Pediatric Respirology and Critical Care Medicine最新文献

{"title":"Treatment of mild to moderate COVID-19 in children","authors":"S. Kabra","doi":"10.4103/prcm.prcm_7_21","DOIUrl":"https://doi.org/10.4103/prcm.prcm_7_21","url":null,"abstract":"Children as such have less infection and less severe covid 19 illness. Majority will be asymptomatic or mildly symptomatic. Symptoms are nonspecific and suspect in children presenting with influenza-like illness (ILI) or children presenting with respiratory difficulty. Children with definite contact with COVID-positive patients or those who had severe illness (irrespective of COVID status) in the past 2 weeks should be subjected to test. The rest of the children may be tested if any of the following are present: 1. The presence of high-risk factor in child such as immunocompromised condition (long-term steroids, cancer chemotherapy, biological agents, and primary or secondary immune deficiency) or chronic illnesses including chronic respiratory illnesses 2. Any person in family who is at risk of developing serious illness (elderly, immunocompromised, diabetic, hypertensive, etc.,). Majority of mild to moderate illness can be managed at home with symptomatic treatment ensuring monitoring for worsening of symptoms. There is no proven benefit of antibiotics, antiviral agents, steroids, hydroxychloroquine or other anti-inflammatory agents.","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131096390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 in children: Treat now and stop with vaccines in future","authors":"Yu-Tsun Su","doi":"10.4103/prcm.prcm_6_21","DOIUrl":"https://doi.org/10.4103/prcm.prcm_6_21","url":null,"abstract":"","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125482948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum nonenzymatic anti-oxidants in Nigerian children with severe pneumonia: Association with complications and hospital outcomes","authors":"B. Kuti, O. Oyelami","doi":"10.4103/prcm.prcm_7_20","DOIUrl":"https://doi.org/10.4103/prcm.prcm_7_20","url":null,"abstract":"Background: Tissue damaging effects of free radicals generated during the acute inflammation processes of childhood pneumonia may be ameliorated by antioxidants. This study aimed to determine the serum non-enzymatic antioxidants {Total Phenols, Carotenoids, Flavoids, Ascorbic acid, Tocopherols and Total Antioxidant Contents (TAC)} of Nigerian children with or without severe pneumonia (SP) and relate these to the presence of parapneumonic effusions (PPE) and length of hospitalisation (LOH). Methods: Consecutive children two months to 14 years admitted with severe pneumonia and their age and sex matched controls were recruited over a 12-month period at a Nigerian Health facility. Serum antioxidants were assayed using chromatography method and related to PPE and LOH. Results: The majority (86.1%) of the 144 children (72 each with SP and controls) were under-fives and eight (11.1%) of SP group had PPE. Median (IQR) LOH was 5.0 (4.0 – 7.0) days and 45 (62.5%) had prolonged (≥5 days) hospital stay with 3 (4.2%) mortality. Serum Tocopherols, 10.1 (4.7) vs. 13.2 (7.6) µg/dl; total flavoids 1.0 (0.6) vs. 1.3 (0.8) µg/dl and TAC 6.1 (4.4-8.9) vs. 7.4 (5.0 – 13.3) ng/dl were significantly lower in children with SP (p < 0.05). Serum antioxidants levels were not related to the PPE, however children with prolonged LOH had lower TAC (p<0.05), which also correlated negatively with LOH (r =- 0.418; p < 0.001) Conclusion: Lower serum antioxidants observed in children with severe pneumonia may connote increased demand or increased predisposition to the infection. Antioxidant supplementation may aid recovery of Nigerian children with SP.","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122011523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infection and COVID-19","authors":"D. Ng","doi":"10.4103/prcm.prcm_18_20","DOIUrl":"https://doi.org/10.4103/prcm.prcm_18_20","url":null,"abstract":"","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129606151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of procalcitonin in detecting severe bacterial infections among critically ill children","authors":"K. Sitthikool, C. Aksilp","doi":"10.4103/prcm.prcm_11_19","DOIUrl":"https://doi.org/10.4103/prcm.prcm_11_19","url":null,"abstract":"Objectives: The aims of this study are to determine the accuracy of serum procalcitonin (PCT) in the early detection of severe bacterial infections among critically ill children and to establish the correlation between PCT changes and clinical outcomes. Design: This was a prospective, observational study at Queen Sirikit National Institute of Child Health, Bangkok, Thailand, between March 2014 and December 2014. Materials and Methods: Children aged between 1 month and 15 years with acute severe life-threatening conditions were included. Microbiologic specimens were sent for multiplex polymerase chain reaction and bacterial culture on day 1 of hospitalization. PCT was obtained on days 1, 2, 3, and 5. Measurement and Main Results: A total