ARDS in children

OBJECTIVES: Mechanical ventilation (MV) is pervasive among critically ill children. We sought to validate a computerized physiologic equation to predict minute ventilation requirements in children and test its performance against clinician actions in an in silico trial. DESIGN: Retrospective, electronic medical record linkage, cohort study. SETTING: Quaternary PICU. PATIENTS: Patients undergoing invasive MV, serial arterial blood gas (ABG) analysis within 1-6 hours, and pharmacologic neuromuscular blockade (NMB)...

BACKGROUND: Coronavirus disease 2019 (COVID-19) tends to have mild presentations in children. However, severe and critical cases do arise in the pediatric population with debilitating systemic impacts and can be fatal at times, meriting further attention from clinicians. Meanwhile, the intricate interactions between the pathogen virulence factors and host defense mechanisms are believed to play indispensable roles in severe COVID-19 pathophysiology but remain incompletely understood. DATA SOURCES: A comprehensive literature review was conducted for pertinent publications by reviewers independently using the PubMed, Embase, and Wanfang databases...

The methacholine challenge test (MCT) is a standard evaluation method of assessing airway hyperresponsiveness (AHR) and its severity, and has significant clinical value in the diagnosis and treatment of bronchial asthma. A consensus working group consisting of experts from the Pulmonary Function and Clinical Respiratory Physiology Committee of the Chinese Association of Chest Physicians, the Task Force for Pulmonary Function of the Chinese Thoracic Society, and the Pulmonary Function Group of Respiratory Branch of the Chinese Geriatric Society jointly developed this consensus...

OBJECTIVE: To investigate the effect of different doses of prophylactic dextrose gel on neurocognitive function and health at 6-7 years. DESIGN: Early school-age follow-up of the pre-hPOD (hypoglycaemia Prevention with Oral Dextrose) study. SETTING: Schools and communities. PATIENTS: Children born at ≥35 weeks with ≥1 risk factor for neonatal hypoglycaemia: maternal diabetes, small or large for gestational age, or late preterm...

RATIONALE: The epidemiology, management, and outcomes of acute respiratory distress syndrome (ARDS) differ between children and adults, with lower mortality rates in children despite comparable severity of hypoxemia. However, the relationship between age and mortality is unclear. OBJECTIVES: We aimed to define the association between age and mortality in ARDS, hypothesizing that it would be non-linear. METHODS: We performed a retrospective cohort study using data from two pediatric ARDS observational cohorts (n = 1,236), multiple adult ARDS trials (n = 5,547), and an adult observational ARDS cohort (n = 1,079)...

BACKGROUND: In this study, we reviewed the outcomes of pediatric patients with malignancies who underwent hematopoietic stem cell transplantation (HSCT) and extracorporeal membrane oxygenation (ECMO). METHODS: We retrospectively analyzed the records of pediatric hemato-oncology patients treated with chemotherapy or HSCT and who received ECMO in the pediatric intensive care unit (PICU) at Seoul National University Children's Hospital from January 2012 to December 2020...

BACKGROUND: Mechanical power (MP) refers to the energy transmitted over time to the respiratory system and serves as a unifying determinant of ventilator-induced lung injury. MP normalization is required to account for developmental changes in children. We sought to examine the relationship between mechanical energy (MEBW ), MP normalized to body weight (MPBW ), and MP normalized to respiratory compliance (MPCRS ) concerning the severity and outcomes of pediatric acute respiratory distress syndrome (pARDS)...

BACKGROUND: In refractory respiratory failure (RF), extracorporeal membrane oxygenation (ECMO) is a salvage therapy that seeks to reduce lung injury induced by mechanical ventilation. The parameters of optimal mechanical ventilation in children during ECMO are not known. Pulmonary ventilatory management during this therapy may impact mortality. The objective of this study was to evaluate the association between ventilatory parameters in children during ECMO therapy and in-hospital mortality...

OBJECTIVES: To investigate the number of children per man and the proportion of childless men as a proxy of fertility in a national cohort of men with inflammatory joint diseases (IJDs), compared with matched controls from the general population. METHODS: This is a nationwide, population-based retrospective cohort study. Male patients with IJDs (n = 10 865) in the Norwegian Arthritis Registry were individually matched 1:5 on birth year and county of residence with men without IJDs obtained from the National Population Register (n = 54 325)...

The most common acute infection and leading cause of death in children worldwide is pneumonia. Clinical and laboratory tests essentially diagnose community-acquired pneumonia (CAP). CAP can be caused by bacteria, viruses, or atypical microorganisms. Imaging is usually reserved for children who do not respond to treatment, need hospitalisation, or have hospital-acquired pneumonia. This review discusses the imaging findings for acute CAP complications and the diagnostic role of each imaging modality. Pleural effusion, empyema, necrotizing pneumonia, abscess, pneumatocele, pleural fistulas, and paediatric acute respiratory distress syndrome (PARDS) are acute CAP complications...

