Paediatric Respiratory Reviews最新文献

{"title":"Sleep problems and sleep disordered breathing in children with cerebral palsy.","authors":"R Dhandayuthapani, C M McDougall, F Gahleitner, S Cunningham, D S Urquhart","doi":"10.1016/j.prrv.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.prrv.2025.04.007","url":null,"abstract":"<p><p>Cerebral palsy refers to a group of disorders affecting movement and posture, caused by an impact to the developing brain. Children and young people (CYP) with cerebral palsy (CP) may have multiple associated co-morbidities, including sleep disorders. Sleep disorders, including sleep disordered breathing, are more prevalent among CYP with CP compared to typically developing children due to several contributory factors. Sleep-disordered breathing (SDB) collectively represents several different pathologies, namely obstructive sleep apnoea (OSA), central sleep apnoea (CSA), and hypoventilation. Multiple intrinsic and extrinsic factors contribute to each of these pathologies. Sleep studies (either as polysomnography or cardiorespiratory polygraphy) allow the detection of effort and apnoea, with contemporaneous measurement of oxygen saturations (SpO₂) and transcutaneous carbon dioxide (tcpCO₂). Together these enable the diagnosis of SDB, and the delineation of OSA, CSA and/or hypoventilation. The multifactorial component of SDB among CYP with CP may require intervention ranging from conservative measures (e.g. nasopharyngeal airway, soft collar), surgical options (e.g. adenotonsillectomy), or the initiation of respiratory support. Respiratory support, delivered as Continuous Positive Airway Pressure (CPAP) or Non-Invasive Ventilation (NIV), has a key role in the management of SDB in children with CP though the journey can often be turbulent with a high failure rate. Nonetheless, CYP with CP are being increasingly commenced on respiratory support, often for reasons others than SDB, for example aiding airway clearance in order to reduce the frequency of lower respiratory tract infections. Open discussions between the parents and healthcare professionals are important in setting shared goals for CYP with CP, guided by the primary aim of improving quality of life.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of the clinical effectiveness of dry powder inhalers in maintenance treatment and in treatment of acute exacerbations of asthma in children.","authors":"Helen Twohig, Lauren Franklin, Will Carroll, Nadia Corp, Emma Jackson, Christian Mallen, Bernice Ruan, Louisa Yapp, Danielle Van Der Windt, James Smith","doi":"10.1016/j.prrv.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.prrv.2025.04.005","url":null,"abstract":"<p><strong>Background: </strong>Dry powder inhalers (DPIs) are a lower-carbon option than pressurised metered dose inhalers (pMDIs). However, DPIs require a forceful inhalation to achieve good lung deposition and there is uncertainty as to whether younger children can effectively use DPIs for maintenance treatment or rely upon them during exacerbations.</p><p><strong>Methods: </strong>We searched electronic databases to identify randomised trials of children with asthma receiving treatment delivered via DPI, either for maintenance treatment (children ≤ 12 years) or for an acute exacerbation (participants up to age 18). Screening and data extraction were carried out by two reviewers. Risk of bias (RoB) assessment was made using the Cochrane RoB2 tool. Findings were narratively synthesised and a modified GRADE approach was taken to summarise the strength of evidence.</p><p><strong>Results: </strong>27 studies were included. 20 addressed maintenance treatment in children ≤ 12 years although only 4 compared the same treatment delivered via pMDI to DPI. All found no difference in efficacy between the device types (high certainty evidence). Other studies provided weaker, indirect evidence supporting this finding. 7 studies considered acute asthma in hospital/emergency settings. All reported no difference in efficacy between device types but certainty of evidence was low due to high RoB and clinical and methodological heterogeneity.</p><p><strong>Conclusion: </strong>There are few studies directly comparing treatment via DPI/pMDI for asthma in children. Comparative studies suggest that for children who can use both DPI/pMDI, the devices are equal in efficacy for maintenance treatment in children ≤ 12 years but high-quality evidence is lacking regarding their use during acute exacerbations. This review did not find sufficient evidence to identify a lower age at which DPIs can start being used.