Maryam Adnan, Saad Khan, Fatima Sohail, Hiba Thasleem, Junaid Imran
{"title":"Iron Deficiency Anemia in Asthmatic Children.","authors":"Maryam Adnan, Saad Khan, Fatima Sohail, Hiba Thasleem, Junaid Imran","doi":"10.1002/ppul.71045","DOIUrl":"https://doi.org/10.1002/ppul.71045","url":null,"abstract":"<p><p>This letter responds to the article \"The Effect of Iron Deficiency Anemia on Emergency Department Admission in Asthmatic Children\" by Selmanoglu et al. highlighting important limitations in their findings. The authors' retrospective study identified a significant association between iron deficiency anemia (IDA) and increased emergency department admissions for asthma exacerbations in asthmatic children. However, the letter emphasizes the need to consider potential confounding factors such as socioeconomic status and nutritional intake, which may influence both anemia and asthma severity. Additionally, the absence of a control group limits the ability to generalize the findings beyond asthmatic children. There is a need for future research to explore the impact of iron supplementation on asthma control and overall health outcomes, advocating for tailored management strategies in this vulnerable population.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71045"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605472","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}
Carolyn C Foster, Todd A Florin, Derek J Williams, Katherine L Freundlich, Rebecca L Steuart, Julia A Heneghan, Cara Cecil, Nathan M Pajor, Robert J Graham, Sriram Ramgopal
{"title":"Care Utilization for Acute Respiratory Infections in Children Requiring Invasive Long-Term Mechanical Ventilation.","authors":"Carolyn C Foster, Todd A Florin, Derek J Williams, Katherine L Freundlich, Rebecca L Steuart, Julia A Heneghan, Cara Cecil, Nathan M Pajor, Robert J Graham, Sriram Ramgopal","doi":"10.1002/ppul.71026","DOIUrl":"10.1002/ppul.71026","url":null,"abstract":"<p><strong>Introduction: </strong>Children who use invasive long-term mechanical ventilation (LTMV) are a rare, clinically heterogenous population with relatively high hospitalization rates, most commonly for acute respiratory infection (ARI). We sought to describe patterns of ARI-related utilization and mortality in pediatric patients with LTMV, evaluating the association of a pre-existing neurologic diagnoses with outcomes.</p><p><strong>Methods: </strong>We studied a longitudinal retrospective cohort across 40 U.S. children's hospital emergency department (ED) and hospital encounters for patients (< 21 years) with LTMV and an ARI diagnosis code (10/1/2016-6/30/2023). We examined mortality and ED/hospital utilization outcomes, defining short-stay hospitalizations as ≤ 2 calendar days. We stratified analyses by high intensity neurologic impairment (HINI) using a validated coding algorithm.</p><p><strong>Results: </strong>We included 4866 patients (median age 4.5 years; 58.6% male) with LTMV and ≥ 1 ARI encounter. Most (95.1%) were hospitalized on their index encounter, and among those most received intensive care (71.7%). 4.1% died during the index hospitalization (5.3% with HINI vs. 1.3% without HINI, p < 0.001). Median hospital length of stay was 6 days (interquartile range 3-12). Short stay hospitalizations occurred in 16.9% overall but were as high as 26.6% in children without HINI. ED return visits within 1 year occurred in 60.7%; ARI was the most common reason (40.1%).</p><p><strong>Conclusions: </strong>Pediatric patients using LTMV presenting for ED care with ARI are almost always hospitalized, usually in an intensive care setting. Overall, outcomes were poorer for those with HINI than those without HINI. More precision is needed to align resources with illness severity and comorbidities to improve ARI outcomes.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71026"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557593","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}
Stephanie Morakeas, Mark Brian Tracy, Murray Hinder, Viktoria Gruber, Alistair McEwan, Thomas Drevhammar
