Melissa Borrelli, Gaetano Terrone, Roberto Evangelisti, Flora Fedele, Adele Corcione, Francesca Santamaria
Neuromuscular disease (NMDs) encompass a heterogeneous group of genetic disorders, with respiratory problems of variable intensity and progression described at any pediatric age, from infancy to adolescence, and they are largely associated with significant lifelong morbidity and high mortality. Restriction of breathing, impaired gas exchange, decline of lung function and sleep disordered breathing progressively develop because of muscular weakness and culminate in respiratory failure. Depending on the disease progression, airways manifestations can take weeks to months or even years to evolve, thus depicting two major respiratory phenotypes, characterized by rapid or slow progression to respiratory failure...
January 3, 2023: Pediatrics and Neonatology
Prue M Pereira-Fantini, Kristin Ferguson, Karen McCall, Regina Oakley, Elizabeth Perkins, Sean Byars, Nicholas Williamson, Shuai Nie, David G Tingay
BACKGROUND: A lack of clear trial evidence often hampers clinical decision-making during support of the preterm lung at birth. Protein biomarkers have been used to define acute lung injury phenotypes and improve patient selection for specific interventions in adult respiratory distress syndrome. The objective of the study was to use proteomics to provide a deeper biological understanding of acute lung injury phenotypes resulting from different aeration strategies at birth in the preterm lung...
December 14, 2022: Respiratory Research
Anna Lavizzari, Chiara Veneroni
INTRODUCTION: We evaluate the accuracy of postnatal biochemical and lung function tests performed within 3 h from birth for predicting surfactant need in preterm infants ≤34 weeks' gestation receiving noninvasive respiratory support for respiratory distress syndrome (RDS). METHODS: We systematically searched MEDLINE, Embase, The Cochrane Library, PROSPERO, and databases for studies published from 2000 to November 10, 2021, cross-referencing relevant literature and contacting experts...
December 14, 2022: Neonatology
Vincent D Gaertner, Stefan Minocchieri, Andreas D Waldmann, Tobias Mühlbacher, Dirk Bassler, Christoph Martin Rüegger
OBJECTIVE: The effect of prophylactic surfactant nebulisation (SN) is unclear. We aimed to determine whether prophylactic SN improves early lung aeration. DESIGN: Parallel, randomised clinical trial, conducted between March 2021 and January 2022. SETTING: Delivery room (DR) of a tertiary neonatal centre in Zurich, Switzerland. PATIENTS: Preterm infants between 26 0/7 and 31 6/7 weeks gestation INTERVENTIONS: Infants were randomised to receive positive distending pressure alone or positive distending pressure and additional SN (200 mg/kg; poractant alfa) using a customised vibrating membrane nebuliser...
November 24, 2022: Archives of Disease in Childhood. Fetal and Neonatal Edition
K Taylor Wild, Leny Mathew, Holly L Hedrick, Natalie E Rintoul, Anne Ades, Leane Soorikian, Kelle Matthews, Michael A Posencheg, Erin Kesler, K Taylor Van Hoose, Howard B Panitch, John Flibotte, Elizabeth E Foglia
OBJECTIVE: To characterise the transitional pulmonary physiology of infants with congenital diaphragmatic hernia (CDH) using measures of expiratory tidal volume (TV) and end-tidal carbon dioxide (ETCO2 ). DESIGN: Prospective single-centre observational study. SETTING: Quaternary neonatal intensive care unit. PATIENTS: Infants with an antenatal diagnosis of CDH born at the Children's Hospital of Philadelphia. INTERVENTIONS: TV and ETCO2 were simultaneously recorded using a respiratory function monitor (RFM) during invasive positive pressure ventilation immediately after birth...
November 18, 2022: Archives of Disease in Childhood. Fetal and Neonatal Edition
Silvia Fernández Jonusas, Carolina M Cribioli, Alejandra S De Gregorio, Carolina Giudice, Gonzalo Mariani, Cecilia M Acosta
Lung ultrasound (LU) has gained ground in the diagnosis of most respiratory conditions present since birth. It is highly sensitive to variations in air content and pulmonary fluids and functions as a true densitometer of the lung parenchyma with a sensitivity superior to that of radiological studies. A LU is a non-invasive, fast and easy tool that can be used at the patient's bedside and, unlike conventional radiology, does not pose risks of radiation. In addition, a LU provides real-time dynamic information in a variety of neonatal settings and, like heart and brain examinations, can be performed by the neonatologist...
December 2022: Archivos Argentinos de Pediatría
Lindsay A Gil, Lindsey Asti, Jordan C Apfeld, Yuri V Sebastião, Katherine J Deans, Peter C Minneci
BACKGROUND: This study compared perioperative outcomes among infants undergoing repair of congenital anomalies using minimally invasive (MIS) versus open surgical approaches. METHODS: The ACS NSQIP Pediatric (2013-2018) was queried for patients undergoing repair of any of the following 9 congenital anomalies: congenital lung lesion (LL), mediastinal mass (MM), congenital malrotation (CM), anorectal malformation (ARM), Hirschsprung disease (HD), congenital diaphragmatic hernia (CDH), tracheoesophageal fistula (TEF), hepatobiliary anomalies (HB), and intestinal atresia (IA)...
