Pediatric Pulmonology最新文献

{"title":"Predischarge Betamethasone in Infants Diagnosed With Bronchopulmonary Dysplasia.","authors":"Tal-El Ernest, Doreen Ozalvo, Orna Staretz-Chacham, Kyla A Marks, Eilon Shany, Daniela Landau, Justin Richardson","doi":"10.1002/ppul.71201","DOIUrl":"10.1002/ppul.71201","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to assess the influence of a short betamethasone therapy course for infants diagnosed with BPD on the need of oxygen therapy after discharge home, on post-menstrual age (PMA) discharge, and on hospital readmission rates.</p><p><strong>Methods: </strong>This was a retrospective cohort study that included infants born and diagnosed with BPD in the Soroka University Medical Center neonatal department between 2012 and 2020. Demographic and clinical parameters were extracted from computerized medical files.</p><p><strong>Results: </strong>Overall, 187 infants were included in the study; 151 (81%) were treated with betamethasone, of them 110 (73%) were discharged home without supplemental oxygen. Nonsignificant differences were found between infants treated with or without betamethasone regarding home oxygen supplementation at discharge (27% treated vs. 17% without, p = 0.192) and PMA at discharge (40.2 weeks treated vs. 41.2 weeks not treated, p = 0.114). Of the infants receiving betamethasone, those weaned from oxygen were discharged home at an earlier PMA (39.6 ± 5.0 vs. 42.0 ± 3.7 week, p < 0.001) and there was no difference between readmission rates due to respiratory problems of infants discharged home without oxygen supplementation to those discharged with oxygen (37/108 [34%] vs. 14/36 [39%], p = 0.615). In multivariable analysis, respiratory support at 36 weeks PMA (odds ratio: 4.4 [CI: 1.5-13.2], p < 0.009) and receiving two or more courses of betamethasone (odds ratio: 3.6 [CI: 1.2-10.5], p = 0.009) were significant predictors for need of oxygen supplementation at discharge.</p><p><strong>Conclusions: </strong>Use of corticosteroids for infants diagnosed with BPD may shorten hospital stay by promoting weaning from oxygen therapy.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71201"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650102","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":"Interventional Therapy for a Child With Tracheal Lobular Capillary Hemangioma: A Case Report and Literature Review.","authors":"Lijun Wang, Haoran Jing, Yuhuan Liu, Keling Ma, Hao Wu, Yang Li, Mingwei Wang, Fanzheng Meng, Man Gao","doi":"10.1002/ppul.71160","DOIUrl":"https://doi.org/10.1002/ppul.71160","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71160"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584535","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 Delivery Is Crucial for Enhancing Function of Ex-Vivo Premature Sheep Lungs: A Feasibility Study.","authors":"Richard Pasteka, Lisa Hufnagl, Vasil Vodenicharov, Alissa Blessing, Angelika Berger, Michael Wagner, Tobias Werther","doi":"10.1002/ppul.71205","DOIUrl":"10.1002/ppul.71205","url":null,"abstract":"<p><strong>Aim: </strong>To compare effects of bolus and aerosolization surfactant delivery methods and ventilatory support on improving ex-vivo premature sheep lung function.</p><p><strong>Methods: </strong>The xPULM lung simulator was used with 16 ex-vivo preterm sheep lungs, of which 6 were analyzed in the bolus group and 3 in the aerosol group after excluding 7 lungs that ruptured during the trial. Surfactant (0.5 mL poractant alfa) was administered via bolus injection or aerosolization. Tidal volume (VT) was measured before and after administration at positive end-expiratory pressure (PEEP) levels of 0, 5, 10, and 15 cmH₂O.</p><p><strong>Results: </strong>Surfactant administration significantly increased VT (presurfactant median VT = 0.21 mL; post-surfactant median VT = 1.03 mL, p < 0.001). There was a trend toward higher median VT with bolus delivery (1.48 mL) compared to aerosolized delivery (0.43 mL) with borderline significance (p = 0.047) between the two delivery methods. High PEEP levels before surfactant delivery caused lung overdistention. Histological analysis revealed minimal lung tissue injury across samples, despite experimental challenges.