Bronchiolitis: Impact of Age and Etiology on Morbidity and Mortality in Previously Healthy Critically Ill Children.

This retrospective, multicenter observational study analyzed data from 257 children under 2 years old admitted with viral bronchiolitis to pediatric intensive care units (PICU) at Wolfson Children's Hospital and UFHealth Shands Children's Hospital from January 2020 to March 2022. The study explores viral etiologies and their associations with hospital length of stay (H-LOS), PICU length of stay (P-LOS), and severity markers and scores. Younger age was associated with longer H-LOS and P-LOS ( < .

Prevalence, management, health-care burden, and 90-day outcomes of prolonged mechanical ventilation in the paediatric intensive care unit (LongVentKids): an international, prospective, cross-sectional cohort study.

Background: The number of children requiring prolonged mechanical ventilation (PMV) has increased with the advancement of medical care. We aimed to estimate the prevalence of PMV worldwide, document demographic and clinical characteristics of children requiring PMV in paediatric intensive care units (PICUs), and to understand variation in clinical practice and health-care burden.

Methods: This international, multicentre, cross-sectional cohort study screened participating PICUs in 28 countries for children aged >37 postgestational weeks to 17 years who had been receiving mechanical ventilation (MV; invasive or non-invasive) for at least 14 consecutive days.

Airway Remodeling in Cystic Fibrosis Is Heterogeneous.

RATIONALE+OBJECTIVE/ Cystic fibrosis (CF) is characterized by bronchiectasis on imaging, while functionally evolving towards obstructive impairment. Despite its assumed importance in CF, small airway remodeling and its relation to bronchiectasis, is still poorly understood. METHOD/ On high-resolution computed tomography (HRCT, 600µm, CF=21, control=6) and micro-computed tomography (µCT, 150µm, CF=3, control=1) scans of inflated explant lungs, AV% (airway/total lung volume) was calculated as marker for bronchiectasis, while airway segmentation was used for generation analysis.

Immature granulocytes as an early clinical predictor in children with respiratory syncytial virus bronchiolitis.

Background: Immature granulocytes can be measured easily in a complete blood count by new automated hemolytic analyzers and have recently been studied as bio-markers in many infectious/inflammatory diseases. This study aims to investigate whether immature granulocyte percentage (IG%) would enable greater discrimination than conventionally utilized laboratory values in terms of early clinical prediction in instances with respiratory syncytial virus (RSV) bronchiolitis.

Methods: A prospective observational cohort study involved 149 individuals with RSV bronchiolitis.

Application of the TIDieR checklist to improve the HFNC use in bronchiolitis management.

Unlabelled: The use of High-Flow Nasal Cannula (HFNC) in children with bronchiolitis is globally increased in the last decade, despite the lack of evidence-based and universal guidelines to standardize their application in the clinical practice. In this systematic review, we aimed to analyse the completeness of previous studies on HFNC interventions in children with bronchiolitis using an adapted Template for Intervention Description and Replication (TIDieR) checklist. Randomized clinical trials (RCTs) and cohort studies on children younger than 2 years old with a diagnosis of bronchiolitis were included.

Patterns of Use of β-2 Agonists, Steroids, and Mucoactive Medications to Treat Bronchiolitis in the PICU: U.S. Pediatric Health Information System 2009-2022 Database Study.

Objectives: Describe β2-agonists, steroids, hypertonic saline (HTS), n-acetylcysteine (NAC), and dornase alfa (DA) use to treat bronchiolitis, factors associated with use, and associations between use and PICU length of stay (LOS).

Design: Retrospective, multicenter cohort study.

Setting: PICUs in the Pediatric Health Information System database.

Low-dose heparin sodium as a protective factor against bronchiolitis obliterans formation after adenovirus infection.

Background: Adenovirus (ADV) pneumonia in children is a significant contributor to the occurrence of post-infectious bronchiolitis obliterans (BO). Heparin sodium has known anti-inflammatory, immunomodulatory, and tissue repair properties. However, its role in treating BO after ADV infection remains unclear.

Croup in Children and Risk Factors.

Croup is a common respiratory illness in children under 5 years, primarily caused by viral infections. Symptoms include inspiratory stridor, barking cough, and hoarseness due to inflamed vocal cords. Diagnosis is based on symptoms difficulty breathing, stridor, chest in-drawing voice changes and head nodding.

Dysregulated airway epithelial antiviral immunity in Down Syndrome impairs type III IFN response and amplifies airway inflammation during RSV infection.

Trisomy 21 (TS21), also known as Down syndrome (DS), increases pediatric mortality risk from respiratory syncytial virus (RSV) by nine-fold, yet its underlying immunological basis remains unclear. Here, we investigated RSV-induced immunological responses in TS21 airway epithelial cells (AECs), the primary site of respiratory virus entry and host defense. TS21 AECs exhibit hyperactive interferon (IFN) signaling and reduced RSV infectivity, but they also show impaired type-III IFN responses during viral infection.

The role of Copeptin in viral lower respiratory tract infections in child: A prospective case-control study.

