Pediatric Pulmonology最新文献

{"title":"Hospitalizations in Infants and Young Children With Cystic Fibrosis Enrolled in Medicaid.","authors":"Laurie P Murray, Mark Zamani, Jonathan D Cogen, Matt Hall, Hossein Sadeghi, Lisa Saiman","doi":"10.1002/ppul.71302","DOIUrl":"10.1002/ppul.71302","url":null,"abstract":"<p><strong>Background: </strong>There are limited data describing hospitalization rates among infants and young children with CF (cwCF). National administrative claims databases can be used to characterize hospitalizations among cwCF which could inform the future impact of novel therapies increasingly being integrated into routine care for cwCF.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of the Merative Medicaid Marketscan database from 2010 to 2019 to characterize hospitalizations among cwCF during their first 3 calendar-years of life. Eligible cwCF were identified using International Classification of Diseases 9/10 codes and had a pharmacy fill for pancreatic enzymes. Hospitalizations were categorized as complicated neonatal, respiratory, gastrointestinal, or other types using Diagnosis Related Groups (DRG).</p><p><strong>Results: </strong>During the study period, 518 (62.7%) of unique cwCF were hospitalized, amounting to an overall hospitalization rate of 70.9 (95% CI: 67.0-75.0) per 100 child-years. In the birth year complicated neonatal DRGs were most common while in the second and third calendar-years respiratory DRGs were most common. In the second calendar-year of life, respiratory syncytial virus (RSV) and influenza were identified in 11.1% and 6.8% of respiratory hospitalizations, respectively.</p><p><strong>Conclusions: </strong>CwCF experienced a large burden of hospitalizations during their first three calendar-years of life. Respiratory DRGs were most common in the second and third calendar-years and included a substantial proportion of RSV- and influenza-associated hospitalizations. Such data can inform future work assessing the impact of new therapies for CF and RSV.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 9","pages":"e71302"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081330","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":"Upcoming events of interest.","authors":"","doi":"10.1002/ppul.71290","DOIUrl":"https://doi.org/10.1002/ppul.71290","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 9","pages":"e71290"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001244","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":"Evaluation of Vascular Endothelial Growth Factor as a Marker of Severity in Childhood Interstitial Lung Disease.","authors":"Heba A Ali, Shimaa A Metwally, Maha A Sayed, Safya H Zakaria","doi":"10.1002/ppul.71299","DOIUrl":"https://doi.org/10.1002/ppul.71299","url":null,"abstract":"<p><strong>Background: </strong>Vascular endothelial growth factor (VEGF) is thought to play a significant role in interstitial lung disease (ILD) pathogenesis. It has been found to be upregulated in the serum of adult ILD patients. However, its role in childhood interstitial lung disease (chILD) is still undetermined.</p><p><strong>Objectives: </strong>To assess the levels of VEGF in serum and induced sputum of children with chILD and determine their relationship with disease severity.</p><p><strong>Methods: </strong>In this controlled cross-sectional study, serum VEGF levels were measured in 45 pediatric patients and 40 healthy controls of comparable age and gender. Serum VEGF concentrations and induced sputum samples were analyzed simultaneously in the studied patients. Arterial blood gas analysis and pulmonary function test parameters were collected. The chest high-resolution computed tomography (HRCT) score was used to evaluate lung involvement progression. Spearman's correlation coefficient was used to assess the relationship between VEGF cytokine levels, lung function, radiological parameters, and disease severity.</p><p><strong>Results: </strong>Children with chILD had significantly higher serum VEGF levels than controls (p < 0.001). Within the chILD group, serum and sputum VEGF levels showed a significant positive correlation with exacerbation frequency, HRCT score, and Fan score. Furthermore, there was an inverse correlation between VEGF levels and oxygen saturation (p = 0.002, 0.005).