Paediatric Respiratory Reviews最新文献

{"title":"Severe asthma in adolescents: Clinical implications and beyond.","authors":"Francesca Bonomo, Giuliana Ferrante, Michele Piazza, Laura Tenero, Marco Zaffanello, Giorgio Piacentini","doi":"10.1016/j.prrv.2025.01.006","DOIUrl":"https://doi.org/10.1016/j.prrv.2025.01.006","url":null,"abstract":"<p><p>Severe asthma affects about 6.7% of adolescents worldwide, posing a substantial burden on their physical and psychosocial well-being. The impact of severe asthma on adolescents is multifaceted, with several factors that contribute to this burden, such as comorbidities including obesity, dysfunctional breathing, sleep-disordered breathing and mental health issues. Moreover, daily therapy management is often complex and may require lifestyle modification that could lead to a failure in treatment adherence and to peer-related stressors such as feelings of exclusion. Furthermore, adolescents with severe asthma are prone to risk-taking behaviours, including vaping and substance misuse. While current management strategies often fail to account for their developmental stage, digital technologies offer novel solutions to improve disease management. This narrative review aims to provide a comprehensive overview of the multifaceted impact of severe asthma on adolescents, addressing the main clinical management issues and exploring the role of innovative digital tools to enhance asthma management in this critical population.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449718","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":"Diagnostic and interventional paediatric bronchoscopy in low and middle-income countries.","authors":"Pierre Goussard, Ernst Eber, Lisa Frigati, Leonore Greybe, Shyam Sunder B Venkatakrishna, Jacques Janson, Zane Ismail, Andre Gie, Delano Rhode, Pawel Schubert, Marc Merven, Savvas Andronikou","doi":"10.1016/j.prrv.2025.01.005","DOIUrl":"https://doi.org/10.1016/j.prrv.2025.01.005","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the role of both diagnostic and interventional paediatric bronchoscopy in the management of respiratory diseases in children in low- and middle-income countries (LMICs).</p><p><strong>Design: </strong>A review of published English literature from January 2014 to February 2024.</p><p><strong>Results: </strong>Indications for bronchoscopy in LMICs will vary depending on the burden of infectious diseases like tuberculosis (TB) and HIV, and the expertise and equipment available. TB diagnosis in children remains challenging due to the paucibacillary nature of the disease and its overlap with other infectious diseases like actinomycosis and echinococcosis. Acquired conditions, such as foreign body (FB) inhalation, present late with a high complication rate, making them challenging to manage. Paediatric bronchoscopy has an important role in the diagnoses, management and follow-up of many of these conditions. Interventional procedures like endobronchial ultrasound (EBUS), radial EBUS and cryotherapy enhance diagnostic and management capabilities.</p><p><strong>Conclusion: </strong>Children in LMICs are affected by both infectious and acquired conditions. Bronchoscopy remains expensive with limited training offered in LMICs but is increasingly recognised for its important diagnostic and therapeutic role.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414738","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":"The future of paediatric obstructive sleep apnoea assessment: Integrating artificial intelligence, biomarkers, and more.","authors":"Mon Ohn, Kathleen J Maddison, Jennifer H Walsh, Britta S von Ungern-Sternberg","doi":"10.1016/j.prrv.2025.01.004","DOIUrl":"https://doi.org/10.1016/j.prrv.2025.01.004","url":null,"abstract":"<p><p>Assessing obstructive sleep apnoea (OSA) in children involves various methodologies, including sleep studies, nocturnal oximetry, and clinical evaluations. Previous literature has extensively discussed these traditional methods. Despite this, there is no consensus on the optimal screening method for childhood OSA, further complicated by the complexity and limited availability of diagnostic polysomnography (PSG). Recent advancements, such as the integration of artificial intelligence, biomarkers, 3D facial photography, and wearable technology, offer promising alternatives for early detection and more accurate diagnosis of OSA in children. This article provides a comprehensive review of these innovative techniques, highlighting their potential to enhance diagnostic accuracy and overcome the limitations of current methods. With an emphasis on cutting-edge technologies and emerging biomarkers, we discuss the future directions for paediatric OSA assessments and their potential to revolutionise clinical practice.