{"title":"Does Leak Matter? A Novel Dynamic Leak Model to Simulate Leak for Performance Testing of Manual Neonatal Resuscitation Devices. A Bench Study.","authors":"Stephanie Morakeas, Mark Brian Tracy, Murray Hinder, Viktoria Gruber, Alistair McEwan, Thomas Drevhammar","doi":"10.1002/ppul.71043","DOIUrl":"10.1002/ppul.71043","url":null,"abstract":"<p><strong>Introduction: </strong>Newborn resuscitation is commonly performed in the presence of face mask leak. Leak is highly variable, pressure-dependent and often unrecognized. The effectiveness of resuscitation devices to deliver adequate inflations in the presence of leak is unknown. Bench models simulating continuous leak have the disadvantage of not accurately reflecting leak occurring during clinical resuscitation. A dynamic leak model based on pressure-release valves was thus developed.</p><p><strong>Methods: </strong>This study investigates self-inflating bag (SIB) and T-piece resuscitator (TPR) ventilation performance in the presence of dynamic (DLM) compared to continuous (CLM) leak models in a bench study. Five predefined leak levels were tested for each leak model (0%-87%). Resuscitation devices were connected to a test lung (compliance 0.6 mL/cmH<sub>2</sub>O) and respiratory parameters were measured using respiratory function monitors before (patient interface) and after (actual) an induced leak at 40, 60, 80 inflations/min.</p><p><strong>Results: </strong>Three thousand six hundred inflations were analyzed. DLM showed a decrease in actual tidal volumes from 0%-87% leak with tidal volume differences (SIB 4.8 mL, TPR 2.9 mL), contrasting to minimal change for CLM (SIB -0.6 mL, TPR 0.3 mL). CLM demonstrated larger differences between patient interface and actual leak. The absolute difference at 60 inflations/min at 87% leak were SIB 37.5%, TPR 18.2% for CLM compared to SIB 4.6%, TPR 1.4% for DLM.</p><p><strong>Conclusions: </strong>CLM may underestimate the impact of resuscitation device performance with poor correlation between patient interface and actual delivered volume. DLM demonstrates several advantages with a more accurate representation of face mask leak and will prove useful in modeling all systems delivering PPV.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71043"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606148","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}
Elana R Kriegel, Aditya Srinivasan, Luke Mammen, Harini Venkataganesh, Jess T Randall, Lara Reichert
{"title":"Airway Anomalies Predict Risk of Pediatric Pulmonary Hypertension.","authors":"Elana R Kriegel, Aditya Srinivasan, Luke Mammen, Harini Venkataganesh, Jess T Randall, Lara Reichert","doi":"10.1002/ppul.71028","DOIUrl":"https://doi.org/10.1002/ppul.71028","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric pulmonary hypertension (PH) significantly contributes to morbidity and mortality due to the progressive nature of the disease in some subtypes, which leads to severe right heart failure, impaired oxygenation, and subsequent complications of chronic hypoxia, and side effects of long-term therapies. Associations between PH and airway anomalies in pediatric patients are complex and multifactorial. Better understanding of these associations will help identify which patients should receive screening for PH by multidisciplinary care teams (pediatric otolaryngology, cardiology, pulmonology).</p><p><strong>Methods: </strong>A retrospective, observational, single institution, cross-sectional study was performed using inpatient and emergency department visit records and operating room reports from January 2021 to January 2023 of pediatric patients. Odds ratios and logistic regression were used to determine the association between PH and other cardiopulmonary anomalies.</p><p><strong>Results: </strong>PH was associated with cardiac and airway anomalies (Odds ratio, 95% CI; 3.26, 1.01-10.5, p < 0.05; Logistic Regression, pseudo-R<sup>2</sup> = 0.440, p < 0.01), especially bronchopulmonary dysplasia (BPD), atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA), chronic lung disease/respiratory failure (CLD), and Down Syndrome (DS).</p><p><strong>Conclusion: </strong>Our findings demonstrate PH is highly co-morbid with other cardiopulmonary anomalies and provide an estimate of the risk of having a concurrent congenital disease and PH. Patients with multiple comorbidities are at high risk for developing PH and should receive screening for PH via coordinated care by multidisciplinary care teams. Our results, with further quantification at other sites, could help further development of PH screening guidelines.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71028"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658045","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}
Pediatric PulmonologyPub Date : 2025-03-01Epub Date: 2024-09-25DOI: 10.1002/ppul.27292
Antrea Zouvani, Shyam Sunder B Venkatakrishna, Sean Schoeman, Onur Simsek, Pravinkumar Bharde, Karen I Ramirez Suarez, Pierre Goussard, Hansel J Otero, Savvas Andronikou