RATIONALE: New evidence is available examining the use of corticosteroids in sepsis, acute respiratory distress syndrome (ARDS) and community-acquired pneumonia (CAP), warranting a focused update of the 2017 guideline on critical illness-related corticosteroid insufficiency. OBJECTIVES: To develop evidence-based recommendations for use of corticosteroids in hospitalized adults and children with sepsis, ARDS, and CAP. PANEL DESIGN: The 22-member panel included diverse representation from medicine, including adult and pediatric intensivists, pulmonologists, endocrinologists, nurses, pharmacists, and clinician-methodologists with expertise in developing evidence-based Clinical Practice Guidelines...

OBJECTIVES: To characterize immunocompromised-associated pediatric acute respiratory distress syndrome (I-PARDS) and contrast it to PARDS. DESIGN: This is a secondary analysis of the 2016-2017 PARDS incidence and epidemiology (PARDIE) study, a prospective observational, cross-sectional study of children with PARDS. SETTING: Dataset of 145 PICUs across 27 countries. PATIENTS: During 10 nonconsecutive weeks (from May 2016 to June 2017), data about immunocompromising conditions (ICCs, defined as malignancy, congenital/acquired immunodeficiency, posttransplantation, or diseases requiring immunosuppression) were collected...

INTRODUCTION: Cases with early diagnosis of neonatal tuberous sclerosis syndrome (TSC) are relatively seldom seen, and misdiagnosis of intracranial hemorrhage is even more rare. We retrospectively analyzed the clinical data of a case of neonatal tuberous sclerosis with atypical early symptoms and misdiagnosed as more common intracranial hemorrhage of the newborn. PATIENT CONCERNS: The child was female and had no obvious cause of convulsion 12 days after birth. The local hospital was initially diagnosed as "neonatal intracranial hemorrhage, congenital heart disease," and still had convulsions after 5 days of treatment, so it was transferred to neonatal intensive care unit of our hospital...

The COVID-19 pandemic challenged the medical field to rapidly identify and implement new approaches to the diagnosis, treatment and prevention of SARS-CoV-2 infections. The scientific community also needed to rapidly initiate basic, translational, clinical and epidemiological studies to understand the pathophysiology of this new family of viruses, which continues to evolve with the emergence of new genetic variants. One of the earliest clinical observations that provided a framework for the research was the finding that, in contrast to most other respiratory viruses, children developed less severe acute and post-acute disease compared to adults...

Kawasaki disease (KD) is an acute illness primarily affecting children under the age of five. It is characterized by fever and inflammation of small to medium-sized arteries. This case report presents the case of a nine-year-old boy with KD who developed Kawasaki disease shock syndrome (KDSS) complicated by bilateral pleural effusion, which is a rare occurrence. KDSS is defined as KD accompanied by low blood pressure or signs of inadequate blood flow, leading to increased cardiovascular complications. The patient exhibited typical KD symptoms, including conjunctivitis, mucosal changes, rash, extremity swelling, and lymphadenopathy...

Pulmonary surfactant is a lipoprotein complex lining the alveolar surface to decrease the surface tension and facilitate inspiration. Surfactant deficiency is often seen in premature infants and also children and adults with respiratory distress syndrome. Mechanical stretch of alveolar type 2 epithelial (AT2) cells during lung expansion is the primary physiological factor that stimulates surfactant secretion; however, it is unclear whether there is a mechanosensor dedicated for this process. Here we show that loss of mechanosensitive channels TMEM63A and TMEM63B resulted in atelectasis and respiratory failure in mice due to deficit of surfactant secretion...

OBJECTIVE: The aim: To study the of homeostasis links desorder and indicators imbalance in children with Coronavirus infection. PATIENTS AND METHODS: Materials and methods: A clinical and laboratory study was conducted in children (50 persons) with Coronavirus infection. The children were used outpatient treatment. RESULTS: Results: It was found that Direct bilirubin was increased in 3 times (10.55±7.67 vs. 3.63±0.49 μmol/l, p<0...

Bilateral vocal cord paralysis can cause obstruction of glottic airflow, resulting in respiratory distress and the need for a surgical airway. We report a case of acute onset bilateral vocal cord paralysis in a healthy adolescent patient 9 days after a mild severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This 15-year-old patient presented with dyspnea, tachypnea, and stridor. A fiberoptic laryngoscopy revealed bilateral vocal fold paralysis with limited vocal cord abduction causing respiratory distress...

TB is a major concern in the paediatric age group, especially in India. More than 3.33 lakh children between 0 and 14 years of age are affected by TB. Adolescent tuberculosis has been a neglected area and this age group accounts for about 800,000 cases of tuberculosis (TB) cases every year. Information regarding adolescent tuberculosis patient requiring ICU admission/care is very scanty (unlike adult tuberculosis), and the authors believe that the mode of ICU presentation and challenges in adolescents would almost be the same as in adults, although the outcome is generally expected to be better in the adolescent population in view of lesser comorbidities when compared to adults...

Sickle cell has predominantly been a disease in the sub-Saharan Africa. There is scanty data in Africa and none in Tanzania regarding patients with sickle cell disease infected with COVID-19 especially in the paediatric group. This is concerning because a large population of children living with sickle cell disease are found in this part of the world where scarcity of resources also prevail. This is the first paediatric case of sickle cell disease and COVID-19 reported in Tanzania; highlighting the presentation and challenges faced in management...