</p><p><strong>Conclusions: </strong>Children with chILD had significantly higher VEGF levels, which correlated with lung function and disease severity scores. Therefore, increased VEGF levels in the serum and sputum of ILD patients may reflect the severity of chronic pulmonary involvement in childhood ILD, providing clinical benefits in predicting disease progression.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 9","pages":"e71299"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086220","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":"Trends, Burden, and Inequality in Neonatal Pulmonary Arterial Hypertension: Global Estimates From 1990 to 2021.","authors":"Xinbao Wang, Zhe Tang, Ziwei Wang","doi":"10.1002/ppul.71277","DOIUrl":"https://doi.org/10.1002/ppul.71277","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary arterial hypertension (PAH) is a rare but life-threatening disorder in neonates, characterized by increased pulmonary vascular resistance and right heart failure. Despite advances in neonatal intensive care, the global burden of neonatal PAH remains poorly defined, especially in low- and middle-income countries. This study provides the first comprehensive global estimates of mortality, incidence, and disability-adjusted life years (DALYs) attributable to PAH among neonates from 1990 to 2021.</p><p><strong>Methods: </strong>Using data from the Global Burden of Disease Study 2021, we estimated incidence, mortality, and DALY rates for neonatal PAH across 204 countries and territories by year, sex, and socio-demographic index (SDI). Mortality was modeled using the Cause of Death Ensemble model, and Nonfatal outcomes were estimated using DisMod-MR 2.1. Inequality was assessed using the Slope Index of Inequality (SII) and the Concentration Index of Inequality (CII). Trends were evaluated using average annual percent change (AAPC) based on segmented regression models.</p><p><strong>Findings: </strong>Globally, the mortality rate for neonatal PAH declined from 12.44 per 100,000 live births (95% UI: 8.89-15.22) in 1990 to 4.86 per 100,000 (3.77-6.22) in 2021, corresponding to an AAPC of -2.85% (95% CI: -2.97 to -2.72). DALY rates fell from 1,119.20 per 100,000 (799.91-1369.68) to 437.67 per 100,000 (339.45-560.09) over the same period. Incidence remained relatively stable, with a slight increase during 2016-2021 (AAPC: + 0.15%; 95% CI: 0.09-0.22). Regional disparities persisted, with the highest burden concentrated in low- and low-middle SDI countries. Inequality worsened over time: the CII for DALYs decreased from -0.29 (95% CI: -0.42 to -0.11) in 1990 to -0.34 (-0.46 to -0.18) in 2021, and the SII grew more negative across all metrics, indicating an increasing concentration of burden in socioeconomically disadvantaged populations.</p><p><strong>Conclusion: </strong>Neonatal PAH mortality and DALY rates have declined globally since 1990, but the incidence rate remains stable and substantial inequalities persist. The burden is disproportionately higher in low-SDI countries, underscoring the critical need for equitable access to neonatal care, improved diagnostics, and targeted health interventions to reduce preventable deaths and disparities.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 9","pages":"e71277"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070145","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 Pulmonology Year in Review 2024: Physiology.","authors":"Heather Boas, Lucy Tan, Clement L Ren","doi":"10.1002/ppul.71269","DOIUrl":"10.1002/ppul.71269","url":null,"abstract":"<p><p>Pulmonary physiology is central to pediatric pulmonology and pulmonary function testing, and in 2024 there were numerous studies published in Pediatric Pulmonology and other journals focused on this topic. This article will review some of the highlights over the past year.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 9","pages":"e71269"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034008","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":"The Impact of COronaVIrus Disease of 2019 Pandemic on Home Health Nursing Availability in Pediatric Patients After Tracheostomy Placement.","authors":"Ferdinand Cacho, Katherine A Carr, Mariana Bedoya, Jacob A Kaslow","doi":"10.1002/ppul.71273","DOIUrl":"10.1002/ppul.71273","url":null,"abstract":"<p><strong>Background: </strong>Children with tracheostomies require skilled medical care performed by trained caregivers or home health nursing (HHN). HHN services are often limited, resulting in increased caregiver responsibilities. We aim to evaluate HHN availability, healthcare utilization, and mortality in tracheostomy dependent children, pre and post-COVID-19 pandemic.