<div><h3>Introduction</h3><div>Respiratory distress (RD) is the most common cause of admission to the Neonatal Intensive Care Unit (NICU). The role of Vitamin D in the development and fortification of fetal pulmonary architecture and the synthesis of surfactants is well-documented. While different serum levels of 25-hydroxyvitamin D (Vit. D) have been studied for their diagnostic significance in RD, there is limited research on how it specifically affects the development of respiratory problems in infants and their mothers. The purpose of the present study is a systematic review and <em>meta</em>-analysis to evaluate the correlation between serum levels of Vit. D in mothers and newborns with RD, and to determine the impact of treating either population on the clinical outcomes of afflicted infants.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across various databases, including PubMed, ScienceDirect, Cochrane Library, ISI, and Google Scholar, using a combination of keywords such as RD, diagnosis, vitamin D, mothers, infants, vitamin D supplementation, Respiratory distress syndrome(RDS), and Transient Tachypnea of Newborn (TTN). The search was carried out until March 2024.The level of vitamin D in both mothers and their infants was systematically extracted and analyzed to determine the diagnostic efficacy of Vit. D levels. The mean difference (MD) was calculated along with a 95% confidence interval to determine the association between the Vit. D levels in newborns and their mothers and the likelihood of RD, RDS and TTN in infants. To assess potential publication bias, a funnel plot was generated and Egger’s regression test was applied, utilizing a random-effects model.</div></div><div><h3>Results</h3><div>Initially a total of 298 relevant articles was retrieved. Among them, 17 articles with a total of 1,582 infants (745 cases and 837 healthy controls) met the criteria as eligible studies. Of these six were prospective cohort studies, four retrospective case-control studies, four randomized controlled trials (RCTs), and three descriptive-analytical studies. The <em>meta</em>-results revealed a significant association between Vit. D levels and risk of RD in infants (MD = 6.240, 95 %CI: 4.840–7.840, P < 0.001) and mothers (MD = 8.053, 95 %CI: 4.920–11.186, P < 0.001). Furthermore, a strong association was found for risk of RDS (MD = 5.493, 95 %CI: 3.356–7.631, P < 0.001) in infants and TTN (MD = 6.672, 95 %CI: 4.072–9.272, P < 0.001), (MD = 8.595, 95%CI: 4.604-12.586, P < 0.001) both in infants and mothers. Administering 50,000 units of vitamin D to mothers (MD = 8.595, 95 %CI: 4.604–12.586, P < 0.001) prior to childbirth was observed to reduce the likelihood of RD in newborns by 64 % (RR = 0.36, 95 %CI: 0.23–0.57, P < 0.001). Supplemental vitamin D provided to infants was associated with several clinical benefits.</div></div><div><h3>Conclusion</h3><div>Our <em>meta</em>-results indicated
呼吸窘迫（RD）是新生儿重症监护病房（NICU）最常见的入院原因。维生素D在胎儿肺结构的发育和强化以及表面活性剂的合成中的作用是有据可证的。血清25-羟基维生素D (Vit；D)已被研究其在RD中的诊断意义，但关于它如何具体影响婴儿及其母亲呼吸问题发展的研究有限。本研究的目的是通过系统回顾和荟萃分析来评估血清Vit水平之间的相关性。患有RD的母亲和新生儿的D，并确定治疗这两种人群对患病婴儿临床结果的影响。方法综合检索PubMed、ScienceDirect、Cochrane Library、ISI、谷歌Scholar等数据库，检索关键词为RD、诊断、维生素D、母亲、婴儿、维生素D补充、呼吸窘迫综合征（RDS）、新生儿短暂性呼吸急促（TTN）等。搜寻工作一直持续到2024年3月。系统地提取和分析母亲及其婴儿的维生素D水平，以确定Vit的诊断效果。D水平。计算平均差（MD）和95%置信区间，以确定Vit之间的关联。新生儿及其母亲体内的D水平以及婴儿发生RD、RDS和TTN的可能性。为了评估潜在的发表偏倚，采用随机效应模型生成漏斗图，并应用Egger回归检验。结果初步检索到298篇相关文章。其中，17篇文章共1582名婴儿（745例和837名健康对照）符合合格研究标准。其中6项为前瞻性队列研究、4项回顾性病例对照研究、4项随机对照试验（rct）和3项描述性分析研究。荟萃结果揭示了Vit和Vit之间的显著关联。D水平与婴儿RD风险(MD = 6.240, 95% CI: 4.840-7.840, P <；0.001)和母亲(MD = 8.053, 95%置信区间CI: 4.920 - -11.186, P & lt;0.001)。此外，发现RDS的风险有很强的相关性(MD = 5.493, 95% CI: 3.356-7.631, P <；0.001)和TTN (MD = 6.672, 95% CI: 4.072-9.272, P <；0.001), (MD = 8.595, 95%CI: 4.604-12.586, P <；在婴儿和母亲中均为0.001)。给予母亲50,000单位维生素D (MD = 8.595, 95% CI: 4.604-12.586, P <；0.001)可使新生儿RD的可能性降低64% (RR = 0.36, 95% CI: 0.23-0.57, P <；0.001)。向婴儿补充维生素D与几个临床益处有关。结论我们的meta结果显示血清Vit水平之间存在显著相关性。D与婴儿RD、RDS和TTN的风险。母亲预防性服用维生素D对新生儿RD具有保护作用。此外，为早产儿提供维生素D已显示出对减少呼吸系统并发症发生率的显着影响。
