Paediatric Respiratory Reviews最新文献

{"title":"Diagnostic challenges in CFTR-related metabolic syndrome: Where the guidelines fall short","authors":"Erin F. Kallam ,&nbsp;Ajay S. Kasi ,&nbsp;Eileen Barr ,&nbsp;Rachel W. Linnemann ,&nbsp;Lokesh Guglani","doi":"10.1016/j.prrv.2023.08.004","DOIUrl":"10.1016/j.prrv.2023.08.004","url":null,"abstract":"<div><p><span>Newborn screening<span> (NBS) for cystic fibrosis (CF) has enabled earlier diagnosis and has improved nutritional and growth-related outcomes in children with CF. For those with a positive NBS for CF that do not meet the diagnostic criteria for CF, the clinical entity called CFTR-Related </span></span>Metabolic Syndrome (CRMS) or CF Screen- Positive, Inconclusive Diagnosis (CFSPID) is used. Although most children with CRMS remain relatively asymptomatic, studies have shown that between 11% and 48% of these patients may eventually progress to a diagnosis of CF over time. Although the CF Foundation guidelines for CRMS management and European CF Society guidelines for CFSPID have some similarities, there are also some differences. Here, we review challenging case scenarios that highlight remaining gaps in CRMS guidelines, thus supporting the need to update and unify existing guidelines.</p></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"49 ","pages":"Pages 28-33"},"PeriodicalIF":5.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10137990","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":"Positive end-expiratory pressure in the pediatric intensive care unit","authors":"Martin C.J. Kneyber","doi":"10.1016/j.prrv.2023.11.003","DOIUrl":"10.1016/j.prrv.2023.11.003","url":null,"abstract":"<div><p>Application of positive end-expiratory pressure (PEEP) targeted towards improving oxygenation is one of the components of the ventilatory management of pediatric acute respiratory distress syndrome (PARDS). Low end-expiratory airway pressures cause repetitive opening and closure of unstable alveoli, leading to surfactant dysfunction and parenchymal shear injury. Consequently, there is less lung volume available for tidal ventilation when there are atelectatic lung regions. This will increase lung strain in aerated lung areas to which the tidal volume is preferentially distributed. Pediatric critical care practitioners tend to use low levels of PEEP and inherently accept higher FiO₂, but these practices may negatively affect patient outcome. The Pediatric Acute Lung Injury Consensus Conference (PALICC) suggests that PEEP should be titrated to oxygenation/oxygen delivery, hemodynamics, and compliance measured under static conditions as compared to other clinical parameters or any of these parameters in isolation in patients with PARDS, while limiting plateau pressure and/or driving pressure limits.</p></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"49 ","pages":"Pages 5-8"},"PeriodicalIF":5.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1526054223000805/pdfft?md5=8a8401dcb165410bb49f999923c16c82&pid=1-s2.0-S1526054223000805-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461455","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":"Can postural changes in spirometry in children with Duchenne muscular dystrophy predict sleep hypoventilation?","authors":"C. Pandit ,&nbsp;B. Kennedy ,&nbsp;K. Waters ,&nbsp;H. Young ,&nbsp;K. Jones ,&nbsp;D.A. Fitzgerald","doi":"10.1016/j.prrv.2023.08.002","DOIUrl":"10.1016/j.prrv.2023.08.002","url":null,"abstract":"<div><h3>Aim</h3><p><span>To explore the relationship between postural changes in lung function and polysomnography (PSG) in children with </span>Duchenne muscular dystrophy (DMD).</p></div><div><h3>Methods</h3><p>In this prospective cross-sectional study, children with DMD performed spirometry in sitting and supine positions. A control group of age and gender matched healthy children also underwent postural lung function testing. PSG was performed within six months of spirometry.</p></div><div><h3>Results</h3><p>Seventeen children with DMD, aged 12.3 ± 3 years performed sitting spirometry. 14 (84%) performed acceptable spirometry in the supine position. Mean FEV₁<em>_sit</em><span> and FVC</span><em>_sit</em> were 77% (SD ± 22) and 74% (SD ± 20.4) respectively, with mean% ΔFVC₍<em>_sit–sup</em>₎ 9% (SD ± 11) (range 2% to 20%), and was significantly greater than healthy controls 4% (n = 30, SD ± 3, <em>P</em> &lt; 0.001). PSG data on the 14 DMD children with acceptable supine spirometry showed total AHI 6.9 ± 5.9/hour (0.3 to 29), obstructive AHI 5.2 ± 4.0/hour (0.2 to 10), and REM AHI 14.1 ± -5.3/hour (0.1 to 34.7). ΔFVC(sit–sup) had poor correlation with hypoventilation on polysomnography.</p></div><div><h3>Conclusion</h3><p>Children with DMD and mild restrictive lung disease showed greater postural changes in spirometry than healthy controls but lower supine spirometry was not predictive of sleep hypoventilation.</p></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"49 ","pages":"Pages 9-13"},"PeriodicalIF":5.