{"title":"Back to basics: lung volumes on pediatric chest X-rays-pitfalls and diagnostic implications.","authors":"Antrea Zouvani, Shyam Sunder B Venkatakrishna, Sean Schoeman, Onur Simsek, Pravinkumar Bharde, Karen I Ramirez Suarez, Pierre Goussard, Hansel J Otero, Savvas Andronikou","doi":"10.1002/ppul.27292","DOIUrl":"10.1002/ppul.27292","url":null,"abstract":"<p><p>Evaluating lung \"volumes\" when interpreting pediatric chest radiographs is useful for supporting the diagnosis of lung pathology in children. Lung volumes can be estimated using semi-objective criteria such as anterior rib counting. Estimating lung volumes is one advantage plain radiographs have over other imaging modalities such as ultrasound or even cross-sectional imaging (Computed Tomography and Magnetic Resonance Imaging, where volumes can be calculated, but remain difficult to quickly be appreciated subjectively or semi-objectively in clinical practice). Lung hyperinflation is often a surrogate of air-trapping and may be suggestive of diseases such as bronchiolitis. Identifying under-inspired chest radiographs is also important to avoid misinterpreting findings related to low lung volumes as pathology, which is a significant diagnostic pitfall in children. This pictorial review will demonstrate the method for evaluating lung volumes, specifically for identifying lung hyperinflation as a surrogate of air-trapping and under-inspiration for avoiding false positive diagnoses.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S42-S47"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351748","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}
Pediatric PulmonologyPub Date : 2025-03-01Epub Date: 2024-10-03DOI: 10.1002/ppul.27304
Mariëlle W Pijnenburg
{"title":"Long-term respiratory consequences of prematurity.","authors":"Mariëlle W Pijnenburg","doi":"10.1002/ppul.27304","DOIUrl":"10.1002/ppul.27304","url":null,"abstract":"<p><p>Approximately 10% of all children worldwide are born preterm and respiratory consequences are amongst the most common sequelae of preterm birth. Except for a higher prevalence of respiratory symptoms and hospital admissions, preterm birth is associated with lower lung function that may track into adulthood. Lung function impairment is not restricted to extreme or very preterm-born subjects as also children born moderate-late preterm have lower Z-scores for lung function. Given the heterogeneity of prematurity-associated lung disease, phenotype-based, multidisciplinary management is needed to improve respiratory health in preterm-born subjects.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S59-S61"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366178","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}
Pediatric PulmonologyPub Date : 2025-03-01Epub Date: 2024-10-17DOI: 10.1002/ppul.27307
Karin M de Winter-de Groot
{"title":"Natural course of CPAM and pulmonary sequestration: to operate or not to operate, this is the question.","authors":"Karin M de Winter-de Groot","doi":"10.1002/ppul.27307","DOIUrl":"10.1002/ppul.27307","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S64-S65"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472196","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}
Pediatric PulmonologyPub Date : 2025-03-01Epub Date: 2024-10-28DOI: 10.1002/ppul.27361
Thomas Ferkol
{"title":"The threat of vaping in youths.","authors":"Thomas Ferkol","doi":"10.1002/ppul.27361","DOIUrl":"10.1002/ppul.27361","url":null,"abstract":"<p><p>Electronic cigarettes are driving a new epidemic of nicotine dependence among youths and are now the dominant tobacco product used by adolescents in the United States and other countries. Candy and fruit flavorings have driven their use, and many products contain higher nicotine concentrations, which contributed to their addictive potential. Numerous epidemiologic studies have described increased rates of respiratory symptoms in adolescent electronic cigarette users, and in vitro and in vivo studies showed that electronic cigarette vapors exert extensive biological effects on human airways, different from tobacco smoke, leading to epithelial cell dysregulation, inflammation, mucus hypersecretion, and apoptosis. Severe acute lung injury has been reported in adolescents and young adults, particularly in those using tetrahydrocannabinol (THC)-containing products, underscoring the threats of electronic cigarettes to lung health.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S88-S89"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505733","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}