</p><p><strong>Methods: </strong>Retrospective chart review of pediatric patients who underwent tracheostomy between November 2017 and September 2023. The COVID-19 pandemic time point was defined as March 15, 2020. Demographic, clinical and outcome parameters were collected from the electronic medical record. The pre- and postpandemic trend of HHN hours were evaluated using correlation statistics.</p><p><strong>Results: </strong>Both groups had similar surrogate markers of medical complexity. There was no difference in the mean number of approved HHN hours, but both the mean number of HHN hours/week staffed (90 h vs. 50, p = 0.001) and mean percentage of approved HHN hours staffed (63% vs. 41%, p = 0.011) were significantly lower in the post-COVID-19 cohort. The trend in the pre-COVID-19 group was not statistically significant (ρ = 0.087, p = 0.639); the trend in the post-COVID-19 group was negative (ρ = -0.380, p = 0.001).</p><p><strong>Conclusions: </strong>Since the COVID-19 pandemic, there has been a decrease in both the number and percentage of HHN hours staffed with no change in the number of approved HHN hours. Additionally, there was a decrease in hospital encounters in the post-COVID-19 group compared to pre-COVID-19. By assessing workforce shifts, medical providers, caregivers, and policymakers can appropriately anticipate the impact on this vulnerable population.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 9","pages":"e71273"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006474","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":"Observational Study: Lung Function and Symptom Control in Youth With Asthma up to 34 Months After COVID-19.","authors":"Kristina Gaietto, Nicholas Bergum, Daniel J Weiner, Erick Forno","doi":"10.1002/ppul.71288","DOIUrl":"10.1002/ppul.71288","url":null,"abstract":"<p><strong>Introduction: </strong>Prior studies of pediatric asthma control and lung function after COVID-19 have been limited by short follow-up intervals. We aimed to evaluate symptom control and lung function in children with asthma up to 34 months post-COVID-19.</p><p><strong>Methods: </strong>We conducted a prospective observational chart review study. We reviewed electronic health records of children with asthma in the Western Pennsylvania COVID-19 Registry, abstracting pre- and all post-infection spirometry results and Childhood Asthma Control Test (C-ACT) or Asthma Control Test (ACT) scores (to measure symptom control) through August 2023. We conducted adjusted mixed models with linear spline to compare C-ACT/ACT or FEV₁ before and after COVID-19. For individuals with worse outcomes at initial follow-up, we evaluated characteristics associated with lack of eventual recovery.</p><p><strong>Results: </strong>We found no significant differences between baseline and post-infection symptom control (n = 267) or lung function (n = 196). Of the 28% of children who had worse lung function at initial follow-up, 34% fully recovered at final follow-up. Of the 19% with worse C-ACT/ACT score at initial follow-up, 38% fully recovered at final follow-up. Final follow-up median C-ACT/ACT scores and mean FEV₁ were in the normal range even for the group without eventual recovery. Obesity (p = 0.04) was associated with hindered symptom control recovery.</p><p><strong>Conclusion: </strong>There were no significant differences between baseline and follow-up symptom control or lung function in children with asthma up to 34 months post-COVID-19. Only a small proportion of children worsened and did not recover, and decrements were generally small. Obesity was associated with impaired symptom control recovery.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 9","pages":"e71288"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024005","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":"Respiratory Muscle Strength in Healthy Children Aged 6 Years and Under: An Observational Study.","authors":"Kayley Noxell, Emily Acquaye, Vicky MacBean","doi":"10.1002/ppul.71270","DOIUrl":"10.1002/ppul.71270","url":null,"abstract":"<p><strong>Study question: </strong>Measurement of respiratory muscle strength is important in the assessment and management of neuromuscular diseases. Reference data are essential for interpretation of clinical findings, but are lacking in infants and young children. This study aimed to provide reference data for maximum inspiratory (PImax) and maximum expiratory (PEmax) pressures in children aged 6 years and under.