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075278","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":"Narrative review of clinical prediction models for paediatric community acquired pneumonia","authors":"Chris A. Rees ,&nbsp;Stuart Haggie ,&nbsp;Todd A. Florin","doi":"10.1016/j.prrv.2025.01.002","DOIUrl":"10.1016/j.prrv.2025.01.002","url":null,"abstract":"<div><div>Community acquired pneumonia (CAP) is a disease experienced by children the world over, though CAP-related morbidity and mortality differ markedly between low- and middle-income countries (LMICs) and high-income countries (HICs). Thus, setting-specific clinical prediction models are needed to identify children at risk for CAP-related morbidity and mortality. Here, we outline published clinical prediction models from LMICs and HICs for pediatric CAP-related outcomes. To date, there have been four clinical prediction models to predict treatment failure, two to predict a composite outcome of poor outcomes, and eight models for mortality prediction for CAP in LMICs. No prediction models developed in LMICs had publications that described their impact on clinical care through implementation. In HICs, to date there are three published clinical prediction models evaluating disease severity and one examining the need for major medical interventions. While clinical prediction models described in this review provide a strong foundation for risk stratification for children with CAP in HICs, there is a need for widespread external validation and implementation of optimally performing models.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"54 ","pages":"Pages 19-27"},"PeriodicalIF":4.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449713","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":"Comparison of video laryngoscopy and direct laryngoscopy for urgent intubation in newborn infants: A meta-analysis","authors":"Wenhao Xu ,&nbsp;Peng Wang ,&nbsp;Jun Wan ,&nbsp;Qingyu Bao ,&nbsp;Ruixia Yu ,&nbsp;Yuxin Zheng ,&nbsp;Xingyu Kuang ,&nbsp;Yulin Li ,&nbsp;Zhicheng He ,&nbsp;Jorge Luis Cuyubamba Dominguez ,&nbsp;Yu Zhang","doi":"10.1016/j.prrv.2024.11.002","DOIUrl":"10.1016/j.prrv.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Securing a stable airway is a critical component in neonatal resuscitation. Compared to direct laryngoscopy, video laryngoscopy provides improved visualization of the glottis, potentially enhancing the success rate of intubation. This systematic review and <em>meta</em>-analysis were conducted to assess and compare the efficacy and safety of video laryngoscopy versus direct laryngoscopy in neonatal intubation.</div></div><div><h3>Methods</h3><div>A thorough search was performed across CENTRAL, Embase, and PubMed databases to identify relevant randomized controlled trials (RCTs) that evaluated the use of video laryngoscopy in comparison with direct laryngoscopy for neonatal intubation. The data extraction and analysis were conducted in alignment with Cochrane guidelines. The primary outcome of interest was the time required for intubation, while secondary outcomes included the number of intubation attempts and the success rate on the first attempt.</div></div><div><h3>Results</h3><div>The <em>meta</em>-analysis included nine RCTs, encompassing a total of 719 neonates. The findings revealed that video laryngoscopy was associated with a longer intubation time (mean difference [MD] 3.23 s, 95 % confidence interval [CI] 2.42 to 4.04; I² = 96 %). However, it also significantly improved the first-attempt success rate (risk ratio [RR] 1.31, 95 % CI 1.20 to 1.44; I² = 76 %) and borderline reduced the total number of intubation attempts (MD −0.08, 95 % CI −0.15 to 0.00; I² = 53 %).</div></div><div><h3>Conclusions</h3><div>While video laryngoscopy is associated with a modest increase in intubation time, it provides clear benefits by enhancing the success rate of first-attempt intubations and reducing the need for multiple attempts in neonatal intubation procedures.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"54 ","pages":"Pages 28-34"},"PeriodicalIF":4.