Pediatric pulmonology
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Pediatric pulmonology · Aug 2016
Review Meta AnalysisEfficacy of oral corticosteroids in the treatment of acute wheezing episodes in asthmatic preschoolers: Systematic review with meta-analysis.
Systemic corticosteroids (SCS) are used for treat preschoolers with acute asthma or wheezing exacerbations, with conflicting results. ⋯ Treatment with OCS in the ED or hospital may be beneficial in toddlers and preschoolers with frequent asthma/wheezing exacerbations. However, more studies are needed before OCS can be broadly recommended for this age group. Future trials should be carefully designed to avoid bias and according to our findings regarding administration setting. Pediatr Pulmonol. 2016;51:868-876. © 2016 Wiley Periodicals, Inc.
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Pediatric pulmonology · Apr 2015
Review Meta AnalysisNasal intermittent positive pressure ventilation versus nasal continuous positive airway pressure for preterm infants with respiratory distress syndrome: a meta-analysis and up-date.
To evaluate whether nasal intermittent positive pressure ventilation (NIPPV) would decrease the requirement for endotracheal ventilation compared with nasal continuous positive airway pressure(NCPAP) for preterm infants with respiratory distress syndrome (RDS) and compare the related complications between these two noninvasive variations of respiratory support ⋯ Among preterm infants with RDS, there was a significant decrease in the need for invasive ventilation in the NIPPV group as compared with NCPAP group, especially for the infants who received surfactant. However, NIPPV could not decrease the need for invasive ventilation both in the subgroup of infants whose GA ≤ 30 weeks or BW < 1,500 g and the subgroup of infants with BW of >30 weeks or BW > 1,500 g. It is limited to analysis the primary outcome generally. Larger trials of this intervention are needed to assess the difference in this primary outcome and the related complications between both forms of noninvasive respiratory support.
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Pediatric pulmonology · Aug 2006
Review Meta AnalysisInhaled drugs for the prevention and treatment of bronchopulmonary dysplasia.
Bronchopulmonary dysplasia (BPD) is one of the most common long-term complications and treatment challenges in preterm infants. Theoretically, inhaled corticosteroids may suppress pulmonary inflammation without causing systemic side-effects, while bronchodilators will improve airway resistance and thereby work of breathing. This article reviews current data on these drugs in BPD prevention or treatment. ⋯ Inhaled steroids started before 2 weeks of age may improve rates of successful extubation and reduce the need for rescue systemic glucocorticoids, but have not been shown to reduce the incidence of BPD. Thus, their use cannot be generally recommended. The data currently available are not sufficient to give any clearer recommendation on the use of these drugs in infants at high risk of, or established, BPD.
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Pediatric pulmonology · Mar 2000
Meta Analysis Comparative StudyLong-acting beta(2)-agonists in management of childhood asthma: A critical review of the literature.
This review assesses the evidence regarding the use of long-acting beta(2)-agonists in the management of pediatric asthma. Thirty double-blind, randomized, controlled trials on the effects of formoterol and salmeterol on lung function in asthmatic children were identified. Single doses of inhaled salmeterol or formoterol cause prolonged bronchodilatation (>12 h) and extended bronchoprotection against exercise-induced bronchoconstriction in children, some children achieving full protection for more than 12 h. ⋯ The evidence does not support a recommendation for long-acting beta(2)-agonists as monotherapy, nor does it support their general use as regular add-on therapy. In conclusion, long-acting beta(2)-agonists provide effective bronchodilatation and bronchoprotection when used as intermittent, single-dose treatment of asthma in children, but not when used as regular treatment. Future studies should examine the positioning of long-acting beta(2)-agonists as an "as needed" rescue medication instead of short-acting beta(2)-agonists for pediatric asthma management.