Pediatric Pulmonology最新文献

{"title":"Respiration and Ventilation Outcomes With Passy Muir Valve Use in Infants and Children Requiring Mechanical Ventilation via Tracheostomy.","authors":"Laura Brooks, Steven Goudy, Andrew Jergel, Walter Reeder, Ajay S Kasi","doi":"10.1002/ppul.71834","DOIUrl":"10.1002/ppul.71834","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to evaluate the clinical characteristics associated with successful Passy Muir Valve (PMV) use in children requiring mechanical ventilation via tracheostomy.</p><p><strong>Methods: </strong>A retrospective study of children requiring mechanical ventilation via tracheostomy who completed PMV evaluations between 2021 and 2023 was conducted. Clinical characteristics of patients were compared based on success and failure of PMV tests. Group comparisons before and after cuff deflation and during PMV utilized the Wilcoxon signed-rank test. Wilcoxon rank sum and Fisher's exact tests were used to compare patients who passed and failed PMV.</p><p><strong>Results: </strong>Thirty-two children completed PMV evaluations with a success rate of 69%. After cuff deflation, there were no significant changes in median PEEP (p = 0.565), tidal volume (p = 0.118), oxygen saturation (SpO₂, p > 0.999), and end-tidal carbon dioxide (ETCO₂, p = 0.628). There was a small decrease in median PIP (p = 0.028). For patients who passed the PMV test, before and during PMV use, the median PEEP/transtracheal pressure remained unchanged, there was a decrease in tidal volume (p = 0.004), and a small decrease in PIP (p = 0.024) without significant changes in SpO₂ (p = 0.837), and ETCO₂ (p = 0.515). Patients on pressure-controlled ventilation who passed PMV tests demonstrated a median decrease of 35% in exhaled tidal volume after cuff deflation, while patients who failed demonstrated a 2% decrease.</p><p><strong>Conclusion: </strong>The changes in PEEP, PIP, and tidal volume with tracheostomy cuff deflation and during PMV tests did not adversely impact oxygenation or ventilation in patients who passed the PMV test. Assessing airway patency via manometry could be implemented for all pediatric patients in our cohort rather than solely utilizing the decrease in exhaled tidal volume with cuff deflation. A systematic multidisciplinary protocol could identify patients who are eligible for PMV use.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"61 9","pages":"e71834"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977676","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":"Residence-Associated Differences in Airway Microbiology Among Tracheostomy-Dependent Children.","authors":"Elia D Rackovsky, Marley Cutrona, Monica L Koncicki, Brenda I Anosike, Ilir Agalliu, Michelle M Perez","doi":"10.1002/ppul.71847","DOIUrl":"https://doi.org/10.1002/ppul.71847","url":null,"abstract":"<p><strong>Background: </strong>Tracheostomy-dependent children (TDC) experience chronic airway instrumentation and frequent healthcare exposure, increasing their risk for colonization and infection with multidrug-resistant organisms (MDROs). Most TDC reside either in the community or in healthcare facilities, yet the impact of residential setting on airway microbiology in these children is not well characterized.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of TDC ≤ 18 years admitted to an academic tertiary pediatric intensive care unit (PICU) between Jan 2017 and Dec 2022 who underwent tracheal aspirate cultures (TACs) within 72 h of admission. Airway microbiology and MDRO prevalence were compared between children presenting from healthcare facilities and the community. Multivariate mixed-effect logistic regression models evaluated factors associated with MDRO isolation, adjusting for age, number of admissions, and cuffed tracheostomy status.</p><p><strong>Results: </strong>Among 109 children (282 admissions; 207 community, 75 facility), facility residence was associated with higher odds of isolating any MDROs in bivariate analysis (OR 2.73 95% CI 1.19-6.25 p = 0.017). In multivariate analysis, ≥ 5 prior hospital admissions and cuffed tracheostomy remained independently associated with MDRO isolation. Although facility residence no longer retained statistical significance after adjustment, the adjusted odds ratio remained similar to the bivariate estimate.</p><p><strong>Conclusions: </strong>Healthcare facility residence is associated with increased MDRO isolation. Cumulative healthcare exposure and cuffed tracheostomy status may also be important risk factors for MDRO presence. Respiratory microbiology differs between facility- and community-based TDC. Awareness of local airway microbiologic patterns and cumulative healthcare exposure may improve interpretation of TACs and guide empiric antimicrobial therapy.