Intranasal Dexmedetomidine Administration Precipitates Respiratory Failure in Child With Croup and Asthma.

Intranasal dexmedetomidine administration in clinically recommended doses has a small but important risk of causing catastrophic respiratory failure in the setting of preexisting severe respiratory workloads.

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.

Dexamethasone regime and clinical outcomes in children hospitalized with croup: A cohort study.

Background: High-quality trial evidence supports the use of one dose of dexamethasone in the outpatient management of croup; however, there are no inpatient trials, and the optimal treatment regimen for the inpatient management of croup remains uncertain. Significant practice variability exists in the corticosteroid treatment of children hospitalized for croup.

Objective: To evaluate the association of dexamethasone treatment regimen (1 vs.

Comparison of Croup Management Patterns between Pediatricians and Emergency Medicine Physicians: A Single Pediatric Emergency Department Study.

: With the advent of the field of pediatric emergency medicine, studies on the differences in treatment patterns between pediatricians and emergency medicine (EM) physicians in various pediatric conditions have been accumulating. This study aimed to compare croup (acute laryngotracheobronchitis) management patterns between pediatricians and EM physicians to enhance pediatric emergency care and inform the training of future specialists. : A retrospective review of medical records was conducted for 1676 previously healthy children diagnosed with croup who visited a single pediatric emergency department (PED) of a tertiary university-affiliated hospital in South Korea, from March 2019 to February 2023.

Outcomes of heliox use in children with respiratory compromise: A 10-year single institution experience.

Objective: Heliox, a mixture of helium and oxygen, has been shown to improve laminar airflow and decrease airway resistance in children. This study aims to describe the outcomes of heliox use in children with respiratory compromise and to identify variables associated with a need for airway surgical intervention.

Methods: A retrospective cohort study of patients who received heliox between 2012 and 2022 at a tertiary care children's hospital.

Quality Indicators for Pediatric Bronchiolitis and Croup Care in the Emergency Department; a Systematic Review and Meta-Analysis.

Introduction: As the quality of care for respiratory diseases in pediatric patients in emergency departments (EDs) becomes increasingly important, this systematic review aims to evaluate the current quality indicators (QIs) specifically designed for the ED management of pediatric bronchiolitis and croup.

Methods: We conducted searches in four electronic databases (Scopus, Web of Science, CINAHL, and MEDLINE) from their inception up to February 2024. We focused on English-language qualitative and quantitative publications that suggested or described at least one indicator initiative related to ED care for pediatrics with bronchiolitis and croup diseases.

Subglottic Hemangioma: A Hidden Cause of an Infant's Respiratory Distress.

Subglottic hemangiomas are uncommon forms of infantile vascular tumors often misdiagnosed due to symptom overlap with other conditions like laryngomalacia, bronchiolitis, and asthma. Early and accurate diagnosis is vital for effective management. This case report discusses a unique presentation of subglottic hemangioma in a three-month-old infant, highlighting its diagnostic challenge and management.

Consensus-based guideline for the supportive anthroposophic therapies to treat children with pseudocroup (stenosing laryngotracheitis).

Purpose: Supportive anthroposophic therapies are used to treat children with pseudocroup by pediatricians in outpatient and inpatient settings. Anthroposophic treatment comprises forms of creative therapies, external applications as well as remedies, which production is based on the knowledge of the human being, nature and substances. A scientifically based guideline for these therapies is lacking.

High Flow Nasal Cannula Versus Conventional Oxygen Therapy and Incidence of Post-Extubation Airway Obstruction in PICU: An Open-Label Randomized Controlled Trial (HiFloCOT-PICU Trial).

Objectives: To study the impact of high flow nasal cannula (HFNC) vs. conventional oxygen therapy (COT) (by simple nasal cannula) as respiratory support after extubation on the rates of post-extubation airway obstruction (PEAO) among mechanically ventilated critically ill children.

Methods: This open-label randomized controlled trial was conducted in pediatric intensive care unit (PICU) of a tertiary care teaching hospital in North India over a period of 7 mo (11 August 2021 to 10 March 2022).

Potentially Avoidable Emergency Department Transfers for Acute Pediatric Respiratory Illness.

Background: Acute pediatric respiratory illness is one of the most common reasons for emergency department (ED) transfer; however, few studies have examined predictors of potentially avoidable ED transfer (PAT) in this subpopulation. This study aimed to characterize patterns and predictors of PATs in children with acute respiratory illness.