August 10, 2022: Journal of Pediatric Surgery
Haifeng Zong, Zhifeng Huang, Jie Zhao, Bingchun Lin, Yongping Fu, Yanqing Lin, Peng Huang, Hongyan Sun, Chuanzhong Yang
Point-of-care lung ultrasound (LUS) is increasingly applied in the neonatal intensive care unit (NICU). Diagnostic applications for LUS in the NICU contain the diagnosis of many common neonatal pulmonary diseases (such as Respiratory distress syndrome, Transient tachypnea of the newborn, Meconium aspiration syndrome, Pneumonia, Pneumothorax, and Pleural effusion) which have been validated. In addition to being employed as a diagnostic tool in the classical sense of the term, recent studies have shown that the number and type of artifacts are associated with lung aeration...
2022: Frontiers in Pediatrics
Cristina Ardura-Garcia, Alicia Abellan, Sara Cuevas-Ocaña, Nadine Freitag, Yin Ting Lam, Heidi Makrinioti, Monique Slaats, Matteo Storti, Emma E Williams, Theodore Dassios, Liesbeth Duijts, Refika H Ersu, Stojka Fustik, Rory E Morty, Marijke Proesmans, Dirk Schramm, Sejal Saglani, Alexander Moeller, Marielle W Pijnenburg
In this review, Early Career Members of the European Respiratory Society (ERS) and the Chairs of the ERS Assembly 7: Paediatrics present the highlights in paediatric respiratory medicine from the ERS International Congress 2021. The eight scientific Groups of this Assembly cover respiratory physiology and sleep, asthma and allergy, cystic fibrosis (CF), respiratory infection and immunology, neonatology and intensive care, respiratory epidemiology, bronchology, and lung and airway development. We here describe new developments in lung function testing and sleep-disordered breathing diagnosis, early life exposures affecting pulmonary function in children and effect of COVID-19 on sleep and lung function...
April 2022: ERJ Open Research
Urvi Jhaveri Sanghvi, Clyde J Wright, Teri L Hernandez
Bronchopulmonary dysplasia (BPD) is a chronic lung disease of infancy associated with high morbidity and mortality. Although most prevalent following extremely preterm birth, BPD is diagnosed at 36 weeks post-menstrual age, when the disease trajectory is underway, and long-term physiological implications may be irreversible. There is an urgent and unmet need to identify how early exposures can be modified to decrease the risk of developing BPD before disease progression becomes irreversible. Extremely preterm newborns encounter a paradox at birth: oxygen is a life-sustaining component of ex utero life yet is undeniably toxic...
2022: Neonatology
Sarah Marie de Medeiros, Avneet Mangat, Graeme R Polglase, G Zeballos Sarrato, Peter G Davis, Georg M Schmölzer
IMPORTANCE: Animal and observational human studies report that delivery of excessive tidal volume (VT ) at birth is associated with lung and brain injury. Using a respiratory function monitor (RFM) to guide VT delivery might reduce injury and improve outcomes. OBJECTIVE: To determine whether use of an RFM in addition to clinical assessment versus clinical assessment alone during mask ventilation in the delivery room reduces in-hospital mortality and morbidity of infants <37 weeks' gestation...
November 2022: Archives of Disease in Childhood. Fetal and Neonatal Edition
Nadja Bednarczuk, Emma E Williams, Theodore Dassios, Anne Greenough
BACKGROUND: Nicotine replacement therapy (NRT) and e-cigarettes are recommended to pregnant women who wish to stop smoking. Albeit eliminating other harmful components of cigarettes, those alternatives still expose the developing fetus to nicotine. The lungs may be particularly vulnerable to damage by nicotine as there is widespread nicotinic-acetylcholine receptor expression in the lungs. There is, however, a paucity of information about the effect of NRT and e-cigarette use in pregnancy on infant respiratory outcomes...
January 2022: Early Human Development
Jintao Lei, Tiankai Sun, Yongjiang Jiang, Ping Wu, Jinjian Fu, Tao Zhang, Eric McGrath
Bronchopulmonary dysplasia (BPD) is one of the most common complications in premature infants. This disease is caused by long-time use of supplemental oxygen, which seriously affects the lung function of the child and imposes a heavy burden on the family and society. This research aims to adopt the method of ensemble learning in machine learning, combining the Boruta algorithm and the random forest algorithm to determine the predictors of premature infants with BPD and establish a predictive model to help clinicians to conduct an optimal treatment plan...
2021: Frontiers in Pediatrics
Shen-Hao Lai, Ming-Han Tsai, Man-Chin Hua, Kuo-Wei Yeh, Tsung-Chieh Yao, Jing-Long Huang, Sui-Ling Liao
BACKGROUND: Recurrent or unresolved wheezing is a common complaint in certain young children populations, especially those born preterm. Using infant lung function testing, we aimed to distinguish the differences between term and preterm young children with recurrent wheezing. METHODS: Children under 2 years of corrected age were enrolled if they had 3 or more wheezing episodes during the enrollment period. Healthy term controls of comparable age were also recruited for reference...
