Acute Respiratory Failure in Children: A Clinical Update on Diagnosis.

IF 2 4区 医学 Q2 PEDIATRICS Children-Basel Pub Date : 2024-10-12 DOI:10.3390/children11101232
Beatrice Panetti, Ilaria Bucci, Armando Di Ludovico, Giulia Michela Pellegrino, Paola Di Filippo, Sabrina Di Pillo, Francesco Chiarelli, Marina Attanasi, Giuseppe Francesco Sferrazza Papa
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Abstract

Acute respiratory failure (ARF) is a sudden failure of the respiratory system to ensure adequate gas exchanges. Numerous clinical conditions may cause ARF, including pneumonia, obstructive lung diseases (e.g., asthma), restrictive diseases such as neuromuscular diseases (e.g., spinal muscular atrophy and muscular dystrophy), and albeit rarely, interstitial lung diseases. Children, especially infants, may be more vulnerable to ARF than adults due to anatomical and physiological features of the respiratory system. Assessing respiratory impairment in the pediatric population is particularly challenging as children frequently present difficulties in reporting symptoms and due to compliance and cooperation in diagnostic tests. The evaluation of clinical and anamnestic aspects represents the cornerstone of ARF diagnosis: first level exams (e.g., arterial blood gas analysis) confirm and evaluate the severity of the ARF and second level exams help to uncover the underlying cause. Prompt management is critical, with supplemental oxygen, mechanical ventilation, and the treatment of the underlying problem. The aim of this review is to provide a comprehensive summary of the current state of the art in diagnosing pediatric ARF, with a focus on pathophysiology, novel imaging applications, and new perspectives, such as biomarkers and artificial intelligence.

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儿童急性呼吸衰竭:诊断的临床更新。
急性呼吸衰竭(ARF)是指呼吸系统突然无法确保充分的气体交换。许多临床疾病都可能导致急性呼吸衰竭,包括肺炎、阻塞性肺部疾病(如哮喘)、限制性疾病(如神经肌肉疾病,如脊髓性肌萎缩症和肌营养不良症),以及间质性肺部疾病(尽管很少见)。由于呼吸系统的解剖和生理特点,儿童(尤其是婴儿)可能比成人更容易患 ARF。评估儿科人群的呼吸功能损害尤其具有挑战性,因为儿童在报告症状时经常遇到困难,在诊断测试中也难以服从和配合。对临床和病理方面的评估是诊断 ARF 的基石:一级检查(如动脉血气分析)可确认和评估 ARF 的严重程度,二级检查有助于发现潜在病因。及时处理至关重要,包括补充氧气、机械通气和治疗潜在问题。本综述旨在全面总结当前诊断小儿 ARF 的技术水平,重点关注病理生理学、新型成像应用以及生物标记物和人工智能等新视角。
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来源期刊
Children-Basel
Children-Basel PEDIATRICS-
CiteScore
2.70
自引率
16.70%
发文量
1735
审稿时长
6 weeks
期刊介绍: Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.
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