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"61 9","pages":"e71847"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025733","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":"Lung Clearance Index in CF and PCD: Unraveling Distinct Patterns of Airway Involvement.","authors":"Jia-Xue Zhang, Hai-Rong Bao","doi":"10.1002/ppul.71822","DOIUrl":"https://doi.org/10.1002/ppul.71822","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"61 9","pages":"e71822"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025741","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":"Bilateral Diffuse Multilobar CPAM in a Twin-to-Twin Transfusion Recipient: First Case of a Survivor.","authors":"Bettina W Paek, Rebecca Stark, MacKenzie Wyatt, Hannah Cody, Stephanie Yeager, Erin K Romberg, Alexander Gauger, Kimberly Ma, Martin P R Walker","doi":"10.1002/ppul.71824","DOIUrl":"https://doi.org/10.1002/ppul.71824","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"61 9","pages":"e71824"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025722","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":"Pediatric Functional Lung Imaging: A Scoping Review.","authors":"Matthew Bruorton, Sarah Greenslade, Shagufta Perveen, Martin Donnelley, Antonia O'Connor, Jessica Phillips, David Parsons, Thomas Goddard, Kristin Carson-Chahhoud, Andrew Tai","doi":"10.1002/ppul.71786","DOIUrl":"10.1002/ppul.71786","url":null,"abstract":"<p><p>Functional lung imaging enables pulmonary parameters, including ventilation, perfusion, gas exchange, and biomechanics, to be mapped and quantified noninvasively throughout the lungs. Pulmonary function testing is generally more difficult to perform in a child in comparison to an adult, and so pulmonary functional imaging has the potential to significantly benefit pediatric cohorts, giving clinicians an additional tool in assessing and managing pediatric lung disease. This scoping review aims to (1) identify current and emerging functional lung imaging techniques that have been investigated in pediatric cohorts and (2) describe how they have been compared to pulmonary function tests. PubMed, EMBASE, and CINAHL were searched for studies comparing pulmonary functional imaging techniques with pulmonary function testing in pediatric cohorts ≤ 18 years old. A total of 54 studies were included. Techniques were grouped into magnetic resonance imaging (MRI), computed tomography (CT), electrical impedance tomography (EIT), X-ray, and nuclear medicine methods. Most studies compared spirometry, multiple breath nitrogen washout, or both. At present, hyperpolarized gas MRI studies are the most widely investigated modality in children. However, despite the multiple different modalities investigated, there are no methods that have entered standard clinical pediatric use. Further research into functional lung imaging in pediatrics is required to provide validation, standardization, and establishment of normal values prior to implementation of these modalities into routine clinical care.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"61 9","pages":"e71786"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857494","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":"\"Left My Family Scrambling\": Caregiver Experiences Following Brand-Name Flovent Discontinuation.","authors":"Ashley L Saint-Fleur, Vivian Tran, Robyn T Cohen, Michelle Trivedi, Gregory S Sawicki","doi":"10.1002/ppul.71823","DOIUrl":"10.1002/ppul.71823","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"61 9","pages":"e71823"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881401","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":"Human Milk and Bronchopulmonary Dysplasia in Preterm Infants: The Mediation of Inflammatory Cytokines.","authors":"Yunbei Rao, Xuan Wang, Qingling Li, Lingling Yang, Xiaoyun Xiong, Dongshan Han, Chuanzhong Yang, Xueyu Chen","doi":"10.1002/ppul.71836","DOIUrl":"10.1002/ppul.71836","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the mediating role of inflammatory cytokines in the protective effect of human milk against bronchopulmonary dysplasia (BPD) in preterm infants.</p><p><strong>Methods: </strong>This prospective cohort study included 73 infants born at < 28 weeks' gestation.Infants were classified into high-dose human milk and high-dose formula groups according to feeding patterns at 36 weeks postmenstrual age (PMA). Cross-sectional group comparisons of inflammatory factors at postnatal day 7, day 28, and PMA 36 weeks were examined by Mann-Whitney U test, while longitudinal changes in plasma inflammatory cytokines were evaluated using generalized estimating equations (GEE), and mediation analysis was performed using PROCESS version 4 to assess the potential indirect effects of inflammatory cytokines on the association between human milk exposure and BPD severity.</p><p><strong>Results: </strong>Infants in the high-dose human milk group had a significantly lower incidence of grade II/III BPD and lower plasma concentrations of CXCL10, IL-1Ra, and IL-13 at 36 weeks PMA than those in the high-dose formula group. Longitudinal GEE analysis showed significant temporal changes in these cytokines but no significant group × time interactions. Mediation analysis demonstrated a significant joint indirect effect through IL-1Ra and CXCL10 (effect = -0.245, 95% CI -0.487 to -0.046), accounting for 34.9% of the total association between human milk exposure and BPD severity.</p><p><strong>Conclusion: </strong>High human milk feeding was associated with lower BPD severity and a less activated inflammatory profile at 36 weeks PMA. IL-1Ra- and CXCL10-related inflammatory pathways may partially account for this association, although the observational design precludes definitive causal inference.