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067108","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":"Exercise capacity and the psychosocial effect in preterm born infants - Should we do more?","authors":"H T Fitzgerald, T Halvorsen, M Engan, S Li, H Selvadurai","doi":"10.1016/j.prrv.2025.01.001","DOIUrl":"https://doi.org/10.1016/j.prrv.2025.01.001","url":null,"abstract":"<p><p>Physical activity is crucial for children's physical, cognitive, and social development, reducing the risk of non-communicable diseases and improving overall well-being. A major legacy of extremely preterm delivery is respiratory limitation with reduced lung function and decreased exercise capacity which can be further exacerbated by inactivity and deconditioning. Strategies to increase incidental physical activities in early childhood and participation in sport and more formal exercise programmes in middle childhood have the potential to optimize cardiopulmonary function, improve quality of life, and foster social interactions in childhood and beyond, thereby providing benefits that extend far beyond the physical domain. Intervention strategies such as supervised aerobic and resistance training, and incorporation of physical activity into daily routines have shown promise in increasing activity levels and improving exercise capacity in this population. Engaging families and tailoring programs to individual needs are crucial for the success of these interventions. Overall, a holistic approach that promotes increased physical activity and addresses psychosocial barriers is essential for optimizing the health, well-being, and quality of life of preterm-born children. Further research and development of effective, long-term intervention programs are needed to support these vulnerable individuals throughout childhood and into adulthood.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143040689","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 review of imaging in the diagnosis and management of complicated paediatric pneumonia","authors":"Wendy E. Huang ,&nbsp;Joan A. Matifoll ,&nbsp;David Lord ,&nbsp;Stuart Haggie","doi":"10.1016/j.prrv.2024.12.001","DOIUrl":"10.1016/j.prrv.2024.12.001","url":null,"abstract":"<div><div>Paediatric pneumonia and its complications present substantial health and economic challenges. While chest radiographs are commonly used as the initial imaging modality for diagnosing uncomplicated pneumonia, they are less effective for complicated cases. In response, various imaging techniques, such as lung ultrasound, computed tomography (CT), and chest MRI, have been integrated into clinical practice to enhance diagnosis and guide management decisions. No definitive gold standard exists for imaging complicated paediatric pneumonia and clinicians may find it challenging to choose the best imaging technique for a given clinical scenario. In this review we describe the available imaging options relevant for the management of paediatric pneumonia and evaluate the strengths and limitations of each modality.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"54 ","pages":"Pages 12-18"},"PeriodicalIF":4.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984564","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":"Surfactant administration and cerebral oxygenation and perfusion in preterm neonates - A systematic review of literature.","authors":"Christina H Wolfsberger, Marlies Bruckner, Christoph Schlatzer, Bernhard Schwaberger, Nariae Baik-Schneditz, Berndt Urlesberger, Gerhard Pichler","doi":"10.1016/j.prrv.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.prrv.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>Surfactant replacement is standard for preterm neonates with respiratory distress syndrome, improving survival and outcomes. Less invasive surfactant administration (LISA) and intubation-surfactant-extubation (INSURE) are preferred methods for surfactant replacement in spontaneously breathing preterm neonates. Despite the undeniable benefits of surfactant implementation in neonatal care, surfactant administration can affect vital parameters and cerebral oxygenation and perfusion, assessed by near-infrared spectroscopy (NIRS).</p><p><strong>Objective: </strong>This review systematically examined the literature on surfactant administration in preterm neonates and its impact on NIRS-measured cerebral oxygenation.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, CINAHL, Clinical Trials, and Ovid Medline was conducted using following terms: newborn, infant, neonate, preterm, premature, prematurity, surfactant, LISA, less-invasive surfactant administration, INSURE, near-infrared-spectroscopy, NIRS, oximetry, spectroscopy, cerebral oxygenation, cerebral tissue oxygen saturation (crSO₂), crSO₂, cerebral perfusion. Only studies in human preterm neonates were included.