</p><p><strong>Conclusions: </strong>In ex-vivo preterm sheep lungs, surfactant delivery is the primary driver of improved lung function, while PEEP has a smaller impact. The xPULM lung simulator enables research during spontaneous breathing while avoiding ethical issues associated with animal models.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71205"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637762","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":"Pulmonary Artery Denervation in Children: Insights From a Case Series With Five-Year Follow-Up.","authors":"Yue Wang, Gang Luo, Silin Pan","doi":"10.1002/ppul.71178","DOIUrl":"https://doi.org/10.1002/ppul.71178","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71178"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601191","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":"Long-Term Home Noninvasive Ventilation Program in Children: 17 Years of Follow-Up From a Tertiary Center in Chile.","authors":"Gerardo Torres-Puebla, Daniel Zenteno Araos, Javiera Flores Arrey, Roberto Vera-Uribe, Jaime Tapia Zapatero","doi":"10.1002/ppul.71198","DOIUrl":"https://doi.org/10.1002/ppul.71198","url":null,"abstract":"<p><strong>Introduction: </strong>Established in 2006, Chile's National Program of Noninvasive Mechanical Ventilation (NIV) provides continuous home ventilatory support.</p><p><strong>Objective: </strong>To provide an overview of the NIV Program in children and adolescents at a tertiary care center in Chile.</p><p><strong>Materials and methods: </strong>A retrospective study analyzed children in the NIV Program at a tertiary hospital from 2006 to 2023. We examined demographic characteristics, program duration, and respiratory, polygraphic, and gasometric variables, along with NIV initiation criteria. Statistical tests evaluated factors linked to program permanence, survival, and discharge outcomes. Data were divided into equal time periods for analysis.</p><p><strong>Results: </strong>A total of 113 children were included (median age: 8.3 years; IQR: 3.2-12.8). At the time of analysis, 51.3% continued in the program. The most common diagnoses were neuromuscular disease (NMD, 38.9%), central nervous system disorder (30.1%), and upper airway obstruction (14.2%). The age for NIV initiation was significantly lower in 2018-2020 compared to 2009-2011 (p < 0.05). The annual admission rate was 7.3 patients, with 3.1 discharges. The median program duration was 7 years (IQR: 5-11), varying by discharge reason (p < 0.001). Of the 55 discharged patients, 30.9% transitioned to adult care, 23.6% died, and 21.8% improved. The 5-year survival and ventilator discharge incidences were 88% and 67%, respectively. NIV was primarily initiated based on clinical (44%) and polygraphic (19%) criteria.</p><p><strong>Conclusions: </strong>NMD was the most prevalent diagnosis at the start of NIV and the main condition linked to the transition to adult care. NIV initiation occurred earlier over time, with high 5-year survival rates.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71198"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637759","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":"Temperature and Humidity During Different Neonatal Respiratory Support Modes: An In-Vitro Performance of Four Heated Humidifiers.","authors":"Emanuela Zannin, Camilla Rigotti, Stefano Robbiani, Raffale L Dellacà, Maria Luisa Ventura","doi":"10.1002/ppul.71184","DOIUrl":"10.1002/ppul.71184","url":null,"abstract":"<p><strong>Background: </strong>Adequate heating and humidification of inspired gas are crucial in preterm infants requiring respiratory support. Our objective was to compare the temperature (T) and absolute humidity (AH) achieved with different neonatal heated humidifiers commonly used during different respiratory support modes and respiratory settings.</p><p><strong>Methods: </strong>Four neonatal heated humidifiers were tested at different gas flow rates and during conventional and high-frequency oscillatory ventilation at clinically relevant settings. The patient was simulated using a neonatal test lung placed in a neonatal incubator warmed at 37°C. Temperature and relative humidity were measured using a thermohygrometer placed proximal to the test lung and used to calculate AH.