Paediatric Respiratory Reviews最新文献

Consolidated nighttime sleep is a critical milestone in infant development, underpinning physical, cognitive, and socioemotional growth. Despite being a normative maturational process, fragmented sleep and difficulties initiating/maintaining sleep are common parental concerns. This review synthesizes developmental and behavioral science to elucidate mechanisms and evidence-based strategies that foster healthy sleep consolidation in infants and toddlers. First, we describe the evolution of sleep architecture and the interaction between circadian and homeostatic processes that regulate sleep-wake cycles. Then, we highlight how environmental and caregiving factors support these biological systems. Lastly, we describe behavioral strategies and the influence of environmental elements on circadian entrainment and independent sleep initiation. Across approaches, we emphasize the importance of family-centered implementation, where caregivers can both promote and benefit from optimal infant sleep. This review provides clinicians, researchers, and caregivers with a comprehensive framework to promote sleep consolidation and well-being during early childhood.

Preterm birth, affecting approximately 10 % of live births worldwide, is the most common cause of altered lung development and can have lasting respiratory consequences, including the occurrence of bronchopulmonary dysplasia (BPD). This review summarizes prenatal and postnatal strategies to promote pulmonary growth and reduce morbidity in preterm infants. Prenatal interventions such as optimizing maternal health and antenatal corticosteroids improve foetal lung maturity. Postnatally, non-invasive respiratory support-particularly continuous positive airway pressure (CPAP)-both prevents injury and promotes alveolar and vascular growth. Lung-protective ventilation strategies, adequate nutrition, and pharmacologic agents like caffeine enhance outcomes. Experimental therapies, including mesenchymal stem cells, insulin-like growth factor-1 (IGF-1), and artificial placenta technology, show promise in restoring pulmonary growth and function. Despite advances, many preterm survivors exhibit persistent lung deficits into adulthood, underscoring the need for longitudinal monitoring and continued innovation to support lung growth and lifelong respiratory health.

Pressurised metered-dose inhalers (pMDIs) are widely used in the treatment of paediatric respiratory diseases. Despite their widespread use, knowledge about effective inhaler technique amongst patients and clinicians is poor. Even amongst well-trained specialists, knowledge about how these devices function is limited. This short review outlines what it is critical to understand about how pMDIs work. This allows advanced troubleshooting of problems for patients and can decrease non-intentional non-adherence from a variety of causes.

Non-invasive ventilation (NIV) has become an essential component of pediatric respiratory support, offering effective alternatives to invasive mechanical ventilation in both acute and chronic conditions. Advances in technology and a growing understanding of pediatric respiratory physiology have expanded the application of NIV across a range of clinical scenarios, from acute respiratory failure in the intensive care unit to long-term management of neuromuscular and sleep-related breathing disorders in outpatient settings. As part of a review series, in this part 1 we provide an overview of conventional NIV modes in children, highlighting the history of mechanical ventilation, indications, interfaces, conventional modes of NIV and considerations unique to the pediatric population in both acute and chronic care contexts.

Non-invasive ventilation (NIV) has become an essential component of pediatric respiratory support, offering effective alternatives to invasive mechanical ventilation in both acute and chronic conditions. Advances in technology and a growing understanding of pediatric respiratory physiology have expanded the application of NIV across a range of clinical scenarios, from acute respiratory failure in the intensive care unit to long-term management of neuromuscular and sleep-related breathing disorders in outpatient settings. As part of a review series, in this part 2 we provide an overview of new and emerging modes of NIV, their recommended clinical applications and we will briefly discuss the available evidence in pediatrics.

In the era of cystic fibrosis transmembrane conductance regulator (CFTR) modulators, we have seen impressive improvements to quality of life and life expectancy in people with cystic fibrosis (pwCF). However, there have been emerging adverse events related to elexacaftor/tezacaftor/ivacaftor (ETI). We present 8 paediatric pwCF who developed chalazion/hordeolum on standard dosing of ETI, of which one third needed interruption of ETI therapy to achieve resolution. This report highlights a 5.5-fold increased incidence of chalazion/hordeolum in pwCF and raises concerns of a clinical association between ETI and chalazion/hordeolum.

Large language models (LLMs) such as ChatGPT, Claude, and Gemini have become widely accessible since 2022. As childhood asthma remains the most common chronic paediatric condition with persistent gaps in optimal management, these tools present both opportunities and challenges for families and healthcare professionals. This narrative review examines the role of commercially available LLMs in childhood asthma care, exploring their fundamental principles, current evidence, and potential applications. Studies show that LLMs can generate medically accurate and comprehensible responses to asthma-related queries. Healthcare professionals may also benefit from rapid summarisation and tailored educational content. However, risks include hallucinations, bias, and data privacy concerns. Further research is required to evaluate the safety, clinical utility, and real-world acceptability of LLMs - particularly in acute asthma management by families and in supporting clinical decisions by healthcare professionals - and to guide the development of reliable, inclusive tools tailored to paediatric respiratory care.

Despite a high burden of respiratory disease among infants globally, limited options exist for lung function testing in this age group. Tidal breathing techniques such as oscillometry allow for understanding the pathophysiology of diseases that originate early in life, thus providing the opportunity to develop timely prevention and treatment strategies. This review summarises the principles of infant oscillometry, the primary oscillometry measures, physiological differences compared to older age groups, commonly used testing platforms, laboratory benchmarking, and future directions for research. Expanding the use of infant oscillometry will require further standardisation of equipment, calibration, protocols, and technical standards, followed by well-designed studies to outline clinical utility. While infant oscillometry is currently limited to the research setting, this technique has the potential for clinical applications in the future, ultimately providing opportunities for improving respiratory outcomes in infants globally.