{"title":"Evaluation of vitamin D in the diagnosis of infants with respiratory distress, the clinical value: A systematic review and meta-analysis","authors":"Hassan Boskabadi , Maryam Zakerihamidi , Hassan Mehrad-Majd , Sahar Ghoflchi","doi":"10.1016/j.prrv.2024.06.005","DOIUrl":"10.1016/j.prrv.2024.06.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Respiratory distress (RD) is the most common cause of admission to the Neonatal Intensive Care Unit (NICU). The role of Vitamin D in the development and fortification of fetal pulmonary architecture and the synthesis of surfactants is well-documented. While different serum levels of 25-hydroxyvitamin D (Vit. D) have been studied for their diagnostic significance in RD, there is limited research on how it specifically affects the development of respiratory problems in infants and their mothers. The purpose of the present study is a systematic review and <em>meta</em>-analysis to evaluate the correlation between serum levels of Vit. D in mothers and newborns with RD, and to determine the impact of treating either population on the clinical outcomes of afflicted infants.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across various databases, including PubMed, ScienceDirect, Cochrane Library, ISI, and Google Scholar, using a combination of keywords such as RD, diagnosis, vitamin D, mothers, infants, vitamin D supplementation, Respiratory distress syndrome(RDS), and Transient Tachypnea of Newborn (TTN). The search was carried out until March 2024.The level of vitamin D in both mothers and their infants was systematically extracted and analyzed to determine the diagnostic efficacy of Vit. D levels. The mean difference (MD) was calculated along with a 95% confidence interval to determine the association between the Vit. D levels in newborns and their mothers and the likelihood of RD, RDS and TTN in infants. To assess potential publication bias, a funnel plot was generated and Egger’s regression test was applied, utilizing a random-effects model.</div></div><div><h3>Results</h3><div>Initially a total of 298 relevant articles was retrieved. Among them, 17 articles with a total of 1,582 infants (745 cases and 837 healthy controls) met the criteria as eligible studies. Of these six were prospective cohort studies, four retrospective case-control studies, four randomized controlled trials (RCTs), and three descriptive-analytical studies. The <em>meta</em>-results revealed a significant association between Vit. D levels and risk of RD in infants (MD = 6.240, 95 %CI: 4.840–7.840, P < 0.001) and mothers (MD = 8.053, 95 %CI: 4.920–11.186, P < 0.001). Furthermore, a strong association was found for risk of RDS (MD = 5.493, 95 %CI: 3.356–7.631, P < 0.001) in infants and TTN (MD = 6.672, 95 %CI: 4.072–9.272, P < 0.001), (MD = 8.595, 95%CI: 4.604-12.586, P < 0.001) both in infants and mothers. Administering 50,000 units of vitamin D to mothers (MD = 8.595, 95 %CI: 4.604–12.586, P < 0.001) prior to childbirth was observed to reduce the likelihood of RD in newborns by 64 % (RR = 0.36, 95 %CI: 0.23–0.57, P < 0.001). Supplemental vitamin D provided to infants was associated with several clinical benefits.</div></div><div><h3>Conclusion</h3><div>Our <em>meta</em>-results indicated ","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"53 ","pages":"Pages 44-54"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141710982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tuberculosis (TB) survivors, especially children and adolescents, can develop chronic respiratory problems called post-tuberculosis lung disease (PTLD). We conducted a scoping review to identify the current knowledge gaps on PTLD definitions, measuring tools, and research specific to this age group. We searched MEDLINE, EMBASE, Global Health, CINAHL, and Web of Science for studies published between January 1, 2000, and March 1, 2024, and identified 16 studies.