Methods: Cross-sectional analysis of 8,402,577 visits for patients ≤17 years from 2018 to 2019 Health Care Utilization Project State ED and Inpatient Datasets from New York, Maryland, Wisconsin, and Florida.

Exposures and coexisting conditions in pediatric nodular tracheobronchitis.

Background: The aim of our study was to investigate the prevalence of coexisting conditions and exposures in children with nodular tracheobronchitis diagnosed by flexible bronchoscopy.

Methods: We conducted a single-center retrospective review of 100 children diagnosed with nodular tracheobronchitis by flexible bronchoscopy between 2012 and 2023.

Results: Common coexisting diagnoses included gastroesophageal reflux disease (GERD, 50%), dysphagia/aspiration (40%), asthma (30%), recurrent croup (30%), tracheostomy dependence (19%) and eosinophilic esophagitis (EOE) (12%).

Antibiotics for Pediatric Patients With Laryngotracheobronchitis in Korea: A Nationwide Study Based on Administrative Data.

Background: Antimicrobial resistance (AMR) is an important global public health concern in adults and children. Laryngotracheobronchitis (croup) is a common acute respiratory infection (ARI) among children, most often caused by a virus, and should not be treated with antibiotics. Reducing the usage of unnecessary antibiotics in ARI using an antimicrobial stewardship program (ASP) is an effective measure against AMR in children.

Clinical Characteristics of Pediatric Parainfluenza Virus Infections: A Comparative Analysis of Parainfluenza Virus Serotypes 1-4 From April 2021 to October 2023 in Hokkaido, Japan.

Background: Parainfluenza virus (PIV) is widely known as a causative virus of acute respiratory tract infections in children, and 4 serotypes (PIV-1-PIV-4) have been identified. The purpose of the present study was to clarify the clinical characteristics of the PIV serotypes in pediatric PIV infections in Japan.

Methods: Between April 2021 and October 2023, 8821 children aged <16 years who presented with respiratory symptoms underwent multiplex polymerase chain reaction analyses at the Department of Pediatrics, NTT Medical Center Sapporo.

Laryngeal Foreign Body Aspiration in Infancy: A Diagnostic Challenge.

Foreign body aspiration (FBA) is a significant cause of accidental death among children, with laryngeal FBA being relatively rare but potentially fatal due to airway obstruction. This report highlights a case of laryngeal FBA in an 11-month-old child, initially misdiagnosed as viral croup. Otolaryngological evaluation, particularly in the case of laryngeal FBA, may facilitate management.

Clinical severity of Omicron and Delta SARS-CoV-2 infections in children.

Background: We aimed to compare the clinical features and severity of the Omicron and Delta variant infections among children hospitalized for coronavirus disease 2019 (COVID-19).

Methods: Children 12 years old or less hospitalized for COVID-19 across five hospitals between January 1, 2021 and March 31, 2022 were identified using the state's pediatric COVID-19 registry. Delta and Omicron-infected patients without previous COVID-19 infection, COVID-19 vaccination, or co-infections were propensity-score matched 1:1 to control for differences in baseline characteristics.

Clinical characteristics of SARS-CoV-2 Omicron BA.2 infection and its impact on pediatric emergency care in northern Taiwan.

Background: The SARS-CoV-2 Omicron BA.2 outbreak started in Taiwan in April 2022. The pandemic posed a challenge to pediatric emergency departments (PEDs) because of increased PED visits and diverse clinical presentations.

Improving croup management at a pediatric emergency department.

Objectives: Over-testing and over-treatment are common in children with croup at pediatric emergency departments (PED). The objective of the study was to improve care for children with croup.

Methods: In this quality improvement (QI) initiative, all pediatric residents starting their rotation in the PED attended an informative presentation about croup and were provided reminders throughout their rotation.

Revisiting dexamethasone use in the pediatric emergency department.

Purpose Of Review: Dexamethasone is an essential treatment for common pediatric inflammatory, airway, and respiratory conditions. We aim to provide up-to-date recommendations for treatment of anaphylaxis, croup, coronavirus disease, multisystem inflammatory syndrome in children, and asthma with dexamethasone for use in the pediatric emergency department.

Recent Findings: Literature largely continues to support the use of dexamethasone in most of the above conditions, however, recommendations for dosing and duration are evolving.