</p><p><strong>Results: </strong>Sixteen studies were identified that described cerebral oxygenation measured by NIRS in the context of surfactant administration demonstrating a decrease in crSO₂ during surfactant administration, followed by a subsequent increase. Three studies specifically described the course of crSO₂ in neonates while receiving LISA, whereby in two of these LISA was compared to INSURE describing differences in crSO₂ behaviour. Two additional studies described surfactant administration using the INSURE procedure and the influence on cerebral oxygenation. Ten studies investigated surfactant administration in intubated neonates receiving mechanical ventilation. One study described crSO₂ in neonates receiving aerosolised surfactant.</p><p><strong>Conclusion: </strong>This systematic review indicates that surfactant administration is associated with a transient decrease in crSO₂ followed by a return to baseline levels, whereby differences between the LISA and INSURE methods were observed.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818889","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":"The lower airway microbiome in paediatric health and chronic disease","authors":"S Campbell ,&nbsp;K Gerasimidis ,&nbsp;S Milling ,&nbsp;AJ Dicker ,&nbsp;R Hansen ,&nbsp;RJ Langley","doi":"10.1016/j.prrv.2024.02.001","DOIUrl":"10.1016/j.prrv.2024.02.001","url":null,"abstract":"<div><div>The advent of next generation sequencing has rapidly challenged the paediatric respiratory physician’s understanding of lung microbiology and the role of the lung microbiome in host health and disease. In particular, the role of “microbial key players” in paediatric respiratory disease is yet to be fully explained. Accurate profiling of the lung microbiome in children is challenging since the ability to obtain lower airway samples coupled with processing “low-biomass specimens” are both technically difficult. Many studies provide conflicting results. Early microbiota-host relationships may be predictive of the development of chronic respiratory disease but attempts to correlate lower airway microbiota in premature infants and risk of developing bronchopulmonary dysplasia (BPD) have produced mixed results. There are differences in lung microbiota in asthma and cystic fibrosis (CF). The increased abundance of oral taxa in the lungs may (or may not) promote disease processes in asthma and CF. In CF, correlation between microbiota diversity and respiratory decline is commonly observed. When one considers other pathogens beyond the bacterial kingdom, the contribution and interplay of fungi and viruses within the lung microbiome further increase complexity. Similarly, the interaction between microbial communities in different body sites, such as the gut-lung axis, and the influence of environmental factors, including diet, make the co-existence of host and microbes ever more complicated. Future, multi-omics approaches may help uncover novel microbiome-based biomarkers and therapeutic targets in respiratory disease and explain how we can live in harmony with our microbial companions.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"52 ","pages":"Pages 31-43"},"PeriodicalIF":4.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139927150","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":"Effectiveness of high flow nasal Cannula (HFNC) therapy compared to standard oxygen therapy (SOT) and continuous positive airway pressure (CPAP) in bronchiolitis","authors":"Emma C Alexander ,&nbsp;Toranj Wadia ,&nbsp;Padmanabhan Ramnarayan","doi":"10.1016/j.prrv.2024.05.004","DOIUrl":"10.1016/j.prrv.2024.05.004","url":null,"abstract":"<div><div><span><span><span>High Flow Nasal Cannula<span> therapy (HFNC) is a form of respiratory support for </span></span>bronchiolitis. Recent evidence confirms HFNC reduces the risk of treatment escalation by nearly half (45%) compared to standard oxygen therapy (SOT), although most patients (75%) with mild-moderate respiratory distress manage well on SOT. The majority of children (60%) failing SOT respond well to HFNC making </span>rescue use of HFNC a more cost-effective approach compared to its first-line use. HFNC is compared to</span> <span>CPAP in the setting of moderate to severe bronchiolitis. Patients on HFNC have a slightly elevated risk of treatment failure especially in severe bronchiolitis, but this does not translate to a significant difference in patient or healthcare centred outcomes. HFNC has improved tolerance, a lower complication rate and is more easily available in peripheral hospitals. It is therefore the preferred first line option followed by rescue CPAP. HFNC is clinically effective and safe to use in bronchiolitis of all severities.</span></div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"52 ","pages":"Pages 3-8"},"PeriodicalIF":4.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141402272","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}