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What a paediatric pulmonologist needs to know about vaping.","authors":"M Horgan, D W Cox","doi":"10.1016/j.prrv.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.prrv.2025.04.006","url":null,"abstract":"<p><p>Electronic nicotine delivery systems (ENDS), often known as e-cigarettes or vapes, have transitioned from a smoking cessation tool to a widely used recreational product, particularly among adolescents. The prevalence of youth vaping has surged, driven by accessibility, appealing flavours, targeted marketing, and the rise of disposable vapes. Despite regulations and legislation, underage access remains widespread. Adolescents often perceive vaping as less harmful than smoking, though emerging evidence links e-cigarette use to pulmonary toxicity, increased respiratory symptoms, and potential long-term lung damage. Studies indicate associations between vaping and asthma, bronchiolitis, and chronic obstructive pulmonary disease. Additionally, harmful chemical by-products produced from e-liquid decomposition, raise future health concerns. Regulatory measures vary globally, and the effectiveness of different strategies remains unclear. Paediatric pulmonologists play a key role in addressing this epidemic through patient education and advocacy. Urgent research is needed to assess the long-term health impacts of vaping and develop the most effective vaping cessation interventions.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary hemorrhage in preterm infants born <29 weeks' gestation: a population cohort study.","authors":"Pranav R Jani, Traci-Anne Goyen, James Elhindi, Rajesh Maheshwari, Daphne D'Cruz, Himanshu Popat, Mohamed Abdel-Latif, Melissa Luig, Dharmesh Shah","doi":"10.1016/j.prrv.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.prrv.2025.04.001","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the incidence, clinical characteristics and outcomes of pulmonary hemorrhage (PH) in preterm infants who were born <29 weeks' gestation in relation to their small for gestational age (SGA) status.</p><p><strong>Study design: </strong>This retrospective cohort study included preterm infants born <29 weeks' gestation and admitted to one of eight tertiary perinatal hospitals in New South Wales and The Australian Capital Territory, Australia from 1 January 2007 to 31 December 2019. Data for analysis was obtained from the Neonatal Intensive Care Units' (NICUs) database. Temporal trends and changes in the outcomes were examined using multivariable logistic regression models.</p><p><strong>Results: </strong>The median gestational age was 27 weeks' (interquartile range (IR): 25-28) and the median birth weight was 928 g (IR: 756-1,106). PH occurred in 281/4,823 infants (5.8 %). PH more than doubled in SGA compared to appropriately grown infants (11.1 %: 39/353 versus 5.4 %: 242/4,470, difference 5.7; 95 % CI:2.14-9.12) and in infants born <26 weeks compared to ≥26 weeks (137/1,356: 10.1 % versus 144/3,467: 4.2 %, difference 5.9; 95 % CI:4.16-7.63). After confounder adjustments, PH was associated with a higher predischarge mortality (OR:3.97, 95 % CI:3.00-5.24) and severe intraventricular hemorrhage (OR:4.2, 95 % CI:3.10-5.67) but made no difference in levels of functional impairment at 2-3 years corrected age (OR:1.13, 95 % CI:0.77-1.66).</p><p><strong>Conclusion: </strong>PH was more common in infants born SGA and in those born <26 weeks' gestation. PH was associated with poorer predischarge clinical outcomes. Timely risk prediction is needed to improve outcomes in these infants.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric pulmonary and sleep medicine - Best recent articles to read in 2025.","authors":"Bruce K Rubin","doi":"10.1016/j.prrv.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.prrv.2025.04.002","url":null,"abstract":"<p><p>It is a challenge to select the \"best\" recent publications in a field. This is especially so when faced with a feast of outstanding manuscripts across a broad range of topics. I therefore reached out to a Who's Who of friends and colleagues in pediatric pulmonary and sleep medicine for suggestions, and I was delighted and overwhelmed by the response - please see the Acknowledgements for those who contributed ideas. Overwhelmed, by having to read 77 publications suggested by one or more colleagues and having to winnow the list down to a somewhat reasonable number. I chose to include all papers mentioned by two or more of my colleagues and I then selected the remainder to cover the broad range of our field, based upon my belief that a manuscript represented an important contribution to our understanding and clinical care. What follows are the chosen papers organized by topic area. Given the number of papers that made the final cut, I have briefly summarized each of these manuscripts. I hope that you will find something new and exciting in these publications and that you will have as much fun in reading them as I did.