Paediatric respiratory reviews
-
Although the symptom complex we call asthma has been well described since antiquity, our understanding of the causes and therapy of asthma has evolved. Even with this evolution in our understanding, there are persistent myths (widely held but false beliefs) and dogma (entrenched beliefs) regarding the causes, classification, and therapy of asthma. It is sobering that some of the knowledge we hold dear today, will become the mythology of tomorrow.
-
Paediatr Respir Rev · Dec 2014
ReviewMagnesium should be given to all children presenting to hospital with acute severe asthma.
Asthma is one of the most prevalent chronic condition affecting children worldwide and acute exacerbations requiring emergency medical management are common. In addition to corticosteroids, a number of drugs may be used in the management of acute severe asthma aiming to reverse bronchoconstriction. ⋯ Despite its safety profile and effectiveness, the use of magnesium sulphate has been inconsistent due to lack of consensus. The authors believe that the accumulating evidence of a favorable 'cost benefit' profile justifies the use of magnesium for all children presenting with acute severe asthma.
-
Paediatr Respir Rev · Sep 2014
ReviewCystic fibrosis related diabetes: potential pitfalls in the transition from paediatric to adult care.
One of the major complications of Cystic Fibrosis (CF) is CF-Related Diabetes (CFRD), which increases in incidence with age, from 1-2% below the age of 10 years to ∼20% of adolescents and 40-50% of adults. Multiple guidelines have been published over the last few years for the diagnosis and management of CFRD, from the American Diabetes Association (ADA) / US Cystic Fibrosis Foundation, International Society for Pediatric and Adolescent Diabetes (ISPAD) and the Thoracic Society of Australia and New Zealand-Australian Diabetes Society. However, little is published about the particular issues involved in transition of patients with CFRD from paediatric to adult care, nor the issues concerning the development of CFRD during the transition period. This document seeks to provide assistance to physicians, dieticians, nurses, diabetes educators, CF patients and their families by outlining the issues surrounding CFRD during transition from paediatric to adult care.
-
High flow nasal cannula (HFNC) devices deliver an adjustable mixture of heated and humidified oxygen and air at a variable flow rate. Over recent years HFNC devices have become a frequently used method of non-invasive respiratory support in infants and preterm neonates that is generally popular amongst clinicians and nursing staff due to ease of use and being well tolerated by patients. ⋯ We describe the features of a modern HFNC device and discuss current knowledge about the mechanisms of action and results of clinical studies in preterm neonates and infants with bronchiolitis. We also highlight future areas of research that are likely to increase our understanding, inform best clinical practice and strengthen the evidence base for the use of HFNC.
-
Cystic fibrosis (CF) respiratory infection is characterised by the presence of typical human bacterial pathogens such as Pseudomonas aeruginosa, Haemophilus influenzae and Staphylococcus aureus. Less typical pathogens such as Burkholderia, Stenotrophomonas, Achromobacter, Pandorea and Ralstonia have emerged as problematic infections which are largely unique to people with CF. ⋯ Collectively, the diversity of microorganisms present in respiratory specimens has been designated the CF microbiome. The challenges posed by emerging CF pathogens and a microbiome-based view of CF infection are discussed in terms of their impact on clinical outcome, diagnosis and therapy.