Paediatric Respiratory Reviews最新文献

{"title":"Expiratory airflow limitation in adults born extremely preterm: A systematic review and meta-analysis","authors":"Henriette Lahn-Johannessen Lillebøe ,&nbsp;Merete Salveson Engeset ,&nbsp;Hege H Clemm ,&nbsp;Thomas Halvorsen ,&nbsp;Ola Drange Røksund ,&nbsp;Thomas Potrebny ,&nbsp;Maria Vollsæter","doi":"10.1016/j.prrv.2024.02.002","DOIUrl":"10.1016/j.prrv.2024.02.002","url":null,"abstract":"<div><p>Extreme preterm (EP) birth, denoting delivery before the onset of the third trimester, interrupts intrauterine development and causes significant early-life pulmonary trauma, thereby posing a lifelong risk to respiratory health. We conducted a systematic review and <em>meta</em>-analysis to investigate adult lung function following EP birth (gestational age &lt;28 weeks); comparing forced expiratory volume in first second (FEV₁), forced vital capacity (FVC), and FEV₁/FVC to reference values. Subgroup differences were explored based on timing of birth relative to surfactant use (1991) and bronchopulmonary dysplasia (BPD) status. Systematic searches were performed in Medline, EMBASE, Web of Science and Cochrane Central. Quality assessments were carried out using a modified Newcastle-Ottawa Scale for cohort studies. Sixteen studies encompassing 1036 EP-born adults were included, with 14 studies (n = 787) reporting data as %predicted, and 11 (n = 879) as z-score (not mutually exclusive). Overall mean [95 % confidence interval (CI)] %FEV₁ was 85.30 (82.51; 88.09), %FVC was 94.33 (91.74; 96.91), and FEV₁/FVC was 79.54 (77.71 to 81.38), all three with high heterogeneity. Overall mean (95 %CI) zFEV₁ was −1.05 (-1.21; −0.90) and zFVC was.</p><p>−0.45 (-0.59; −0.31), both with moderate heterogeneity. Subgroup analyses revealed no difference in FEV₁ before versus after widespread use of surfactant, but more impairments after neonatal BPD. This <em>meta</em>-analysis revealed significant airflow limitation in EP-born adults, mostly explained by those with neonatal BPD. FEV₁ was more reduced than FVC, and FEV₁/FVC was at the lower limit of normal. Although at a group level, most adult EP-born individuals do not meet COPD criteria, these findings are concerning.</p></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"50 ","pages":"Pages 2-22"},"PeriodicalIF":5.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1526054224000198/pdfft?md5=1cbd340fc004995d5289d5a0dc978981&pid=1-s2.0-S1526054224000198-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139927099","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":"Characterising the lifelong consequences of bronchopulmonary dysplasia","authors":"Dominic A. Fitzgerald","doi":"10.1016/j.prrv.2024.03.001","DOIUrl":"10.1016/j.prrv.2024.03.001","url":null,"abstract":"","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"50 ","pages":"Page 1"},"PeriodicalIF":5.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140403352","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":"Adherence in paediatric respiratory medicine: A review of the literature","authors":"Ella A. Kotecha ,&nbsp;Dominic A. Fitzgerald ,&nbsp;Sailesh Kotecha","doi":"10.1016/j.prrv.2023.09.004","DOIUrl":"10.1016/j.prrv.2023.09.004","url":null,"abstract":"<div><p>Poor adherence is an important factor in unstable disease control and treatment failure. There are multiple ways to monitor a patient’s adherence, each with their own advantages and disadvantages. The reasons for poor adherence are multi-factorial, inter-related and often difficult to target for improvement. Although practitioners can implement different methods of adherence, the ultimate aim is to improve health outcomes for the individual and the health care system. Asthma is a common airway disease, particularly diagnosed in children, often treated with inhaled corticosteroids and long-acting bronchodilators. Due to the disease’s tendency for exacerbations and consequently, when severe will require unscheduled health care utilisation including hospital admissions, considerable research has been done into the effects of medication adherence on asthma control. This review discusses the difficulties in defining adherence, the reasons for and consequences of poor adherence, and the methods of recording and improving adherence in asthma patients, including an in-depth analysis of the uses of smart inhalers.</p></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"50 ","pages":"Pages 41-45"},"PeriodicalIF":5.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1526054223000660/pdfft?md5=633e8afb7aa539e37c80492304a0f737&pid=1-s2.0-S1526054223000660-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41208098","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":"Should an inhaled corticosteroid accompany each dose of fast-acting beta2-agonist for relief of asthma symptoms?","authors":"Leslie Hendeles ,&nbsp;Miles Weinberger","doi":"10.1016/j.prrv.2023.05.005","DOIUrl":"10.1016/j.prrv.2023.05.005","url":null,"abstract":"","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"50 ","pages":"Pages 38-40"},"PeriodicalIF":5.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402126","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 chronic care of children with obstructive sleep apnoea","authors":"Brigitte Fauroux ,&nbsp;Meryl Vedrenne-Cloquet","doi":"10.1016/j.prrv.2023.01.001","DOIUrl":"10.1016/j.prrv.2023.01.001","url":null,"abstract":"<div><p>Positive end-expiratory pressure (PEEP) consists of the delivery of a constant positive pressure in the airways by means of a noninvasive interface aiming to maintain airway patency throughout the entire respiratory cycle. PEEP is increasingly used in the chronic care of children with anatomical or functional abnormalities of the upper airways to correct severe persistent obstructive sleep apnea despite optimal management which commonly includes adenotonsillectomy<span> in young children<span>. PEEP may be used at any age, due to improvements in equipment and interfaces. Criteria for CPAP/NIV initiation, optimal setting, follow-up and monitoring, as well as weaning criteria have been established by international experts, but validated criteria are lacking. As chronic PEEP is a highly specialised treatment<span>, patients should be managed by an expert pediatric multidisciplinary team.</span></span></span></p></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"49 ","pages":"Pages 2-4"},"PeriodicalIF":5.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9179042","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 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}