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10579871","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":"Preventative therapies for respiratory Syncytial virus (RSV) in children: Where are we now?","authors":"Marie-Hélène Bourassa,&nbsp;Larry C. Lands","doi":"10.1016/j.prrv.2023.08.005","DOIUrl":"10.1016/j.prrv.2023.08.005","url":null,"abstract":"<div><p><span>Respiratory Syncytial Virus (RSV) is a leading cause of hospitalization in </span>young children<span><span> and represents a substantial health-care burden around the world. Advances in research have helped identify the prefusion F protein as the key target component in RSV immunization. In this article, we review the previous, current, and ongoing research efforts for immunization against RSV in children. We present the different types of immunization which include monoclonal antibodies, maternal immunization and vaccines while addressing the challenges of preventing </span>RSV infections<span> in the pediatric population.</span></span></p></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"49 ","pages":"Pages 24-27"},"PeriodicalIF":5.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10579835","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":"Individualized aerosol medicine: Integrating device into the patient","authors":"Arzu Ari ,&nbsp;Namita Raghavan ,&nbsp;Martha Diaz ,&nbsp;Bruce K. Rubin ,&nbsp;James B. Fink","doi":"10.1016/j.prrv.2023.07.003","DOIUrl":"10.1016/j.prrv.2023.07.003","url":null,"abstract":"<div><p>Pulmonary drug delivery is complex due to several challenges including disease-, patient-, and clinicians-related factors. Although many inhaled medications are available in aerosol medicine, delivering aerosolized medications to patients requires effective disease management. There is a large gap in the knowledge of clinicians who select and provide instructions for the correct use of aerosol devices. Since improper device selection, incorrect inhaler technique, and poor patient adherence to prescribed medications may result in inadequate disease control, individualized aerosol medicine is essential for effective disease management and control. The components of individualized aerosol medicine include: (1) Selecting the right device, (2) Selecting the right interface, (3) Educating the patient effectively, and (4) Increasing patient adherence to therapy. This paper reviews each of these components and provides recommendations to integrate the device and interface into the patient for better clinical outcomes.</p></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"49 ","pages":"Pages 14-23"},"PeriodicalIF":5.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41121867","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":"Virtues of PEEP in the PICU and beyond","authors":"Henry Rozycki ,&nbsp;Brigitte Fauroux","doi":"10.1016/j.prrv.2023.12.003","DOIUrl":"10.1016/j.prrv.2023.12.003","url":null,"abstract":"","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"49 ","pages":"Page 1"},"PeriodicalIF":5.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139020477","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":"Bronchoscopy findings in children with congenital lung and lower airway abnormalities","authors":"Pierre Goussard ,&nbsp;Ernst Eber ,&nbsp;Shyam Venkatakrishna ,&nbsp;Jacques Janson ,&nbsp;Pawel Schubert ,&nbsp;Savvas Andronikou","doi":"10.1016/j.prrv.2023.10.001","DOIUrl":"10.1016/j.prrv.2023.10.001","url":null,"abstract":"<div><p>Congenital lung and lower airway abnormalities are rare, but they are an important differential diagnosis in children with respiratory diseases, especially if the disease is recurrent or does not resolve. The factors determining the time of presentation of congenital airway pathologies include the severity of narrowing, association with other lesions and the presence or absence of congenital heart disease (CHD). Bronchoscopy is required in these cases to assess the airway early after birth or when intubation and ventilation are difficult or not possible. Many of these conditions have associated abnormalities that must be diagnosed early, as this determines surgical interventions. It may be necessary to combine imaging and bronchoscopy findings in these children to determine the correct diagnosis as well as in operative management. Endoscopic interventional procedures may be needed in many of these conditions, ranging from intubation to balloon dilatations and aortopexy. This review will describe the bronchoscopic findings in children with congenital lung and lower airway abnormalities, illustrate how bronchoscopy can be used for diagnosis and highlight the role of interventional bronchoscopy in the management of these conditions.</p></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"49 ","pages":"Pages 43-61"},"PeriodicalIF":5.