</p><p><strong>Results: </strong>Measured temperature and humidity varied among heated humidifiers and respiratory support settings. The bias flow was the primary determinant of the measured temperature and humidity: temperature and AH significantly increased with flow. When the flow through the chamber was below 5 L/min the MR950 produced T < 36.7°C and AH < 37 g/m³ proximal to the patient. The Hydraltis 9500neo with chamber and proximal temperature set to 38°C and 40°C and the MR850 produced AH > 44 g/m³ in most conditions.</p><p><strong>Conclusion: </strong>The temperature and humidity proximal to the patients' airways might vary considerably based on the heated humidifiers and the flow through the chamber. Further clinical studies are needed to evaluate the effect of such variability on the patients.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71184"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601154","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":"Randomized Cross-Over Analysis of the Influence of Nitrogen Multiple Breath Washout on Spirometry in Monitoring Lung Function in Patients With Cystic Fibrosis and Primary Ciliary Dyskinesia.","authors":"Anna Charlotte Schoop, Robin Denz, Christoph Maier, Folke Brinkmann, Thomas Lücke, Anne Schlegtendal","doi":"10.1002/ppul.71189","DOIUrl":"10.1002/ppul.71189","url":null,"abstract":"<p><strong>Background: </strong>When monitoring lung function in patients with Cystic Fibrosis (pwCF) and Primary Ciliary Dyskinesia (pwPCD), nitrogen multiple breath washout (N₂MBW) is usually performed before spirometry to prevent forced expiratory maneuvers from altering N₂MBW results. The N₂MBW may affect spirometry if cooperation decreases after a long period of examination or due to prolonged oxygen inhalation. The equivalence of these concepts has never been investigated in a randomized cross-over trial. We hypothesized that the order of pulmonary function tests (PFTs) would not influence the z-score FEV₁.</p><p><strong>Methods: </strong>A total of 47 clinically stable outpatients (36 pwCF, 11 pwPCD; 16.7 ± 8.1 years) were randomized into two groups. Each patient underwent N₂MBW and spirometry at two consecutive visits (median interval 104 days): Group I: Spirometry followed by N₂MBW (A), reversed order at the second visit (B), Group II reversed (B→A).</p><p><strong>Statistics: </strong>For the equivalence test, a change in z-score FEV1 (primary endpoint) ±0.2 and lung clearance index (LCI_2.5, secondary endpoint) ±15% was not considered relevant; therefore, changes outside this range were considered an intervention effect in the linear mixed model (p < 0.05).</p><p><strong>Results: </strong>There was a significant deterioration in z-score FEV1 between the two appointments (period effect: -0.177; p = 0.012). The intervention effect and 95% confidence interval were within the equivalence range in both groups (z-score FEV1: 0.039; -0.0765 to 0.1539, LCI_2.5: -0.082; -0.3691 to 0.2054).</p><p><strong>Discussion: </strong>In our cohort the order of PFTs has no influence on the results suggesting that a greater flexibility in practice is possible without the risk of falsifying results.</p><p><strong>Trial registration: </strong>German Clinical Trials Register (No. DRKS00027473).</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71189"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601193","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":"Online Tool for Predicting Severe Cases of Childhood Community-Acquired Pneumonia Based on the PIRO Concept.","authors":"Xin Long, Wanling Li, Yuyi Tang, Zhengxiu Luo, Jian Luo, Zhou Fu, Enmei Liu, Ximing Xu, Yu Deng","doi":"10.1002/ppul.71199","DOIUrl":"10.1002/ppul.71199","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia remains a leading cause of mortality among children under 5 years of age. This study aimed to compare existing prognostic scoring systems and identify the most effective tool for assessing outcomes in children with community-acquired pneumonia (CAP).