Our review found that no consistent definition of PTLD was used in the studies, and the measurement tools used varied widely. Moreover, there was a lack of research on children under five years old, who are disproportionately affected by TB. Also, symptom screening tools designed for adults were frequently used in these studies, raising concerns about their accuracy in detecting PTLD in children and adolescents.
Several critical research gaps require attention to improve our understanding and treatment of PTLD. Firstly, the use of inconsistent definitions of PTLD across studies makes it challenging to compare research findings and gain a clear understanding of the condition. Therefore, we need to include an objective measurement of respiratory health, such as a comprehensive post-TB lung function assessment for children and adolescents. It is also crucial to determine the optimal timing and frequency of post-TB assessments for effective PTLD detection. Furthermore, we need more knowledge of the modifiable risk factors for PTLD. The scarcity of prospective studies makes it difficult to establish causality and track the long-term course of the disease in children and adolescents. Finally, current approaches to PTLD management often fail to consider patient-reported outcomes and strategies for social support. Addressing these research gaps in future studies can improve our understanding and management of paediatric PTLD, leading to better long-term health outcomes for this vulnerable population.
结核病（TB）幸存者，特别是儿童和青少年，可能会出现称为结核后肺病（PTLD）的慢性呼吸道问题。我们进行了范围审查，以确定当前在PTLD定义、测量工具和针对该年龄组的研究方面的知识差距。我们检索了MEDLINE， EMBASE, Global Health， CINAHL和Web of Science在2000年1月1日至2024年3月1日之间发表的研究，并确定了16项研究。我们的回顾发现，在研究中没有使用一致的PTLD定义，并且使用的测量工具差异很大。此外，缺乏对五岁以下儿童的研究，这些儿童受到结核病的影响不成比例。此外，在这些研究中经常使用为成人设计的症状筛查工具，这引起了人们对其在儿童和青少年中检测PTLD的准确性的担忧。需要注意几个关键的研究空白，以提高我们对PTLD的理解和治疗。首先，在不同的研究中使用不一致的PTLD定义使得比较研究结果和获得对该疾病的清晰理解具有挑战性。因此，我们需要包括呼吸健康的客观测量，例如对儿童和青少年进行全面的结核病后肺功能评估。确定结核病后评估的最佳时间和频率以有效发现PTLD也至关重要。此外，我们需要对PTLD可改变的危险因素有更多的了解。由于缺乏前瞻性研究，因此很难确定儿童和青少年的因果关系并追踪疾病的长期病程。最后，目前的PTLD管理方法往往未能考虑患者报告的结果和社会支持策略。在未来的研究中解决这些研究差距可以提高我们对儿科PTLD的理解和管理，从而为这一弱势群体带来更好的长期健康结果。
{"title":"Post-tuberculosis lung disease in children and adolescents: A scoping review of definitions, measuring tools, and research gaps","authors":"Esin Nkereuwem , Sheila Ageiwaa Owusu , Victory Fabian Edem , Beate Kampmann , Toyin Togun","doi":"10.1016/j.prrv.2024.07.001","DOIUrl":"10.1016/j.prrv.2024.07.001","url":null,"abstract":"<div><div>Tuberculosis (TB) survivors, especially children and adolescents, can develop chronic respiratory problems called post-tuberculosis lung disease (PTLD). We conducted a scoping review to identify the current knowledge gaps on PTLD definitions, measuring tools, and research specific to this age group. We searched MEDLINE, EMBASE, Global Health, CINAHL, and Web of Science for studies published between January 1, 2000, and March 1, 2024, and identified 16 studies.</div><div>Our review found that no consistent definition of PTLD was used in the studies, and the measurement tools used varied widely. Moreover, there was a lack of research on children under five years old, who are disproportionately affected by TB. Also, symptom screening tools designed for adults were frequently used in these studies, raising concerns about their accuracy in detecting PTLD in children and adolescents.</div><div>Several critical research gaps require attention to improve our understanding and treatment of PTLD. Firstly, the use of inconsistent definitions of PTLD across studies makes it challenging to compare research findings and gain a clear understanding of the condition. Therefore, we need to include an objective measurement of respiratory health, such as a comprehensive post-TB lung function assessment for children and adolescents. It is also crucial to determine the optimal timing and frequency of post-TB assessments for effective PTLD detection. Furthermore, we need more knowledge of the modifiable risk factors for PTLD. The scarcity of prospective studies makes it difficult to establish causality and track the long-term course of the disease in children and adolescents. Finally, current approaches to PTLD management often fail to consider patient-reported outcomes and strategies for social support. Addressing these research gaps in future studies can improve our understanding and management of paediatric PTLD, leading to better long-term health outcomes for this vulnerable population.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"53 ","pages":"Pages 55-63"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The social determinants of tuberculosis (TB) are well established. However, evidence indicates that genetic variants may also significantly influence an individual’s susceptibility to or resistance to TB.
