Paradoxical metabolic acidosis after vomiting in children with spinal muscular atrophy: A report of 9 patients.

Background: Spinal muscular atrophy (SMA) is a hereditary neuromuscular disease that progresses toward restrictive respiratory failure due to muscle paralysis. We observed that SMA patients presented with a specific clinical and laboratory profile, consisting of severe metabolic acidosis following an episode of mild vomiting. This is an unusual, little-known, and life-threatening situation for these patients, as hyperventilation induced by metabolic acidosis can lead to exhaustion and to death by mixed acidosis.

Infectious acute respiratory failure in patients under 5 years of age: a retrospective cohort study.

Background: Acute lower respiratory infections in children under 5 years present a real challenge for diagnosis and treatment and are the first cause of mortality for this group of age. The study aimed to describe the characteristics of infectious acute respiratory failure due to bronchiolitis, pulmonary infection or severe acute asthma related to a virus or bacteria in this population of children under 5 years old at admission to the paediatric intensive care unit (PICU), PICU management and outcomes in order to better identify the needs of these patients. Our secondary aim was to compare the characteristics and PICU management of this population (1) depending on their age (less or more than 6 months old) and (2) depending on the pulmonary imaging (absence or presence of an alveolar condensation on the chest X-ray or lung ultrasound).

Pediatric intensive care unit follow-up: Thinking before acting.

Objective: It is now well established that post-intensive care syndrome is frequent in critically ill children after discharge from the pediatric intensive care unit (PICU). Nevertheless, post-intensive care follow-up is highly heterogenous worldwide and is not considered routine care in many countries. The purpose of this viewpoint was to report the reflections of the French PICU society working group on how to implement post-PICU follow-up.

Determinants of diaphragm inspiratory motion, diaphragm thickening, and its performance for predicting respiratory restrictive pattern in Duchenne muscular dystrophy.

Introduction/aims: Respiratory status is a key determinant of prognosis in patients with Duchenne muscular dystrophy (DMD). We aimed to evaluate the determinants of diaphragm ultrasound and its performance in predicting restrictive respiratory patterns in DMD.

Methods: This was a retrospective study of DMD patients followed in our center and admitted for an annual checkup from 2015 to 2018.