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Pediatric Pulmonology

Monica L Koncicki, Philip Zachariah, Adam R Lucas, Jeffrey D Edwards
OBJECTIVES: To characterize a multi-institutional cohort of children with chronic respiratory failure that use long-term, non-invasive respiratory support, perform a time-to-event analysis of transitions to transtracheal ventilation and identify factors associated with earlier transition to transtracheal ventilation. STUDY DESIGN: A retrospective cohort study of patients less than 21 years of age with diagnoses associated with chronic respiratory failure and discharged on non-invasive respiratory support was performed using data from the Pediatric Health Information System (PHIS) between 2007 and 2015...
January 17, 2018: Pediatric Pulmonology
Yoshihiko Morikawa, Masaru Miura, Megumi Y Furuhata, Saeko Morino, Tae Omori, Masahiro Otsuka, Michiko Chiga, Toshimasa Obonai, Hiroshi Hataya, Tetsuji Kaneko, Kenji Ishikura, Masataka Honda, Yukihiro Hasegawa
INTRODUCTION: The efficacy of nebulized hypertonic saline (HS) therapy for shortening hospital length of stay (LOS) or improving bronchiolitic symptoms remains controversial. Most studies enrolled small numbers of subjects and did not consider the role of respiratory syncytial virus (RSV), the most common cause of acute bronchiolitis. Our aim was to evaluate the efficacy and safety of nebulized HS therapy for acute bronchiolitis due to RSV in moderately ill hospitalized infants. MATERIALS AND METHODS: This was an open-label, multicenter, randomized controlled trial comparing a nebulized HS treatment group with a normal saline (NS) group...
January 12, 2018: Pediatric Pulmonology
Frank A Zelko, Tracey M Stewart, Cindy D Brogadir, Casey M Rand, Debra E Weese-Mayer
OBJECTIVE: To investigate neurocognitive deficits in children with Congenital Central Hypoventilation Syndrome (CCHS) by comparing them to their parents, since parents comprise a particularly suitable control group matched on disease-extrinsic factors that can influence neurocognitive functioning. We compared CCHS patients to their parents and to population norms, hypothesizing that they would obtain lower intelligence test scores than both groups. We also compared patient-parent differences against patient-normative differences, to determine whether the two analytic approaches would yield different results...
January 12, 2018: Pediatric Pulmonology
Jessica Lo, Sanja Zivanovic, Alan Lunt, Mireia Alcazar-Paris, Gwendolyn Andradi, Mark Thomas, Neil Marlow, Sandy Calvert, Janet Peacock, Anne Greenough
OBJECTIVES: To assess longitudinally small airway function in children born extremely prematurely and whether there was a correlation between airway function in infancy and at 11-14 years. WORKING HYPOTHESES: There would be tracking of airways obstruction and small airway function would deteriorate during childhood in those born extremely prematurely. STUDY DESIGN: A longitudinal study. PATIENT-SUBJECT SELECTION: Thirty-five children with a mean gestational age of 26 weeks had lung function assessed at 1 year corrected and 11-14 years of age...
January 9, 2018: Pediatric Pulmonology
Päivi Korhonen, Paula Haataja, Riitta Ojala, Mikko Hirvonen, Matti Korppi, Marita Paassilta, Jukka Uotila, Mika Gissler, Tiina Luukkaala, Outi Tammela
OBJECTIVE: To assess the incidence and risk factors of asthma and atopic dermatitis by seven years of age after early-term (ET) (37+0 -38+6 weeks), full-term (FT) (39+0 -40+6 weeks), late-term (LT) (41+0 -41+6 weeks), and especially post-term (PT) (≥42 weeks) birth. METHODS: Altogether, 965 203 infants born between 1991 and 2008 in Finland were investigated in ET, FT, LT, and PT groups. Data on asthma medication reimbursement and hospital visits for atopic dermatitis were retrieved from national health databases...
