>Trial Registration:</b> clinicaltrials.gov, ID #NCT 02455687</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1948-1958"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70530","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vasopressin Use in Extremely Preterm Infants With Refractory Cardiopulmonary Instability: Physiological Response and Mortality-Associated Factors","authors":"Faisal Alamer,&nbsp;Kamal Ali,&nbsp;Saif Alsaif,&nbsp;Mohanned Alrahili,&nbsp;Mohammed Almahdi,&nbsp;Eman Bazbouz,&nbsp;Rana Almuqati,&nbsp;Saad Alshareedah,&nbsp;Faisal Alsehli,&nbsp;Abdulaziz Homedi","doi":"10.1111/jpc.70534","DOIUrl":"10.1111/jpc.70534","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the physiological response following vasopressin initiation and identify factors associated with mortality in extremely preterm infants with refractory cardiopulmonary instability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>Retrospective cohort study of infants born at less than 29 weeks' gestation who received vasopressin. Physiological responses and mortality were evaluated using multivariate logistic regression and receiver operating characteristic analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort included 87 infants, of whom 60 (69.0%) died before discharge. Prior to vasopressin initiation, non-survivors had lower pH (7.20 [7.07–7.26] vs. 7.25 [7.21–7.30]; <i>p</i> = 0.009), higher lactate concentrations (5.6 vs. 1.1 mmol/L; <i>p</i> = 0.001), and higher oxygen saturation index (14.7 vs. 12.0; <i>p</i> = 0.022). Following vasopressin initiation, mean blood pressure increased from 29.0 to 39.0 mmHg at 24 h (<i>p</i> &lt; 0.001), while FiO₂ requirements, oxygenation indices, and lactate concentrations decreased. Lower pre-treatment pH (adjusted OR 0.53, 95% CI 0.33–0.87; <i>p</i> = 0.012), higher oxygen saturation index (adjusted OR 1.10, 95% CI 1.02–1.19; <i>p</i> = 0.017), and higher lactate concentration (adjusted OR 1.62, 95% CI 1.04–2.54; <i>p</i> = 0.035) were independently associated with mortality. Lactate showed the strongest discrimination for mortality (AUC 0.85, 95% CI 0.69–0.97).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Vasopressin initiation was associated with improved physiological markers. Mortality was associated more strongly with impaired perfusion and oxygenation severity than with blood pressure alone.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1971-1980"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70534","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}