</p><p><strong>Methods: </strong>The Predisposition, Insult, Response, and Organ Dysfunction score for CAP (PIRO-CAP) was modified to create the Ch-online PIRO score based on a comprehensive cohort study. This new scoring system was validated in a cohort of 75,965 children under the age of 5 years with CAP, treated at the Children's Hospital of Chongqing Medical University between 2016 and 2021. Effectiveness in predicting severe cases was then compared against the Pediatric Critical Illness Score (PCIS), Pneumonia Etiology Research for Child Health (PERCH) score, and PIRO-CAP score.</p><p><strong>Results: </strong>The Ch-online PIRO score retained most of the original PIRO-CAP factors, including age under 6 months, comorbidities, SpO₂ below 90%, multilobar or complicated pneumonia, kidney or liver dysfunction, and respiratory failure, but replaced hypotension and bacteremia with delayed capillary refill time (> 3 s) and procalcitonin > 0.5 ng/mL. When predicting severe CAP cases, the Ch-online PIRO score demonstrated superior discriminatory performance (AUC = 0.85, 95% CI: 0.85-0.86) compared to the PCIS (AUC = 0.67, 95% CI: 0.66-0.69), PERCH score (AUC = 0.64, 95% CI: 0.64-0.65), and PIRO-CAP score (AUC = 0.68, 95% CI: 0.64-0.71).</p><p><strong>Conclusion: </strong>The Ch-online PIRO score shows promise as an effective prognostic tool for assessing the severity of CAP in young children.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71199"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637760","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":"Lung Consolidation Caused by Bocavirus Presenting as Hypoxemia in a Child.","authors":"Xiaoping Jing, Shuang Shi, Haoxiang Gu","doi":"10.1002/ppul.71104","DOIUrl":"https://doi.org/10.1002/ppul.71104","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 6","pages":"e71104"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226180","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":"Social Determinants of Health and Healthcare Utilization in Infants With Bronchopulmonary Dysplasia.","authors":"Haley Urbach, Sharon Ostfeld-Johns, Sarah McCollum, Pnina Weiss, Sarah Kandil, Eliaz Brumer","doi":"10.1002/ppul.71153","DOIUrl":"https://doi.org/10.1002/ppul.71153","url":null,"abstract":"<p><strong>Background and objectives: </strong>Infants with bronchopulmonary dysplasia (BPD) are at high risk for adverse health outcomes, yet the influence of social determinants of health (SDOH) in shaping disparities and healthcare utilization remains poorly understood. This study evaluates the impact of SDOH on healthcare utilization in infants with BPD during the first-year post NICU discharge.</p><p><strong>Methods: </strong>We conducted a retrospective study of 161 infants with BPD discharged from the NICU between January 2021 and December 2023. Key SDOH variables included the Area Deprivation Index (ADI), Childhood Opportunity Index (COI), and insurance type. Primary outcomes were healthcare utilization within the first year after NICU discharge, including emergency department (ED) visits, hospital admissions, pediatric pulmonology follow-up, and medication use.</p><p><strong>Results: </strong>Infants from high-deprivation neighborhoods (higher ADI, Mean ± SD: 6.93 ± 2.37) had significantly more ED visits without admission than those from less deprived areas (5.67 ± 2.86, p = 0.003). Higher COI scores, reflecting greater opportunity, were associated with fewer ED visits (p = 0.004). Medicaid was associated with lower COI/higher ADI scores (p < 0.001) and independently associated with increased ED visits (OR = 3.01, 95% CI: 1.52-5.97, p = 0.001). No significant associations were found between SDOH and pediatric pulmonology follow-up or medication prescriptions. Mediation analysis demonstrated that structural factors-ADI, COI, and insurance-mediated the relationship between race/ethnicity and hospital visits.</p><p><strong>Conclusion: </strong>Neighborhood disadvantages, lower childhood opportunity, and Medicaid insurance were associated with greater hospital utilization. Mediation analysis revealed that these structural factors accounted for racial/ethnic differences, underscoring SDOH's role in shaping healthcare use and the importance of addressing structural inequities to promote equitable outcomes.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 6","pages":"e71153"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275583","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}