Pediatric pulmonology
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Pediatric pulmonology · Nov 2020
Lung ultrasound predicts histological lung injury in a neonatal model of acute respiratory distress syndrome.
Point-of-care ultrasound (POCUS) is used to evaluate pulmonary edema in adults with acute respiratory distress syndrome (ARDS). Its use has not been validated in neonatal models. ⋯ We conclude that POCUS may be valuable in neonates for early quantification of acute lung injury or ARDS; and that nondependent ultrasound regions clearly distinguish severity of pulmonary edema.
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Pediatric pulmonology · Nov 2020
Use of bilevel positive pressure ventilation in patients with bronchiolitis.
This study aims at describing the use of bilevel positive airway pressure (BiPAP) in infants with severe bronchiolitis. ⋯ The use of BiPAP was not associated with endotracheal intubation, however it was associated with increased PICU length of stay and increased duration of NIV.
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Pediatric pulmonology · Nov 2020
Weaning from noninvasive ventilation and high flow nasal cannula in bronchiolitis: A survey of practice.
This study aims to describe the current weaning practices from any type of noninvasive support in infants with bronchiolitis, in terms of weaning procedures, weaning initiation and weaning failure criteria. ⋯ In infants with bronchiolitis requiring NIV support, the sudden weaning procedure was the most commonly used strategy. We observed a certain consensus on criteria for weaning initiation. These findings should help in building nurse-driven weaning protocols, but prospective studies remain needed to assess the best weaning strategy in infants with bronchiolitis-related acute respiratory failure.
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Pediatric pulmonology · Oct 2020
ReviewTen key points about COVID-19 in children: The shadows on the wall.
The pandemic of the new coronavirus disease-2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), initially described in China, is challenging the health care systems of all countries. Every emerging disease raises many questions with a scarcity of answers since all its characteristics are still being discovered. In the case of SARS-CoV-2, most of the literature comes from adult patients. ⋯ Pediatric patients diagnosed with COVID-19 disease usually suffer a mild illness, with a low risk of complications, or mortality. Defining the role of children in the transmission of SARS-CoV-2 is critical as some national infection control decisions involving children, such as school closures or social distancing, will probably impact the dynamics of the virus. To aid in the knowledge of COVID-19 in children, this study presents an expert review of the literature published from 1 January to 28 May 2020, including peer-reviewed and preprint nonpeer-reviewed studies, along with some relevant articles afterward, summarizing ten key points that characterize the disease in children.
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Pediatric pulmonology · Oct 2020
Observational StudyEffects of CFTR modulators on pharmacokinetics of tobramycin during acute pulmonary exacerbations in the pediatric cystic fibrosis population.
Individuals with cystic fibrosis (CF) require higher dosages of aminoglycosides due to an increased volume of distribution (Vd ) and clearance. Optimal dosing of aminoglycosides in the CF population is essential as repeated exposure to aminoglycosides during acute pulmonary exacerbations increases risk of nephrotoxicity and ototoxicity. To date, no studies have evaluated whether chronic cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy affects pharmacokinetics of aminoglycoside antibiotics in patients with CF. The objective of this study was to determine if the addition of a CFTR modulator affects elimination rate (Ke ) for intravenously administered tobramycin in the pediatric CF population. ⋯ The pharmacokinetic parameters of intravenously administered tobramycin during admission for acute pulmonary exacerbation do not appear to change significantly after initiating chronic therapy with a CFTR modulator. Empiric dose adjustments for patients on CFTR modulators are not recommended.