Premature infants, particularly born before 30 weeks gestation who have been given a diagnosis of chronic lung disease, bronchopulmonary dysplasia, or post-prematurity respiratory disease face significant challenges in transition from the NICU environment to life at home. The lack of guidelines to help focus care and quality medical literature differentiating outcomes is stark. Parents and physicians need tools to care for these high risk infants. These new ATS guidelines nicely evaluate the role of inhaled medications, swallowing assessment, airway endoscopy, and especially sleep testing and provide timely recommendations.
Tuesday, January 18, 2022
Tuesday, January 11, 2022
SARS-CoV-2 infection does not seem to be a main trigger of severe bronchiolitis, and children with this condition should be managed according to clinical practice guidelines.
Wednesday, December 22, 2021
A useful and much study needed since neonatologists and consulting pediatric pulmonologists rely on few reliable indicators to judge discharge readiness. And with little guidance, often managed care restrictions may prompt premature discharge. A baseline CO2 retention above a certain threshold always seemed like at least 1 useful measure, now supported by this South Korean study.
Children with chronic lung disease of prematurity tend to have reduced lung function, increased susceptibility to respiratory viral illness, and elevated risk for rehospitalization. Setting goals for discharge are greatly needed in this high risk population.
Capillary partial pressure of carbon dioxide for predicting rehospitalization in preterm infants under noninvasive respiratory support with severe bronchopulmonary dysplasia
Monday, November 8, 2021
Monday, October 18, 2021
Good News (Mostly) for Asthma Patients During Pandemic
1) Having a written asthma action plan with clear recommendations for flare ups
2) Regular follow up with asthma specialist to monitor asthma control
3) Becoming familiar with symptoms of poor control, including frequent SABA use and exercise intolerance
Friday, October 1, 2021
The impact of lockdown on sleep patterns of children and adolescents with ADHD
Tuesday, August 31, 2021
AHA Releases Scientific Statement on Obstructive Sleep Apnea and Cardiovascular Health in Children and Adolescents
In a recent scientific statement, the American Heart Association (AHA) outlined evidence highlighting the effect of obstructive sleep apnea (OSA) on the cardiovascular health of children and adolescents. The full statement was published in Journal of the American Heart Association.
The AHA noted that this statement may be used to develop future guidelines in managing OSA with regard to cardiovascular disease (CVD) risk in the pediatric population.
Epidemiology and Risk Factors
Patients with OSA experience disruption during sleep caused by upper airway obstruction. In children and adolescents, the clinical presentation of the condition can vary by age, but it is generally characterized by habitual snoring, labored breathing, gasps/snorting noises, and daytime sleepiness. According to the AHA, 1% to 6% of children and adolescents have OSA. Current evidence suggests that the OSA prevalence in a pediatric population peaks between 2 and 8 years of age and corresponds to a peak in adenotonsillar hypertrophy prevalence.
Primary risk factors for OSA in the pediatric population include obesity, allergic rhinitis, upper and lower airway disease, enlarged tonsils and adenoids, low muscle tone, neuromuscular disorders, and craniofacial malformations. In addition, sickle cell disease (SCD) may be an independent risk factor for OSA. Premature birth, or birth that occurs prior to 37 weeks’ gestation, may also be associated with an increased risk for sleep-disordered breathing among children, partially because of delayed development of respiratory control.