January 5, 2018: Pediatric Pulmonology
Florian Kipfmueller, Lukas Schroeder, Christoph Berg, Katrin Heindel, Peter Bartmann, Andreas Mueller
BACKGROUND: Pulmonary hypertension (PH) is an important contributor of morbidity and mortality in infants with congenital diaphragmatic hernia (CDH). Treatment options are limited, but sildenafil might improve oxygenation and PH in neonates with CDH. OBJECTIVE: Aim of this study is to assess effects of intravenous sildenafil on oxygenation and PH in neonates with CDH. METHODS: A retrospective chart review was performed in all neonates with CDH born in our institution between September 2012 and December 2014...
January 5, 2018: Pediatric Pulmonology
Christopher J Russell, Cary Thurm, Matt Hall, Tamara D Simon, Michael N Neely, Jay G Berry
OBJECTIVE: Identify characteristics associated with hospital readmission due to bacterial respiratory tract infections (bRTI) after tracheotomy. STUDY DESIGN: Retrospective study of 8009 children 0-17 years undergoing tracheotomy from 2007 to 2013 at 48 children's hospitals in the Pediatric Health Information System database. The primary outcome was first hospital admission after tracheotomy for bRTI (ie, primary diagnosis of bRTI or a primary diagnosis of bRTI symptom and secondary diagnosis of bRTI)...
January 4, 2018: Pediatric Pulmonology
Victoria MacBean, Simon B Drysdale, Muska N Yarzi, Janet L Peacock, Gerrard F Rafferty, Anne Greenough
OBJECTIVES: To determine the impact of viral lower respiratory tract infections (LRTIs) in infancy including rhinovirus (RV) and infancy respiratory syncytial virus (RSV), on school age pulmonary function and healthcare utilization in prematurely born children. WORKING HYPOTHESIS: School age respiratory outcomes would be worse and healthcare utilization greater in children who had viral LRTIs in infancy. STUDY DESIGN: Prospective study. SUBJECT SELECTION: A cohort of prematurely born children who had symptomatic LRTIs during infancy documented, was recalled...
January 4, 2018: Pediatric Pulmonology
Ann Marie Ramsey, Sarah Brennan, Adam Stricker, Kurt Riek, Dana Brown, Rachel Gurtowsky, Julie Sturza, Amy Goldstein Filbrun
BACKGROUND: Children discharged home with tracheostomy and chronic mechanical ventilator support are at high risk for complications and adverse events. Private duty nursing and home respiratory care services are a critical support necessary for successful discharge. The literature suggests that there are opportunities for home care staff (HCS) to improve upon the skills necessary to assess and intervene in an emergency thereby increasing the likelihood of improving long-term outcomes...
January 4, 2018: Pediatric Pulmonology
Laura Berdah, Jessica Taytard, Sophie Leyronnas, Annick Clement, Pierre-Yves Boelle, Harriet Corvol
BACKGROUND: While the prevalence of Stenotrophomonas maltophilia lung infection in cystic fibrosis (CF) patients has increased in the last decades, its pathogenicity remains controversial. The aim of this study was to investigate the effects of S. maltophilia initial infection on the progression of lung disease in CF children. METHODS: This case-control retrospective study took place in a pediatric CF center. A total of 23 cases defined by at least one sputum culture positive for S...
January 4, 2018: Pediatric Pulmonology
Richard D Branson, Jeff Griebel, Dario Rodriquez
BACKGROUND: Safe and effective delivery of inhaled nitric oxide (INO) requires the appropriate interface of ventilator and INO delivery device. METHODS: We compared INO delivery using four configurations with the Transport Sinusoidal Bronchotron® and INOmax DSIR Plus® in a lung model. Ventilator settings and lung model values were held constant. Delivered NO, NO2 , and inspired oxygen (FIO2 ) were measured. The mean difference between set and measured NO was calculated and compared using ANOVA...
January 4, 2018: Pediatric Pulmonology
Aliva De, Deepa Manwani, Deepa Rastogi
Asthma and sickle cell disease (SCD) are common chronic conditions in children of African ancestry that are characterized by cough, wheeze, and obstructive patterns on pulmonary function. Pulmonary function testing in children with SCD has estimated a prevalence of obstructive lung disease ranging from 13% to 57%, and airway hyper-responsiveness of up to 77%, independent of a diagnosis of asthma. Asthma co-existing with SCD is associated with increased risk of acute chest syndrome (ACS), respiratory symptoms, pain episodes, and death...