The risk of TB is connected to polymorphisms in genes related to immunity and inflammation. While there is a growing body of evidence regarding the effect of candidate genes on the host immune response to Mycobacterium tuberculosis (Mtb) in adults, available information on children remains limited.
To investigate this topic, we searched electronic databases, including PubMed Central, the Virtual Health Library (encompassing MEDLINE, Lilacs, and WPRIM), Scopus, Scielo, EBSCOhost, and Embase. After applying the relevant inclusion and exclusion criteria, we identified 24 eligible studies.
These studies aimed to explain how specific genetic variations may affect predisposition to Mtb infection, their critical role in modulating the immune response, and their impact on the clinical progression of TB.
{"title":"Genetics of childhood tuberculosis: A scoping review","authors":"Michely Alexandrino Pinheiro Mascarenhas , Rafaela Baroni Aurilio , Gustavo Guida Godinho da Fonseca , Gilberto Bueno Fischer , Clemax Couto Sant’Anna , Paulo Camargos","doi":"10.1016/j.prrv.2025.02.002","DOIUrl":"10.1016/j.prrv.2025.02.002","url":null,"abstract":"<div><div>The social determinants of tuberculosis (TB) are well established. However, evidence indicates that genetic variants may also significantly influence an individual’s susceptibility to or resistance to TB.</div><div>The risk of TB is connected to polymorphisms in genes related to immunity and inflammation. While there is a growing body of evidence regarding the effect of candidate genes on the host immune response to Mycobacterium tuberculosis <em>(Mtb)</em> in adults, available information on children remains limited.</div><div>To investigate this topic, we searched electronic databases, including PubMed Central, the Virtual Health Library (encompassing MEDLINE, Lilacs, and WPRIM), Scopus, Scielo, EBSCOhost, and Embase. After applying the relevant inclusion and exclusion criteria, we identified 24 eligible studies.</div><div>These studies aimed to explain how specific genetic variations may affect predisposition to <em>Mtb</em> infection, their critical role in modulating the immune response, and their impact on the clinical progression of TB.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"56 ","pages":"Pages 61-67"},"PeriodicalIF":4.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-07DOI: 10.1016/j.prrv.2025.02.001
Curtis Budden , Loredana Cuglietta , Amir Sadri
Robin sequence (RS) is diagnosed by the clinical triad of micrognathia, glossoptosis, and airway obstruction. The reported occurrence is variable and noted in 1:8,500 to 1:20,000 live births. Although advances in perinatal imaging, neonatal resuscitation, non-invasive respiratory support and surgical techniques can mitigate against adverse outcomes, there remains much debate as to the best treatment for children born with RS. This review will outline surgical treatment of cleft palate and speech outcomes for children with RS.