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Thinking community acquired pneumonia (CAP) and its impact on lung health.","authors":"Dominic A Fitzgerald","doi":"10.1016/j.prrv.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.prrv.2025.03.003","url":null,"abstract":"","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards standardized and clinically relevant definitions of hypoxemia and hyperoxemia in preterm infants: A systematic review.","authors":"N H Gangaram-Panday, J A Poppe, A N Tintu, C F Poets, I K M Reiss, W van Weteringen, S H P Simons","doi":"10.1016/j.prrv.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.prrv.2025.03.002","url":null,"abstract":"<p><p>In neonatal care, maintaining oxygen levels in the target range is essential to minimize adverse outcomes. Both episodes of hyperoxemia and hypoxemia are associated with adverse neonatal outcomes. Criteria to determine the hypoxemic and hyperoxemic burden are currently not standardized or generally applied in clinical care. This results in difficulty to identify clinically relevant events in preterm infants. Clinical decisions and interventions are therefore mostly based on the experience of the clinical team. This systematic review aims to provide an overview of the used definitions for hypoxemia and hyperoxemia in preterm infants, based on continuous monitoring techniques and the relation to neonatal outcome (PROSPERO: CRD42023493201).</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic determinants of outcomes in childhood asthma.","authors":"Karl A Holden, Daniel B Hawcutt, Ian P Sinha","doi":"10.1016/j.prrv.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.prrv.2025.03.001","url":null,"abstract":"<p><p>Asthma is the commonest chronic condition of childhood. Children with asthma in the UK have the worst outcomes across Europe and other high-income countries. There are significant socioeconomic inequalities that impact the prevalence and outcomes of asthma (emergency healthcare utilisation, hospitalisation, critical care admission, mortality and quality of life). In this review we discuss these inequalities and the underlying mechanistic links, using the UK as an example of how poverty in a high-income country results in inequality in asthma outcomes. These inequalities and underlying mechanisms need to be understood by clinicians, policymakers and wider stakeholders to be redressed such that avoidable harm and asthma deaths in children can be prevented.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post COVID-19 pandemic consequences for children","authors":"Dominic A. Fitzgerald","doi":"10.1016/j.prrv.2025.01.003","DOIUrl":"10.1016/j.prrv.2025.01.003","url":null,"abstract":"","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"53 ","pages":"Pages 1-2"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate change and children’s respiratory health","authors":"Camille Bignier ,&nbsp;Lucile Havet ,&nbsp;Margot Brisoux ,&nbsp;Céline Omeiche ,&nbsp;Swati Misra ,&nbsp;Apolline Gonsard ,&nbsp;David Drummond","doi":"10.1016/j.prrv.2024.07.002","DOIUrl":"10.1016/j.prrv.2024.07.002","url":null,"abstract":"<div><div>Climate change has significant consequences for children’s respiratory health. Rising temperatures and extreme weather events increase children’s exposure to allergens, mould, and air pollutants. Children are particularly vulnerable to these airborne particles due to their higher ventilation per unit of body weight, more frequent mouth breathing, and outdoor activities. Children with asthma and cystic fibrosis are at particularly high risk, with increased risks of exacerbation, but the effects of climate change could also be observed in the general population, with a risk of impaired lung development and growth. Mitigation measures, including reducing greenhouse gas emissions by healthcare professionals and healthcare systems, and adaptation measures, such as limiting outdoor activities during pollution peaks, are essential to preserve children’s respiratory health. The mobilisation of society as a whole, including paediatricians, is crucial to limit the impact of climate change on children’s respiratory health.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"53 ","pages":"Pages 64-73"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897945","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}