January 4, 2018: Pediatric Pulmonology
Hans Pasterkamp
Wheezing is the most widely reported adventitious lung sound in the English language. It is recognized by health professionals as well as by lay people, although often with a different meaning. Wheezing is an indicator of airway obstruction and therefore of interest particularly for the assessment of young children and in other situations where objective documentation of lung function is not generally available. This review summarizes our current understanding of mechanisms producing wheeze, its subjective perception and description, its objective measurement, and visualization, and its relevance in clinical practice...
December 21, 2017: Pediatric Pulmonology
Paula Heikkilä, Marjo Renko, Matti Korppi
We undertook a cumulative meta-analysis for the efficacy of hypertonic saline (HS) compared to normal saline (NS) inhalations or no inhalations as controls in bronchiolitis. We performed literature searches from PubMed, Scopus, and by hand search until 20 June 2017. We accepted published randomized controlled trials of HS inhalations in children with bronchiolitis aged <24 months. We evaluated the differences between treatment group with HS and control group without HS inhalations for the length-of-stay in hospital (LOS) by cumulative mean difference (MD) and in hospitalization rate by cumulative risk ratio (RR)...
December 21, 2017: Pediatric Pulmonology
David R Spielberg, Laura L Walkup, Jill M Stein, Eric J Crotty, Mantosh S Rattan, Md Monir Hossain, Alan S Brody, Jason C Woods
BACKGROUND: Bronchopulmonary dysplasia (BPD) is a common, heterogeneous disease in premature infants. We hypothesized that quantitative CT techniques could assess lung parenchymal heterogeneity in BPD patients across a broad age range and demonstrate how pathologies change over time. METHODS: A cross-sectional, retrospective study of children age 0-6 years with non-contrast chest CT scans was conducted. BPD subjects met NICHD/NHLBI diagnostic criteria for BPD and were excluded for congenital lung/airway abnormalities or other known/suspected pulmonary diagnoses; control subjects were not premature and had normal CT scan findings...
December 21, 2017: Pediatric Pulmonology
Thanakorn Kanjanapradap, Jitladda Deerojanawong, Suchada Sritippayawan, Nuanchan Prapphal
BACKGROUND: Although previous studies have shown benefits of nebulized hypertonic saline (HS) for improving airway clearance and shortening hospitalization in infants with bronchiolitis, prospective blinded studies in preschool children with acute viral wheezing are limited. OBJECTIVES: To determine nebulized 3% HS efficacy in young children admitted with acute viral wheezing. METHODS: This double-blind, randomized controlled trial was conducted in children aged 6 months to 5 years admitted with acute viral wheezing from July 1st to December 31st 2016...
December 21, 2017: Pediatric Pulmonology
Christopher D Baker
No abstract text is available yet for this article.
December 21, 2017: Pediatric Pulmonology
Hendrik S Fischer, Peter C Rimensberger
No abstract text is available yet for this article.
December 21, 2017: Pediatric Pulmonology
Eduardo L L Praca, Christina J Tiller, Jeffrey A Kisling, Robert S Tepper
BACKGROUND: Lung diffusion assessed by the uptake of carbon monoxide (DLCO ) and alveolar volume (VA ) by inert gas dilution are readily assessed in cooperative older subjects; however, obtaining these measurements in infants has been much more difficult. Our laboratory has measured DLCO and VA in sleeping infants using a mass spectrometer, which continuously measures gas concentrations, and demonstrated that infants with bronchopulmonary dysplasia (BPD) have lower DLCO , but no difference in VA compared to full-term controls...
December 19, 2017: Pediatric Pulmonology
Luciano E Busi, Peter D Sly
AIM: The Global Lung Function Initiative (GLI) has produced spirometry reference equations for use in different ethnic groups. Previous reports have shown that the GLI equations do not adequately describe lung function in all populations and that adopting the new equations into clinical practice can increase the number of patients considered to have abnormal lung function. Therefore, before adopting these equations into local practice it is necessary to establish how well the equations represent the local population...
December 19, 2017: Pediatric Pulmonology
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