{"title":"Cleft palate surgery and speech outcomes in children with Robin sequence","authors":"Curtis Budden , Loredana Cuglietta , Amir Sadri","doi":"10.1016/j.prrv.2025.02.001","DOIUrl":"10.1016/j.prrv.2025.02.001","url":null,"abstract":"<div><div><span>Robin sequence (RS) is diagnosed by the clinical triad of micrognathia<span>, glossoptosis, and airway obstruction. The reported occurrence is variable and noted in 1:8,500 to 1:20,000 live births. Although advances in perinatal imaging, </span></span>neonatal resuscitation<span><span>, non-invasive respiratory support and surgical techniques can mitigate against </span>adverse outcomes, there remains much debate as to the best treatment for children born with RS. This review will outline surgical treatment of cleft palate and speech outcomes for children with RS.</span></div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"56 ","pages":"Pages 55-60"},"PeriodicalIF":4.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-04DOI: 10.1016/j.prrv.2025.01.006
Francesca Bonomo, Giuliana Ferrante, Michele Piazza, Laura Tenero, Marco Zaffanello, Giorgio Piacentini
Severe asthma affects about 6.7% of adolescents worldwide, posing a substantial burden on their physical and psychosocial well-being. The impact of severe asthma on adolescents is multifaceted, with several factors that contribute to this burden, such as comorbidities including obesity, dysfunctional breathing, sleep-disordered breathing and mental health issues. Moreover, daily therapy management is often complex and may require lifestyle modification that could lead to a failure in treatment adherence and to peer-related stressors such as feelings of exclusion. Furthermore, adolescents with severe asthma are prone to risk-taking behaviours, including vaping and substance misuse. While current management strategies often fail to account for their developmental stage, digital technologies offer novel solutions to improve disease management. This narrative review aims to provide a comprehensive overview of the multifaceted impact of severe asthma on adolescents, addressing the main clinical management issues and exploring the role of innovative digital tools to enhance asthma management in this critical population.
{"title":"Severe asthma in adolescents: Clinical implications and beyond.","authors":"Francesca Bonomo, Giuliana Ferrante, Michele Piazza, Laura Tenero, Marco Zaffanello, Giorgio Piacentini","doi":"10.1016/j.prrv.2025.01.006","DOIUrl":"https://doi.org/10.1016/j.prrv.2025.01.006","url":null,"abstract":"<p><p>Severe asthma affects about 6.7% of adolescents worldwide, posing a substantial burden on their physical and psychosocial well-being. The impact of severe asthma on adolescents is multifaceted, with several factors that contribute to this burden, such as comorbidities including obesity, dysfunctional breathing, sleep-disordered breathing and mental health issues. Moreover, daily therapy management is often complex and may require lifestyle modification that could lead to a failure in treatment adherence and to peer-related stressors such as feelings of exclusion. Furthermore, adolescents with severe asthma are prone to risk-taking behaviours, including vaping and substance misuse. While current management strategies often fail to account for their developmental stage, digital technologies offer novel solutions to improve disease management. This narrative review aims to provide a comprehensive overview of the multifaceted impact of severe asthma on adolescents, addressing the main clinical management issues and exploring the role of innovative digital tools to enhance asthma management in this critical population.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-03DOI: 10.1016/j.prrv.2025.01.005
Pierre Goussard , Ernst Eber , Lisa Frigati , Leonore Greybe , Shyam Sunder B. Venkatakrishna , Jacques Janson , Zane Ismail , Andre Gie , Delano Rhode , Pawel Schubert , Marc Merven , Savvas Andronikou
Objectives
To investigate the role of both diagnostic and interventional paediatric bronchoscopy in the management of respiratory diseases in children in low- and middle-income countries (LMICs).
Design
A review of published English literature from January 2014 to February 2024.
Results
Indications for bronchoscopy in LMICs will vary depending on the burden of infectious diseases like tuberculosis (TB) and HIV, and the expertise and equipment available. TB diagnosis in children remains challenging due to the paucibacillary nature of the disease and its overlap with other infectious diseases like actinomycosis and echinococcosis. Acquired conditions, such as foreign body (FB) inhalation, present late with a high complication rate, making them challenging to manage. Paediatric bronchoscopy has an important role in the diagnoses, management and follow-up of many of these conditions. Interventional procedures like endobronchial ultrasound (EBUS), radial EBUS and cryotherapy enhance diagnostic and management capabilities.
Conclusion
Children in LMICs are affected by both infectious and acquired conditions. Bronchoscopy remains expensive with limited training offered in LMICs but is increasingly recognised for its important diagnostic and therapeutic role.