Background: Lower respiratory tract infection (LRTI) is a leading cause of morbidity and mortality among children globally. Copeptin, released by the pituitary gland, serves as a biomarker for various conditions and, as a neuroendocrine stress hormone, is useful in acute conditions. This study aimed to determine the role of copeptin levels in LRTI in children and whether it can reliably predict pneumonia severity.

Serious games vs. traditional tutorials in the pandemic: a randomised controlled trial.

Background And Aim: The COVID-19 pandemic necessitated the transition to online medical education. This study evaluated the efficacy of online case-based tutorials using a serious game tutorial [PlayMed™ (PM)], as compared to a traditional slideshow tutorial (TT).

Methods: We performed a prospective, mixed-methods, randomised controlled trial on undergraduate medical students during the COVID-19 pandemic, from May 2020 to January 2021.

Acute Human Bocavirus 1 Infection in Children Hospitalized for Acute Bronchiolitis: A 2-Year Prospective Study.

Background: The objective of this prospective study was to assess the proportion and clinical consequences of human bocavirus 1 (HBoV1) replication in children hospitalized for acute bronchiolitis (AB) with HBoV1 DNA in the nasopharynx (NP).

Methods: For this purpose, we detected HBoV1 DNA and mRNA (evidence of viral replication and viable virus) in NP in cases and healthy control children. This research allowed us to distinguish active HBoV1 infections from inactive ones.

Residential Area Characteristics Are Associated With Asthma Burden in Children.

Background: Wheezing illnesses, especially those triggered by rhinovirus infection, cause a major disease burden, and they often precede asthma. Environmental exposures are known to affect recurrence of wheezing. We investigated the relations of population density, greenness (forested areas), and socioeconomic factors of the living surroundings to the burden of asthma in children with prior bronchiolitis.

Assessment of Serum Metabolism and Eicosanoid Profiling in Pediatric Asthma and Bronchiolitis via Liquid Chromatography-Mass Spectrometry.

Background: Asthma, a prevalent chronic inflammatory respiratory disease among children, was the focus of this study. Serum metabolism profiles were examined in patients diagnosed with both asthma and bronchiolitis by using ultra-high performance liquid chromatography-mass spectrometry.

Methods: In this study, the serum samples from three distinct groups-comprising patients diagnosed with asthma, bronchiolitis, and a healthy control group-underwent comprehensive non-targeted metabolomics analysis and targeted eicosanoid profiling.

Early predictors of unfavorable outcomes in pediatric acute respiratory failure.

Objective: Acute respiratory failure is a leading cause of critical illness in children. However, patient outcomes and early predictors of unfavorable outcomes are not well understood. This study aimed to describe composite unfavorable outcomes, defined as in-hospital death or discharge with new comorbidities, and to identify early predictors in children with acute respiratory failure in acute care hospitals.

Outpatient Medications Deimplemented by the AAP Bronchiolitis Guidelines: An Umbrella Review of Meta-Analyses.

Background: The 2014 AAP Bronchiolitis Guidelines deimplemented or recommended against the routine therapeutic use of albuterol, hypertonic saline, and epinephrine for infants and children presenting in the outpatient setting. Our objective was to perform an umbrella review of all meta-analyses that included outpatient subanalyses or network meta-analyses with medication treatment comparisons to study the clinical benefits of these deimplemented medications in the outpatient (i.e.

Exploring the Clinical Characteristics and Outcomes of Rhinovirus Infection in Hospitalized Children Compared with Other Respiratory Viruses.

Background: Acute viral respiratory tract infections constitute a significant challenge in pediatric healthcare globally, with rhinovirus representing one of the primary etiological agents. In this context, we conducted a study with the objective of identifying the clinical characteristics and outcomes of rhinovirus infection in comparison with other respiratory viruses in children hospitalized in one of the largest pediatric hospitals in the capital of Romania.

Methods: We conducted a retrospective study among children hospitalized for influenza-like illness symptoms and who were tested by multiplex RT-PCR with a nasopharyngeal swab between May 2020 and December 2021.

Severe bronchiolitis before and after the COVID-19 pandemic: a retrospective database analysis by the Italian Network of PICU study group (TIPNet).

Background: The first post-COVID-19 pandemic year demonstrated an unusual bronchiolitis epidemic in both hemispheres and has been attributed to the removal of barriers implemented during SARS-CoV-2 infection. Several countries reported an increase in respiratory syncytial virus (RSV) bronchiolitis, with more hospitalizations and a greater need for respiratory support. We aimed to evaluate the consequences of the COVID-19 pandemic on the epidemiology and management of severe bronchiolitis in pediatric intensive care units (PICUs) in Italy.

New paradigms in acute viral bronchiolitis: Is it time to change our approach?

Viral bronchiolitis is the most common pediatric acute respiratory infection leading to hospitalization, and it causes a significant healthcare burden worldwide. Current guidelines recommend supportive management after many clinical trials on specific therapies failed to demonstrate benefits. However, several studies in the past decade have revealed that bronchiolitis may not be a homogeneous disease, but instead may constitute an umbrella comprised of different "endotypes" and "phenotypes" based on patient characteristics, etiology, pathophysiological mechanisms, and clinical presentation.