April 20, 2021: Pediatrics and Neonatology
Steven H Abman
Despite growing awareness of the clinical importance of pulmonary hypertension (PH) in preterm infants, uncertainty persists regarding the different clinical settings in which abnormalities of pulmonary vascular growth, function, and structure contribute to high morbidity and mortality, and potential interventions to improve outcomes are uncertain. A major gap for improving outcomes of preterm infants with PH has been the limited characterization of the distinct settings of PH and related disease-specific mechanisms in preterm infants that represent diverse pulmonary vascular phenotypes of prematurity...
2021: Neonatology
Cristina Ardura-Garcia, Sara Cuevas-Ocaña, Nadine Freitag, Asterios Kampouras, John A King, Panayiotis Kouis, Sara M Mensink-Bout, Abigail L Whitehouse, Emma Williams, Theodore Dassios, Liesbeth Duijts, Refika H Ersu, Erol A Gaillard, Alex R Horsley, Marijke Proesmans, Robbert Rottier, Dirk Schramm, Alexander Moeller, Marielle W Pijnenburg
In this review, the Paediatric Assembly of the European Respiratory Society (ERS) presents a summary of the highlights and most relevant findings in the field of paediatric respiratory medicine presented at the virtual ERS International Congress 2020. Early Career Members of the ERS and Chairs of the different Groups comprising the Paediatric Assembly discuss a selection of the presented research. These cover a wide range of research areas, including respiratory physiology and sleep, asthma and allergy, cystic fibrosis, respiratory infection and immunology, neonatology and intensive care, epidemiology, bronchology and lung and airway development...
January 2021: ERJ Open Research
Y Jane Choi, Benjamin Stoecklin, Naomi R Hemy, Graham L Hall, Dorota A Doherty, Shannon J Simpson, J Jane Pillow
BACKGROUND: Right shift of the peripheral oxyhaemoglobin saturation (SpO2) versus inspired oxygen pressure (PIO2) curve is a sensitive marker of pulmonary gas exchange. OBJECTIVES: The aim of this study was to assess the impact of prematurity and bronchopulmonary dysplasia (BPD) on gas exchange and right-to-left shunt in the neonatal period, and its evolution over the first year of life. METHOD: We assessed shift and shunt in extremely preterm (EP) and very preterm (VP) infants at 36 and 44 weeks' postmenstrual age (PMA), and at 1-year corrected postnatal age (cPNA)...
2021: Neonatology
Jeanie Cheong, Kate Lillian Iona Cameron, Deanne Thompson, Peter J Anderson, Sarath Ranganathan, Ross Clark, Benjamin Mentiplay, Alice Burnett, Katherine Lee, Lex William Doyle, Alicia J Spittle
INTRODUCTION: Children born moderate to late preterm (MLP, 32-36 weeks' gestation) account for approximately 85% of all preterm births globally. Compared with children born at term, children born MLP are at increased risk of poor neurodevelopmental outcomes. Despite making up the largest group of preterm children, developmental outcomes of children born MLP are less well studied than in other preterm groups. This study aimed to (1) compare neurodevelopmental, respiratory health and brain magnetic resonance imaging (MRI) outcomes between children born MLP and term at 9 years of age; (2) examine the differences in brain growth trajectory from infancy to 9 years between children born MLP and term; and in children born MLP; (3) examine the relationship between brain development and neurodevelopment at 9 years; and (4) identify risk factors for poorer outcomes at 9 years...
January 31, 2021: BMJ Open
Ilaria Amodeo, Genny Raffaeli, Nicola Pesenti, Francesco Macchini, Valentina Condò, Irene Borzani, Nicola Persico, Isabella Fabietti, Marijke Ophorst, Stefano Ghirardello, Silvana Gangi, Mariarosa Colnaghi, Fabio Mosca, Giacomo Cavallaro
In newborns with congenital diaphragmatic hernia (CDH), the radiographic lung area is correlated with functional residual capacity (FRC) and represents an alternative method to estimate lung hypoplasia. In a cohort of newborn CDH survivors, we retrospectively evaluated the relationship between radiographic lung area measured on the 1st day of life and long-term respiratory function. As a secondary analysis, we compared radiographic lung areas and respiratory function between patients undergoing fetal endoscopic tracheal occlusion (FETO) and patients managed expectantly (non-FETO)...
2020: Frontiers in Pediatrics
Andre George Gie, Talia Rose Hubble, Yannick Regin, Thomas Salaets, Monica Zamora, Jan Deprest, Jaan Toelen
INTRODUCTION: Prematurely born infants regularly develop respiratory distress syndrome and require assisted ventilation. Ventilation may injure the premature lung and increase the risk of bronchopulmonary dysplasia. Continuous positive airway pressure (CPAP), a form of noninvasive ventilation, is commonly used in modern neonatology. Limited clinical data are available on the acute and long-term effect of neonatal exposure to CPAP on the lung. Given the restricted clinical data, newborn animal models have been used to study the influence of CPAP on lung structure and function...
2021: Neonatology
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