Diagnostics in Children and Adolescents with Suspected or Confirmed Pulmonary Hypertension
We provide a practical approach on the initial assessment and diagnostic work-up of children and adolescents with pulmonary hypertension (PH). Transthoracic echocardiography (TTE) often serves as initial study tool before invasive cardiac catheterization. Misinterpretation of TTE variables may lead to missed or delayed diagnosis with devastating consequences, or unnecessary invasive diagnostics that have inherited risks. In addition to clinical and biochemical markers, serial examination of patients with PH using a standardized TTE approach, determining conventional and novel echocardiographic variables, may allow early di...
Source: Paediatric Respiratory Reviews - October 25, 2016 Category: Respiratory Medicine Authors: Martin Koestenberger, Georg Hansmann, Christian Apitz, Heiner Latus, Astrid Lammers Source Type: research
Lung-protective ventilatory strategies in intubated preterm neonates with RDS
This article provides a narrative review of lung-protective ventilatory strategies (LPVS) in intubated preterm infants with RDS. A description of strategies is followed by results on short-and long-term respiratory and neurodevelopmental outcomes. Strategies will include patient-triggered or synchronized ventilation, volume targeted ventilation, the technique of intubation, surfactant administration and rapid extubation to NCPAP (INSURE), the open lung concept, strategies of high-frequency ventilation, and permissive hypercapnia. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - October 25, 2016 Category: Respiratory Medicine Authors: F. Reiterer, B. Schwaberger, T. Freidl, G. Schm ölzer, G. Pichler, B. Urlesberger Source Type: research
Ralstonia species – do these bacteria matter in cystic fibrosis?
Ralstonia species, often regarded as an environmental organism of low pathogenicity, can cause significant disease in certain at-risk patient groups, including those with cystic fibrosis. Difficulties with its identification in the clinical laboratory mean that it may be misidentified and therefore under recognised as a cause of disease. A number of outbreaks have been associated with the use of devices for inhaled respiratory therapy, putting those with chronic respiratory conditions at risk. Antimicrobial treatment of infection is challenging and limited due to frequent antimicrobial resistance. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - October 20, 2016 Category: Respiratory Medicine Authors: Anna-Rose Prior, Cedric Gunaratnam, Hilary Humphreys Tags: Review Source Type: research
Interfaces for noninvasive ventilation in the acute setting in children
The use of noninvasive ventilation (NIV) is very specific in the acute setting as compared to its use in a chronic setting. In the Pediatric Intensive care Unit (PICU), NIV may be required around the clock and initiation has to be fast and easy. Despite the increasing use of non-invasive ventilation (NIV) and the larger choice of interfaces, data comparing the use of different interfaces for pediatric patients are scarce and recommendations for the most appropriate choice of interface are lacking. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - October 20, 2016 Category: Respiratory Medicine Authors: Guillaume Mortamet, Alessandro Amaddeo, Sandrine Essouri, Sylvain Renolleau, Guillaume Emeriaud, Brigitte Fauroux Source Type: research
Ralstonia species –do these bacteria matter in cystic fibrosis?
Ralstonia species, often regarded as an environmental organism of low pathogenicity, can cause significant disease in certain at-risk patient groups, including those with cystic fibrosis. Difficulties with its identification in the clinical laboratory mean that it may be misidentified and therefore under recognised as a cause of disease. A number of outbreaks have been associated with the use of devices for inhaled respiratory therapy, putting those with chronic respiratory conditions at risk. Antimicrobial treatment of infection is challenging and limited due to frequent antimicrobial resistance. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - October 20, 2016 Category: Respiratory Medicine Authors: Anna-Rose Prior, Cedric Gunaratnam, Hilary Humphreys Source Type: research
Inflammation-induced preterm lung maturation: lessons from animal experimentation
Intrauterine inflammation, or chorioamnionitis, is a major contributor to preterm birth. Prematurity per se is associated with considerable morbidity and mortality resulting from lung immaturity but exposure to chorioamnionitis reduces the risk of neonatal respiratory distress syndrome (RDS) in preterm infants. Animal experiments have identified that an increase in pulmonary surfactant production by the preterm lungs likely underlies this decreased risk of RDS in infants exposed to chorioamnionitis. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - October 19, 2016 Category: Respiratory Medicine Authors: Timothy J.M. Moss, Alana J. Westover Source Type: research
Question 11: How should Allergic Bronchopulmonary Aspergillosis [ABPA] be managed in Cystic Fibrosis?
Aspergillus fumigatus is a ubiquitous, filamentous and spore-bearing fungus which usually grows at 37 degrees Celsius. It can be an opportunistic pathogen and can induce an inflammatory response in the airways through the production of various toxic and allergenic exoproducts. As a consequence, the clinical presentation may take a number of forms: Allergic bronchopulmonary aspergillosis (ABPA), aspergillus bronchitis, invasive pulmonary aspergillosis and an aspergilloma. ABPA occurs almost exclusively in asthma or cystic fibrosis (CF) patients [1]. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - October 12, 2016 Category: Respiratory Medicine Authors: Mon Ohn, Paul Robinson, Hiran Selvadurai, Dominic A. Fitzgerald Tags: Cystic Fibrosis: Frequently Asked Questions Source Type: research
Question 11: How should Allergic Bronchopulmonary Aspergillus [ABPA] be managed in Cystic Fibrosis?
(Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - October 12, 2016 Category: Respiratory Medicine Authors: Mon Ohn, Paul Robinson, Hiran Selvadurai, Dominic A. Fitzgerald Source Type: research
Obesity and common respiratory diseases in children
Obesity has become an important public health problem worldwide that disproportionally affects the underserved. Obesity has been associated with many diseases and unfortunately has not spared the respiratory system. Specifically, the prevalence of common respiratory problems, such as asthma and obstructive sleep apnoea, is higher in obese children. Further, the treatment outcomes of these frequent conditions is also worse in obese children compared to lean controls. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - October 10, 2016 Category: Respiratory Medicine Authors: Melissa Xanthopoulos, Ignacio E. Tapia Source Type: research
Maternal obesity mediated predisposition to respiratory complications at birth and in later life: understanding the implications of the obesogenic intrauterine environment
More women than not are entering pregnancy either overweight or obese. This presents a significant health care burden with respect to maternal morbidities and offspring complications at birth and in later life. In recent years it has also become clear that maternal obesity is an even greater global health problem than anticipated, because the effects are not limited to the mother but are also programmed in the fetus, known as the ‘intergenerational cycle of obestiy’. Despite a large body of epidemiological evidence reporting outcomes of obese pregnancies, including offspring respiratory complications, much less is know...
Source: Paediatric Respiratory Reviews - October 10, 2016 Category: Respiratory Medicine Authors: Erin V. McGillick, Mitchell C. Lock, Sandra Orgeig, Janna L. Morrison Source Type: research
Impulse oscillometry in the assessment of asthmatic children and adolescents: from a narrative to a systematic review
Diagnosis and management of asthma often relies mostly on symptoms because spirometry is not always reliable in some age groups, such as preschoolers. It is unclear whether impulse oscillometry (IOS) can supplement or replace spirometry. Available reports suggest that IOS has been applied with success in asthmatic children and adolescents to assess exacerbations, level of control, severity and response to treatment in the short and long term. Very few studies using adequate sample sizes and methods have been performed comparing the accuracy of IOS to spirometry for the diagnosis of asthma. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - September 27, 2016 Category: Respiratory Medicine Authors: Karoliny dos Santos, L ílian L. Fausto, Paulo A.M. Camargos, Maicon R. Kviecinski, Jane da Silva Source Type: research
Interventions to prevent respiratory diseases - Nutrition and the developing world
Malnutrition is a major cause of morbidity and mortality in developing countries and nutrition plays a critical role in both acute and chronic respiratory conditions. Inadequacies in the nutritional requirements of a developing lung in utero and in early life can compromise the respiratory system integrity and result in poor lung function, reduced protection against infections, greater likelihood of acute illnesses in childhood and chronic illness in adulthood. Nutritional interventions harness great potential in reducing respiratory illness related morbidity and mortality in the developing world. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - September 26, 2016 Category: Respiratory Medicine Authors: Tasneem Karim, Mohammad Muhit, Gulam Khandaker Source Type: research
Dornase alfa for cystic fibrosis
(Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - September 14, 2016 Category: Respiratory Medicine Authors: CL Yang, M Chilvers, M Montgomery, SJ Nolan Source Type: research
Potential Nutrients for Preventing or Treating Bronchopulmonary Dysplasia
Bronchopulmonary dysplasia (BPD) is a frequent complication of extremely preterm infants. Despite recent advances in newborn medicine, the incidence of BPD does not appear to have changed markedly, and specific treatments and prevention strategies are still lacking. Nutrition plays an important role in normal lung development and maturation. Malnutrition may delay somatic growth and new alveoli development, thus aggravating pulmonary injury involved in the pathogenesis of BPD. However, few nutrients have been investigated for their potential to mitigate the pathogenesis of BPD. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - September 14, 2016 Category: Respiratory Medicine Authors: Liya Ma, Ping Zhou, Josef Neu, Hung-Chih Lin Source Type: research
Physical activity outcomes following preterm birth
Physical activity (PA) is an important mediator of health and disease. Many correlates may play an important role in explaining differences in PA between populations; however, the role of birth outcomes such as prematurity on levels PA is relatively poorly represented in the literature. Children born preterm may be at risk for reduced levels of PA as they have increased respiratory symptoms as well as decrements in lung function and exercise capacity. Emerging evidence suggests that the effects are prevalent across the whole range of gestational age. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - August 28, 2016 Category: Respiratory Medicine Authors: John Lowe, Michael Cousins, Sarah J. Kotecha, Sailesh Kotecha Source Type: research