{"title":"Diagnostic and interventional paediatric bronchoscopy in low and middle-income countries","authors":"Pierre Goussard , Ernst Eber , Lisa Frigati , Leonore Greybe , Shyam Sunder B. Venkatakrishna , Jacques Janson , Zane Ismail , Andre Gie , Delano Rhode , Pawel Schubert , Marc Merven , Savvas Andronikou","doi":"10.1016/j.prrv.2025.01.005","DOIUrl":"10.1016/j.prrv.2025.01.005","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the role of both diagnostic and interventional paediatric bronchoscopy in the management of respiratory diseases in children in low- and middle-income countries (LMICs).</div></div><div><h3>Design</h3><div>A review of published English literature from January 2014 to February 2024.</div></div><div><h3>Results</h3><div>Indications for bronchoscopy in LMICs will vary depending on the burden of infectious diseases like tuberculosis (TB) and HIV, and the expertise and equipment available. TB diagnosis<span><span> in children remains challenging due to the paucibacillary nature of the disease and its overlap with other infectious diseases like actinomycosis and </span>echinococcosis<span>. Acquired conditions, such as foreign body (FB) inhalation, present late with a high complication rate, making them challenging to manage. Paediatric bronchoscopy has an important role in the diagnoses, management and follow-up of many of these conditions. Interventional procedures like endobronchial ultrasound<span> (EBUS), radial EBUS and cryotherapy enhance diagnostic and management capabilities.</span></span></span></div></div><div><h3>Conclusion</h3><div>Children in LMICs are affected by both infectious and acquired conditions. Bronchoscopy remains expensive with limited training offered in LMICs but is increasingly recognised for its important diagnostic and therapeutic role.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"56 ","pages":"Pages 37-54"},"PeriodicalIF":4.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-16DOI: 10.1016/j.prrv.2025.01.002
Chris A. Rees , Stuart Haggie , Todd A. Florin
Community acquired pneumonia (CAP) is a disease experienced by children the world over, though CAP-related morbidity and mortality differ markedly between low- and middle-income countries (LMICs) and high-income countries (HICs). Thus, setting-specific clinical prediction models are needed to identify children at risk for CAP-related morbidity and mortality. Here, we outline published clinical prediction models from LMICs and HICs for pediatric CAP-related outcomes. To date, there have been four clinical prediction models to predict treatment failure, two to predict a composite outcome of poor outcomes, and eight models for mortality prediction for CAP in LMICs. No prediction models developed in LMICs had publications that described their impact on clinical care through implementation. In HICs, to date there are three published clinical prediction models evaluating disease severity and one examining the need for major medical interventions. While clinical prediction models described in this review provide a strong foundation for risk stratification for children with CAP in HICs, there is a need for widespread external validation and implementation of optimally performing models.
{"title":"Narrative review of clinical prediction models for paediatric community acquired pneumonia","authors":"Chris A. Rees , Stuart Haggie , Todd A. Florin","doi":"10.1016/j.prrv.2025.01.002","DOIUrl":"10.1016/j.prrv.2025.01.002","url":null,"abstract":"<div><div>Community acquired pneumonia (CAP) is a disease experienced by children the world over, though CAP-related morbidity and mortality differ markedly between low- and middle-income countries (LMICs) and high-income countries (HICs). Thus, setting-specific clinical prediction models are needed to identify children at risk for CAP-related morbidity and mortality. Here, we outline published clinical prediction models from LMICs and HICs for pediatric CAP-related outcomes. To date, there have been four clinical prediction models to predict treatment failure, two to predict a composite outcome of poor outcomes, and eight models for mortality prediction for CAP in LMICs. No prediction models developed in LMICs had publications that described their impact on clinical care through implementation. In HICs, to date there are three published clinical prediction models evaluating disease severity and one examining the need for major medical interventions. While clinical prediction models described in this review provide a strong foundation for risk stratification for children with CAP in HICs, there is a need for widespread external validation and implementation of optimally performing models.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"54 ","pages":"Pages 19-27"},"PeriodicalIF":4.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-13DOI: 10.1016/j.prrv.2024.11.002
Wenhao Xu , Peng Wang , Jun Wan , Qingyu Bao , Ruixia Yu , Yuxin Zheng , Xingyu Kuang , Yulin Li , Zhicheng He , Jorge Luis Cuyubamba Dominguez , Yu Zhang
Background
Securing a stable airway is a critical component in neonatal resuscitation. Compared to direct laryngoscopy, video laryngoscopy provides improved visualization of the glottis, potentially enhancing the success rate of intubation. This systematic review and meta-analysis were conducted to assess and compare the efficacy and safety of video laryngoscopy versus direct laryngoscopy in neonatal intubation.