</p><p><strong>Materials and methods: </strong>Healthy, term-born children were eligible for inclusion. Age, height, weight and BMI were recorded, and height/weight/BMI-for-age percentiles calculated. PImax and PEmax were measured using a tight-fitting face mask attached to a pressure transducer during maximal inspiratory and expiratory efforts respectively, induced via crying in younger participants and volitionally in older children. The greatest pressure was reported from three values within 20% of one another. Repeat measurements were obtained within a week where possible.</p><p><strong>Results: </strong>Sixty-nine children aged 0.08-6.85 years were recruited, from whom technically-acceptable PImax and PEmax data were obtained in 45 and 38 cases respectively. PImax was significantly and inversely related to age (Spearman's rho -0.339, p = 0.046); PEmax was not related to any anthropometric characteristics. Neither PImax or PEmax differed between male and female participants. Predicted PImax was 120 + (-3.89xage); mean (SD) PEmax was 80.3 (21.7) cmH₂O. Repeatability coefficient was 17.2 cmH₂O for PImax and 26.3 cmH₂O for PEmax (based on eleven and nine children respectively).</p><p><strong>Answer to the study question: </strong>This study provides the first contiguous reference range from infancy through to school age. Reference data are provided for PImax and PEmax along with information on repeatability.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 9","pages":"e71270"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070107","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":"Esophageal Duplication Misdiagnosed as Upper Airway Cough Syndrome.","authors":"Xiao-Yu Hao, Xue-Hui Zheng, Yao Yao","doi":"10.1002/ppul.71303","DOIUrl":"https://doi.org/10.1002/ppul.71303","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 9","pages":"e71303"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070159","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":"Caffeine for Persistent Intermittent Hypoxia in Newborns With and Without Chronic Lung Disease.","authors":"Aurore Côté, Phoukim Savanh, Wissam Shalish, Victoria Bizgu, Anne-Marie Canakis","doi":"10.1002/ppul.71312","DOIUrl":"10.1002/ppul.71312","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the caffeine response in preterm and term newborns with persistent intermittent hypoxia (IH) as they approach discharge, with particular focus on newborns with chronic lung disease of prematurity (CLD). To identify factors associated with a lack of response to caffeine.</p><p><strong>Design/settings: </strong>Retrospective cohort study across two neonatal intensive care units between 2015 and 2022.</p><p><strong>Main outcomes following caffeine administration: </strong>Normal oximetry; no need for respiratory support; resolution of hypercapnia.</p><p><strong>Results: </strong>A total of 132 infants received caffeine for persistent IH. Normal oximetry was achieved post-caffeine in 81% (46/57) of newborns with CLD, in 96% (46/48) of preterm with no CLD, in 96% (26/27) of term newborns. Caffeine reduced the % time with SpO₂ < 90% from 6.8% (interquartile range, 3.8%-12.2%), to 0.8% (0.4%-1.6%, p < 0.0001). The desaturation index < 80% dropped from 5.3 events/hour (0.9-14.6 events/hour) to 0.2 events/hour (0-0.78 events/hour, p < 0.0001) and the desaturation index ≥ 10% lasting > 10 s went from 6.6 events/hour (3.3-10.7 events/hour) to 1.4 events/hour (0.7-2.4 events/hour, p < 0.0001). Of the 61 infants on respiratory support, 74% (45/61) were weaned within a few days following caffeine. Caffeine normalized PCO₂ in 63% (41/65) of newborns with elevated PCO₂ pre-caffeine. Infants failing caffeine were more likely to have CLD compared to responders (79% vs. 39%, p < 0.005). Caffeine was successfully discontinued (first attempt, normal oximetry) in 101 infants (88%) at postmenstrual age of 46.1 weeks (45.3-48.3 weeks).</p><p><strong>Conclusion: </strong>Caffeine improved respiratory outcomes in the majority of preterm and term born infants with persistent IH, including those with CLD.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 9","pages":"e71312"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138359","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}