of 61 patients with a mean age of 21.2 months were enrolled. Microbiologic specimens were sent for multiplex polymerase chain reaction and bacterial culture on day 1 of hospitalization. PCT was obtained on days 1, 2, 3, and 5. The medians of PCT levels on days 1 and 2 from the bacterial infections group were significantly higher than those from the viral infections group and the mixed infections group. The sensitivity, specificity, and area under the PCT curve (cutoff value ≥1.1 ng/ml) employed to predict bacterial infections were 67.7%, 73.7%, and 0.72, respectively. The percentage changes of PCT levels on days 2–5 correlated with those of pediatric logistic organ dysfunction (PELOD) scores on days 1–5 but did not correlate significantly with the lengths of PICU stay. Conclusions: PCT is a moderately accurate option for the early detection of bacterial infections among children with acute severe life-threatening conditions since there is a correlation between the percentage changes of PCT levels and PELOD scores but no significant correlation between the percentage changes of PCT levels and the length of PICU stay.W","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129901487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystic fibrosis in asia","authors":"S. Kabra, Shakil Ahmed, G. Cheok, AnneE N Goh, A. Han, S. Hong, W. Indawati, A. L. Lutful Kabir, H. Kamalaporn, H. Kim, Kunling Shen, S. Lochindarat, M. Moslehi, A. Nathan, D. Ng, NguyenNg The Phung, V. Singh, M. Takase, R. Triasih, Z. Dai","doi":"10.4103/prcm.prcm_5_20","DOIUrl":"https://doi.org/10.4103/prcm.prcm_5_20","url":null,"abstract":"Background: Cystic fibrosis (CF) is the most common inherited life-limiting illness in the Caucasian population. It is considered to be rare in Asia, but recent reports suggest that CF does occur in Asia. Methods: We carried out a questionnaire-based survey to determine the prevalence of CF across Asian countries and the diagnostic and therapeutic capabilities available in member countries. A questionnaire was sent to member countries of the Asian Pediatric Pulmonology Society. The questionnaire included the total number of children diagnosed with CF seen in the country and the available resources. available resources for diagnosis and management. Results: Fifteen countries responded to the questionnaire. Three countries/regions (Myanmar, Vietnam, and Macau) have not recorded any case of CF. The remaining 12 countries have recorded a variable number of cases which have also been reported in the literature. Sweat chloride testing facilities were available in all the countries except Taiwan that reported cases of CF. Some countries such as India and Bangladesh have developed their own indigenous method for sweat testing. Some countries have facilities for mutation testing. Basic medications such as pancreatic enzyme supplementation and antibiotics were available in all the countries where children with CF have been diagnosed. Inhaled antibiotics and dornase alfa were available only in a few countries. Some other countries reported using the injectable preparation of gentamicin and amikacin for inhalation therapy. Testing for genetic mutation wherever available showed a low frequency of the Delta F 508 mutation which is the most common mutation found in the Caucasian population. Only two countries (India and Japan) have formal CF associations for the affected community. Two countries Japan and China maintain a CF registry, whereas India already started the process of developing it. Conclusion: CF is increasingly being diagnosed over the past two decades in Asian countries. There is a need to create awareness among pediatricians and to develop regional or country-specific protocols and tools for the diagnosis and treatment of children with CF.","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131904213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic right middle lobe atelectasis in ambulatory children","authors":"K. Wong, C. Chiu","doi":"10.4103/prcm.prcm_12_19","DOIUrl":"https://doi.org/10.4103/prcm.prcm_12_19","url":null,"abstract":"Background: Intrinsic obstruction and extrinsic compression of the airway are the main causes of pulmonary atelectasis. The differential diagnoses of right middle lobe atelectasis (MLA) in children are lengthy, and practicing pediatricians usually are frustrated by the diagnostic possibilities in the clinic. Objective: The aim of our study is to present the experience of a children facility with chronic MLA in ambulatory children and guide a pragmatic approach. Materials and Methods: Retrospective chart analysis was performed by a computer search for discharge diagnosis of right MLA or MLA between January 2006 and December 2017 in a pediatric department in Northern Taiwan. Demographic data, underlying diseases, clinical symptoms, radiographic features, and course of treatment were collected and analyzed by descriptive statistics. Results: A total of 30 pediatric patients with chronic MLA were recruited in this study. Isolated MLA was identified in four (13.3%) patients. The remaining 26 patients had associated atelectasis or bronchiectasis in other parts of the lung. The most common causes of chronic MLA identified in our patients were postinfectious bronchiectasis (40%) and immunodeficiency (23.3%). Asthma was an uncommon cause of MLA in this study. Conclusions: Tumors, tuberculosis, retained foreign body, and asthma were all uncommon in the children identified with MLA. While chronic cough was common in the children studied, most were associated with bronchiectasis in other pulmonary segments. When faced with evidence of right MLA, one should consider a chronic suppurative lung disease with or without bronchiectasis, either postinfectious or related with recurrent aspiration.","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122263047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viral and atypical bacterial infection in young children hospitalized due to acute lower respiratory tract infection in Southern Thailand","authors":"K. Ruangnapa, Phatthareeda Kaeotawee, Pornapat Surasombatpattana, M. Kemapunmanus, U. Intusoma, Kantara Saelim, W. Anuntaseree","doi":"10.4103/prcm.prcm_3_20","DOIUrl":"https://doi.org/10.4103/prcm.prcm_3_20","url":null,"abstract":"Background: The etiology of acute lower respiratory tract infection (ALTI) in Thailand is not well established. Aims: This study aims to determine the prevalence of viral and atypical bacterial infections in young children hospitalized due to ALTI. Settings and Design: This was a retrospective study. Subjects and Methods: Eighty-two leftover nasopharyngeal specimens obtained from children with ALTI admitted from May to October 2017 in Songklanagarind Hospital were analyzed. Multiplex polymerase chain reaction and the bead hybridization method (NxTAG® Respiratory Pathogen Panel) were used to detect 18 instances of respiratory virus and atypical bacteria. The clinical data for the children were retrospectively reviewed and analyzed from the medical records. Results: From a total of 82 ALTI patients, 60% were male. The median (interquartile range) age was 14.8 (8.0–38.1) months. Seventy-six percent of the patients were positive for at least one viral pathogen. The three most identified pathogens were respiratory syncytial virus (RSV) B (39.0%), RSV A (20.7%), and hRV (12.2%), while atypical bacteria were not found. Patients with RSV infection had significantly higher fever on admission (P < 0.01) and a longer duration of fever (log-rank P < 0.001) compared to the non-RSV group. Conclusions: Viral pathogens were detected in 76% of the children hospitalized due to ALTI. Further, 79% were positive for RSV with significantly high-grade fever.","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122964608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritoneal drainage as a safe alternative to laparotomy in children with abdominal compartment syndrome","authors":"B. Choi, Rivfka Shenoy, Dina Levy-Lambert, Jason C. Fisher, S. Tomita","doi":"10.1016/j.jamcollsurg.2019.08.460","DOIUrl":"https://doi.org/10.1016/j.jamcollsurg.2019.08.460","url":null,"abstract":"","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114066865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between variation of aortic peak blood flow velocity, inferior vena cava diameter variation and stroke volume variation in children","authors":"W. Boonjindasup, R. Samransamruajkit","doi":"10.4103/prcm.prcm_17_19","DOIUrl":"https://doi.org/10.4103/prcm.prcm_17_19","url":null,"abstract":"Background: Non-invasive monitoring using ultrasound or Doppler assists in quick haemodynamic assessment and helps to improve outcomes in critical care. Parameters including aortic peak blood flow velocity variation (ΔVpeak), inferior vena cava diameter variation (ΔIVC) and stroke volume variation (SVV) have been commonly used in children. Objectives: The aim of this study was to assess the correlations between ΔVpeak from transthoracic echocardiography, ΔIVC from abdominal ultrasound and SVV from ultrasonic cardiac output monitoring. Settings and Design: A prospective observational cohort study was undertaken in the paediatric intensive care unit in a tertiary university hospital. Methods: ΔVpeak, ΔIVC and SVV were measured in mechanically ventilated children using ultrasound- or Doppler-based monitoring. Statistical Analysis Used: Pearson correlation coefficient was computed to assess the relationship. Results: A convenient sample of 55 patients with a median age of 31 months (range 6 months to 5 years) was enrolled. ΔVpeak, ΔIVC and SVV showed significant positive correlations between the three variables, i.e., ΔVpeak and ΔIVC (r = 0.415 with P = 0.002), ΔVpeak and SVV (r = 0.539 with P < 0.001) and ΔIVC and SVV (r = 0.524 with P < 0.001). Conclusions: In mechanically ventilated children, there is a positive correlation between ΔVpeak, ΔIVC and SVV. ΔVpeak and SVV provided the best, though moderate, correlation.","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131129989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}