Methods
A thorough search was performed across CENTRAL, Embase, and PubMed databases to identify relevant randomized controlled trials (RCTs) that evaluated the use of video laryngoscopy in comparison with direct laryngoscopy for neonatal intubation. The data extraction and analysis were conducted in alignment with Cochrane guidelines. The primary outcome of interest was the time required for intubation, while secondary outcomes included the number of intubation attempts and the success rate on the first attempt.
Results
The meta-analysis included nine RCTs, encompassing a total of 719 neonates. The findings revealed that video laryngoscopy was associated with a longer intubation time (mean difference [MD] 3.23 s, 95 % confidence interval [CI] 2.42 to 4.04; I2 = 96 %). However, it also significantly improved the first-attempt success rate (risk ratio [RR] 1.31, 95 % CI 1.20 to 1.44; I2 = 76 %) and borderline reduced the total number of intubation attempts (MD −0.08, 95 % CI −0.15 to 0.00; I2 = 53 %).
Conclusions
While video laryngoscopy is associated with a modest increase in intubation time, it provides clear benefits by enhancing the success rate of first-attempt intubations and reducing the need for multiple attempts in neonatal intubation procedures.
{"title":"Comparison of video laryngoscopy and direct laryngoscopy for urgent intubation in newborn infants: A meta-analysis","authors":"Wenhao Xu , Peng Wang , Jun Wan , Qingyu Bao , Ruixia Yu , Yuxin Zheng , Xingyu Kuang , Yulin Li , Zhicheng He , Jorge Luis Cuyubamba Dominguez , Yu Zhang","doi":"10.1016/j.prrv.2024.11.002","DOIUrl":"10.1016/j.prrv.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Securing a stable airway is a critical component in neonatal resuscitation. Compared to direct laryngoscopy, video laryngoscopy provides improved visualization of the glottis, potentially enhancing the success rate of intubation. This systematic review and <em>meta</em>-analysis were conducted to assess and compare the efficacy and safety of video laryngoscopy versus direct laryngoscopy in neonatal intubation.</div></div><div><h3>Methods</h3><div>A thorough search was performed across CENTRAL, Embase, and PubMed databases to identify relevant randomized controlled trials (RCTs) that evaluated the use of video laryngoscopy in comparison with direct laryngoscopy for neonatal intubation. The data extraction and analysis were conducted in alignment with Cochrane guidelines. The primary outcome of interest was the time required for intubation, while secondary outcomes included the number of intubation attempts and the success rate on the first attempt.</div></div><div><h3>Results</h3><div>The <em>meta</em>-analysis included nine RCTs, encompassing a total of 719 neonates. The findings revealed that video laryngoscopy was associated with a longer intubation time (mean difference [MD] 3.23 s, 95 % confidence interval [CI] 2.42 to 4.04; I<sup>2</sup> = 96 %). However, it also significantly improved the first-attempt success rate (risk ratio [RR] 1.31, 95 % CI 1.20 to 1.44; I<sup>2</sup> = 76 %) and borderline reduced the total number of intubation attempts (MD −0.08, 95 % CI −0.15 to 0.00; I<sup>2</sup> = 53 %).</div></div><div><h3>Conclusions</h3><div>While video laryngoscopy is associated with a modest increase in intubation time, it provides clear benefits by enhancing the success rate of first-attempt intubations and reducing the need for multiple attempts in neonatal intubation procedures.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"54 ","pages":"Pages 28-34"},"PeriodicalIF":4.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-19DOI: 10.1016/j.prrv.2024.12.001
Wendy E. Huang , Joan A. Matifoll , David Lord , Stuart Haggie
Paediatric pneumonia and its complications present substantial health and economic challenges. While chest radiographs are commonly used as the initial imaging modality for diagnosing uncomplicated pneumonia, they are less effective for complicated cases. In response, various imaging techniques, such as lung ultrasound, computed tomography (CT), and chest MRI, have been integrated into clinical practice to enhance diagnosis and guide management decisions. No definitive gold standard exists for imaging complicated paediatric pneumonia and clinicians may find it challenging to choose the best imaging technique for a given clinical scenario. In this review we describe the available imaging options relevant for the management of paediatric pneumonia and evaluate the strengths and limitations of each modality.