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"61 9","pages":"e71836"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991061","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":"EVALI Presenting as Diffuse Alveolar Hemorrhage in an Adolescent. Case Report.","authors":"Sergio Domingos Hompanera, Pablo Lozano Cuesta, Liliana Pérez Martínez","doi":"10.1002/ppul.71838","DOIUrl":"10.1002/ppul.71838","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"61 9","pages":"e71838"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977727","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":"Real-World Medication Adherence and Medication Reviews in Adults and Children With Cystic Fibrosis.","authors":"Lieke Roeke, Liesbeth I van de Ven, Steffie E M Vonk, Jan J M Coremans, Edward Dompeling, Michiel A G E Bannier, Fatma Karapinar-Çarkit, Judith de Ruijter-van Dalem","doi":"10.1002/ppul.71815","DOIUrl":"10.1002/ppul.71815","url":null,"abstract":"<p><strong>Background: </strong>People with cystic fibrosis (pwCF) have complex treatment regimens with cystic fibrosis transmembrane conductance regulator (CFTR) modulators and supportive therapies. Evidence on adherence across cystic fibrosis (CF) therapies using different assessment methods and the added value of medication reviews remains limited.</p><p><strong>Objective(s): </strong>This study compared adherence across CF therapies using three assessment methods and evaluated the contribution of medication reviews.</p><p><strong>Methods: </strong>This cross-sectional study (February to April 2025) included pediatric and adult pwCF at Maastricht University Medical Centre+. Adherence to CFTR modulators and supportive therapies (vitamin supplements, pancreatic enzymes, inhalers, and nebulizers) was assessed with pharmacy refill data (medication possession ratio, MPR); self-reported adherence (Medication Adherence Report Scale-5, MARS-5), and structured medication reviews. The primary outcome was the proportion of pwCF adherent to CF medication per assessment method. Secondary outcomes were the within-patient differences in adherence between CFTR and supportive therapies (McNemar's exact test) based on MPR and the number and acceptance of DRP-interventions in the medication review.</p><p><strong>Results: </strong>Forty-three pwCF (17 children, 26 adults; 39.5% female) were included. For CFTR modulators, adherence was 91.7% (MPR), 91.2% (MARS-5), and 72.2% (medication review). For supportive therapies, adherence was 56.3%, 77.7%, and 77.4%, respectively. Four nonadherent pwCF were identified exclusively through medication review. Within-patients, adherence was higher for CFTR modulators than for supportive therapies (p < 0.001). Medication reviews identified 51 DRPs in 41 pwCF (including nonadherence in 12 pwCF), all proposed interventions were accepted by the treating physician.</p><p><strong>Conclusion: </strong>Adherence varied by medication class and assessment method. Medication reviews provided clinically relevant information in addition to refill-based and self-reported measures.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"61 9","pages":"e71815"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851148","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":"Data Collection and Harmonization in Preterm Respiratory Research: Recommendations and Insights From PELICAN.","authors":"H L Moore, S Stanojevic, J T D Gibbons, A Bates, L W Doyle, N Garland, N Hemy, J R Hurst, S Kotecha, E Lombardi, C Shackleton, P Um Bergström, M Vollsæter, T Halvorsen, S J Simpson","doi":"10.1002/ppul.71812","DOIUrl":"10.1002/ppul.71812","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals born preterm (before 37 weeks' gestation) have an increased risk of developing lung disease compared with those born at term. However, life-long lung function trajectories and the factors influencing them remain insufficiently understood in this population, reflecting an unfortunate scarcity of data, substantial heterogeneity in findings, and variability across centers. The Prematurity's Effect on the Lungs in Children and Adults Network (PELICAN) was established in 2020 as a Clinical Research Collaboration of the European Respiratory Society, with a key aim to develop the first harmonized global repository of demographic, clinic and lung function data from existing datasets on individuals born preterm.</p><p><strong>Methods: </strong>Eligible datasets for inclusion were identified through three systematic literature reviews. A scientific steering committee was convened and organized into sub-groups, which undertook a consensus-based variable selection and data harmonization exercise. Data contributors uploaded data to a secure online portal, where further harmonization was applied.</p><p><strong>Results: </strong>As of June 2026, the PELICAN data repository includes 20 datasets representing 14 countries and 3,388 individuals born preterm. PELICAN collects 142 variables, of which 96 have been fully harmonized across all contributing datasets, and 42 partially harmonized. Four variables could not be harmonized.</p><p><strong>Conclusions: </strong>In this paper, we describe the PELICAN collaboration, outline key challenges and successes encountered during data harmonization, and report data availability to date. This work represents an important step towards understanding the respiratory consequences of preterm birth and could inform the development of a Core Outcome Set for future data collected in this area.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"61 9","pages":"e71812"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881399","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}