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1526054223000672/pdfft?md5=2866cfc676d1da08cbce77e87abfff92&pid=1-s2.0-S1526054223000672-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522288","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":"Association of respiratory virus types with clinical features in bronchiolitis: Implications for virus testing strategies. A systematic review and meta-analysis","authors":"Dominika Ambrożej ,&nbsp;Izabela Orzołek ,&nbsp;Heidi Makrinioti ,&nbsp;Jose A. Castro-Rodriguez ,&nbsp;Carlos A. Camargo Jr. ,&nbsp;Kohei Hasegawa ,&nbsp;Nikolaos G. Papadopoulos ,&nbsp;James E. Gern ,&nbsp;Gustavo Nino ,&nbsp;Luiz Vicente Ribeiro Ferreira da Silva Filho ,&nbsp;Aya Takeyama ,&nbsp;Özlem Üzüm ,&nbsp;Aleksander Adamiec ,&nbsp;Marek Ruszczyński ,&nbsp;Tuomas Jartti ,&nbsp;Wojciech Feleszko","doi":"10.1016/j.prrv.2023.09.003","DOIUrl":"10.1016/j.prrv.2023.09.003","url":null,"abstract":"<div><h3>Background</h3><p>Bronchiolitis is a leading cause of infant hospitalization, linked to respiratory syncytial virus (RSV) and rhinovirus (RV). Guidelines lack specific viral testing for bronchiolitis management. To establish effective management strategies, it is crucial to assess whether specific respiratory virus types are correlated with distinct examination features.</p></div><div><h3>Methods</h3><p>Through a systematic search of three databases, 21 studies were qualitatively analyzed, with 18 used for meta-analysis. Various outcomes like wheezing on auscultation, fever, atopic traits, and infection severity were evaluated.</p></div><div><h3>Results</h3><p>RSV-positive bronchiolitis was associated with a higher need for oxygen supplementation (OR 1.78, 95% CI 1.04–3.02) in 5 studies, while RV-positive bronchiolitis was more frequently linked to personal history of eczema (OR 0.60, 95% CI 0.41–0.88) in 6 studies. No significant differences were observed in the other outcomes examined.</p></div><div><h3>Conclusions</h3><p>Bronchiolitis caused by RSV or RV presents with similar clinical features. Despite the associations between RSV-positive bronchiolitis and need for oxygen supplementation, and RV-positive bronchiolitis and a history of eczema, our study shows that viral etiology of bronchiolitis cannot be determined solely based on clinical presentation.</p><p>Tailored management strategies, informed by accurate viral testing, seem crucial in clinical practice for enhancing patient outcomes in severe bronchiolitis.</p></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"49 ","pages":"Pages 34-42"},"PeriodicalIF":5.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1526054223000659/pdfft?md5=56f9302ce1ffb1be1dba39f1f50d236b&pid=1-s2.0-S1526054223000659-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41133208","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":"Exercise testing for young athletes","authors":"H. Fitzgerald, D.A. Fitzgerald, H. Selvadurai","doi":"10.1016/j.prrv.2023.12.002","DOIUrl":"https://doi.org/10.1016/j.prrv.2023.12.002","url":null,"abstract":"<p>With increasing competitiveness across the sporting landscape, there is a need for more research into monitoring and managing the young athlete, as the needs of a young athlete are vastly different to those of an older athlete who is already established in their respective sport. As the age of sports specialisation seems to decrease, exercise testing in the younger cohort of athletes is crucial for safety and long-term success. This article provides a comprehensive summary of available testing and monitoring methods that can be used to assist young athletes as they mature and attempt to excel in their chosen sport.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"35 9 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138818971","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":"When to panic about a panic attack: A challenging case of hypersensitivity pneumonitis","authors":"Timothy D. Hicks ,&nbsp;Deena Yousif ,&nbsp;Iris A. Perez ,&nbsp;Thomas G. Keens ,&nbsp;Manvi Bansal","doi":"10.1016/j.prrv.2023.05.002","DOIUrl":"10.1016/j.prrv.2023.05.002","url":null,"abstract":"<div><p>The COVID-19 pandemic has created diagnostic difficulties with the increase in mental health illnesses that often present with nonspecific symptoms, like hypersensitivity pneumonitis. Hypersensitivity pneumonitis is a complex syndrome of varying triggers, onset, severity, and clinical manifestations that can be challenging to diagnose in many cases. Typical symptoms are nonspecific and can be attributed to other entities. There are no pediatric guidelines, which contributes to diagnostic difficulties and delays in treatment. It is particularly important to avoid diagnostic biases, have an index of suspicion for hypersensitivity pneumonitis, and to develop pediatric guidelines as outcomes are excellent when diagnosed and treated promptly. This article discusses hypersensitivity pneumonitis with a focus on the causes, pathogenesis, diagnostic approach, outcomes, and prognosis while using a case to illustrate the diagnostic difficulties worsened by the COVID-19 pandemic.</p></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"48 ","pages":"Pages 20-23"},"PeriodicalIF":5.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9519024","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}