{"title":"A review of imaging in the diagnosis and management of complicated paediatric pneumonia","authors":"Wendy E. Huang , Joan A. Matifoll , David Lord , Stuart Haggie","doi":"10.1016/j.prrv.2024.12.001","DOIUrl":"10.1016/j.prrv.2024.12.001","url":null,"abstract":"<div><div>Paediatric pneumonia and its complications present substantial health and economic challenges. While chest radiographs are commonly used as the initial imaging modality for diagnosing uncomplicated pneumonia, they are less effective for complicated cases. In response, various imaging techniques, such as lung ultrasound, computed tomography (CT), and chest MRI, have been integrated into clinical practice to enhance diagnosis and guide management decisions. No definitive gold standard exists for imaging complicated paediatric pneumonia and clinicians may find it challenging to choose the best imaging technique for a given clinical scenario. In this review we describe the available imaging options relevant for the management of paediatric pneumonia and evaluate the strengths and limitations of each modality.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"54 ","pages":"Pages 12-18"},"PeriodicalIF":4.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.prrv.2024.02.001
S Campbell , K Gerasimidis , S Milling , AJ Dicker , R Hansen , RJ Langley
The advent of next generation sequencing has rapidly challenged the paediatric respiratory physician’s understanding of lung microbiology and the role of the lung microbiome in host health and disease. In particular, the role of “microbial key players” in paediatric respiratory disease is yet to be fully explained. Accurate profiling of the lung microbiome in children is challenging since the ability to obtain lower airway samples coupled with processing “low-biomass specimens” are both technically difficult. Many studies provide conflicting results. Early microbiota-host relationships may be predictive of the development of chronic respiratory disease but attempts to correlate lower airway microbiota in premature infants and risk of developing bronchopulmonary dysplasia (BPD) have produced mixed results. There are differences in lung microbiota in asthma and cystic fibrosis (CF). The increased abundance of oral taxa in the lungs may (or may not) promote disease processes in asthma and CF. In CF, correlation between microbiota diversity and respiratory decline is commonly observed. When one considers other pathogens beyond the bacterial kingdom, the contribution and interplay of fungi and viruses within the lung microbiome further increase complexity. Similarly, the interaction between microbial communities in different body sites, such as the gut-lung axis, and the influence of environmental factors, including diet, make the co-existence of host and microbes ever more complicated. Future, multi-omics approaches may help uncover novel microbiome-based biomarkers and therapeutic targets in respiratory disease and explain how we can live in harmony with our microbial companions.
{"title":"The lower airway microbiome in paediatric health and chronic disease","authors":"S Campbell , K Gerasimidis , S Milling , AJ Dicker , R Hansen , RJ Langley","doi":"10.1016/j.prrv.2024.02.001","DOIUrl":"10.1016/j.prrv.2024.02.001","url":null,"abstract":"<div><div>The advent of next generation sequencing has rapidly challenged the paediatric respiratory physician’s understanding of lung microbiology and the role of the lung microbiome in host health and disease. In particular, the role of “microbial key players” in paediatric respiratory disease is yet to be fully explained. Accurate profiling of the lung microbiome in children is challenging since the ability to obtain lower airway samples coupled with processing “low-biomass specimens” are both technically difficult. Many studies provide conflicting results. Early microbiota-host relationships may be predictive of the development of chronic respiratory disease but attempts to correlate lower airway microbiota in premature infants and risk of developing bronchopulmonary dysplasia (BPD) have produced mixed results. There are differences in lung microbiota in asthma and cystic fibrosis (CF). The increased abundance of oral taxa in the lungs may (or may not) promote disease processes in asthma and CF. In CF, correlation between microbiota diversity and respiratory decline is commonly observed. When one considers other pathogens beyond the bacterial kingdom, the contribution and interplay of fungi and viruses within the lung microbiome further increase complexity. Similarly, the interaction between microbial communities in different body sites, such as the gut-lung axis, and the influence of environmental factors, including diet, make the co-existence of host and microbes ever more complicated. Future, multi-omics approaches may help uncover novel microbiome-based biomarkers and therapeutic targets in respiratory disease and explain how we can live in harmony with our microbial companions.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"52 ","pages":"Pages 31-43"},"PeriodicalIF":4.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139927150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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