Chest
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The 2023 International Pediatric Ventilator Liberation Clinical Practice Guidelines provided evidence-based recommendations to guide pediatric critical care providers on how to perform daily aspects of ventilator liberation. However, because of the lack of high-quality pediatric studies, most recommendations were conditional based on very low to low certainty of evidence. ⋯ Although pediatric ventilator liberation guidelines have been created, the certainty of evidence remains low and multiple research gaps exist that should be bridged through high-quality RCTs, multicenter observational studies, and quality improvement initiatives.
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According to the most recent pulmonary hypertension (PH) guidelines, a main pulmonary artery (MPA) diameter > 25 mm on transthoracic echocardiography supports the diagnosis of PH. However, the size of the pulmonary artery (PA) may vary according to body size, age, and cardiac phases. ⋯ This study presents novel reference limits for MPA based on height indexing and quantile regression.
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A 10-month-old boy with a weight of 5 kg demonstrated recurrent respiratory infections after birth, respiratory distress after feeding, and slow weight gain. At the time of presentation, he had been experiencing a cough accompanied by pyrexia for > 20 days. ⋯ He was born at full term via cesarean delivery and weighed 2.9 kg at birth. He was hospitalized three times because of pneumonia.
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Shortened telomere length (TL) is a genomic risk factor for fibrotic interstitial lung disease (ILD), but its role in clinical management is unknown. ⋯ Incorporating TL testing in ILD impacted clinical management and led to the discovery of new actionable genetic variants.