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Relevant studies collected during the past seven days, ranked by reading priority. This is an on-demand view; no email is sent automatically.
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80 studies in this digest.
Asthma & wheezing · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
Serious game-based interventions in children with asthma showed statistically significant improvements in forced vital capacity (FVC) (mean difference = 4.48, 95% CI: 0.14 to 8.82) and maximal mid-expiratory flow (MMEF) (mean difference = 8.41, 95% CI: 6.63 to 10.19), but no significant effects on forced expiratory volume in 1 second (FEV1) or FEV1/forced vital capacity (FVC) ratio. The evidence was limited by small study numbers, small sample sizes, heterogeneity, and methodological weaknesses.
Other pulmonary · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
This systematic review included studies assessing the prognostic value of perioperative regional oxygen saturation (rSO₂) monitoring in pediatric congenital heart disease patients regarding brain injury, brain development, neurodevelopment, acute kidney injury (AKI), and necrotizing enterocolitis (NEC). Among the studies, associations were reported between rSO₂ and brain injury in 5 of 10 studies, brain development in 3 of 4 studies, neurodevelopment in 10 of 15 studies, AKI in 9 of 15 studies, and NEC in 1 of 3 studies. The review noted high heterogeneity in study populations and NIRS measurements, and most studies had moderate to high risk of bias. Due to heterogeneity, meta-analysis was not performed.
Other pulmonary · Paediatric · Randomized controlled trial · AI summary available · Priority 94/100
High-dose vitamin D3 supplementation (1200 IU) compared to standard-dose (400 IU) from infancy to 24 months did not improve sleep outcomes in children. However, children with 25(OH)D levels ≥ 75 nmol/L at 12 months experienced fewer sleep disturbances at 24 months, particularly disorders of arousal (B = -1.46 points, 95% CI: -2.89 to -0.04; p = 0.05 and B = -0.40, 95% CI: -0.64 to -0.15; p = 0.002). Additionally, maternal 25(OH)D levels ≥ 75 nmol/L during pregnancy were associated with better sleep characteristics in their children.
Ventilation & respiratory support · Paediatric · Randomized controlled trial · AI summary available · Priority 94/100
In high-risk pediatric patients after extubation, the re-intubation rate within 48 hours was 10.5% for the noninvasive ventilation (NIV) group and 11.9% for the high-flow nasal cannula (HFNC) group, showing no statistically significant difference (P = .74). The HFNC group required a significantly lower dosage of dexmedetomidine (0.85 ± 0.22 µg/kg/h) compared to the NIV group (1.02 ± 0.13 µg/kg/h; P < .001) and had a shorter median postextubation pediatric ICU stay of 3 days versus 4 days in the NIV group (P = .02).
Respiratory infection & TB · Paediatric · Randomized controlled trial · AI summary available · Priority 94/100
The study is a feasibility randomized controlled trial designed to assess the usability and feasibility of the Expector device (kangaroo baby-carrier version) for high-frequency chest wall oscillation therapy in healthy infants aged 3-6 months. It involves 30 participants divided into three groups with different device activation settings and measures various physiological and subjective parameters before, during, and after device use.
Sleep & OSA · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
In preterm infants, high-flow nasal cannula (HFNC) showed no significant difference compared to continuous positive airway pressure (CPAP) in the incidence of bronchopulmonary dysplasia (BPD) (RR: 0.86; 95% CI: 0.73-1.02; p = 0.08) or in air leak (RR: 0.76; 95% CI: 0.45-1.27; p = 0.29), but significantly reduced the risk of nasal injury (RR: 0.40; 95% CI: 0.33-0.49; p < 0.00001). Trial sequential analysis indicated insufficient evidence to confirm a 20% reduction in BPD risk.
Cystic fibrosis · Paediatric · Randomized controlled trial · AI summary available · Priority 94/100
The CEASE-CF smoking cessation intervention, delivered by a tobacco treatment specialist integrated into the CF care team, demonstrated high feasibility (64% accrual, 100% retention) and acceptability (86% caregiver satisfaction, 67% finding it helpful). At 6 months, 17% of caregivers quit smoking, 78% reduced smoking by at least 17% with an average reduction of 54%, and children's hair nicotine levels significantly decreased from 2.7 ng/mg to 1.1 ng/mg (p < 0.001), with only 41% remaining above the exposure threshold compared to 100% at baseline.
Sleep & OSA · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
The prevalence of sleep disordered breathing (SDB) in children with myelomeningocele (MMC) is high, ranging from 46-100% in infants with postnatal repair and 92-97% in those prenatally repaired. In individuals aged 12 months to 21 years, SDB prevalence is 49-100% among symptomatic and 39-63% among asymptomatic cases. Mortality rates due to SDB in infancy vary from 0-69%, with SDB accounting for 22% of deaths in one study. Central sleep apnea and obstructive sleep apnea are diagnosed at significantly different ages. Adolescents with MMC, especially females, experience poorer sleep quality and quantity earlier than peers, which may impair executive functioning.
Ventilation & respiratory support · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
Repeated doses of salbutamol probably reduce hospital stay by 2.3 days and a single dose may reduce oxygen therapy duration by 19.4 hours, duration of assisted ventilation by 12.7 hours, tachypnoea duration by 6.6 hours, and improve clinical severity scores at 4 and 8 hours in neonates with transient tachypnoea of the newborn. Effects on the need for mechanical ventilation and continuous positive airway pressure are very uncertain.
Other pulmonary · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
Neonatologist-performed lung ultrasound (LUS) in the delivery room demonstrates rapid identification of normal and high-risk lung adaptation patterns in late preterm and term neonates, with several scoring systems effectively predicting the need for respiratory support, surfactant administration, and mechanical ventilation shortly after birth.
Ventilation & respiratory support · Paediatric · Randomized controlled trial · AI summary available · Priority 94/100
The GASTRIC-PICU trial is a multicenter, randomized, non-inferiority clinical trial designed to compare not routinely measuring gastric residual volume (GRV) to guide enteral feeding versus routine GRV measurement in mechanically ventilated critically ill children. The primary clinical outcome is a composite of survival and days free from mechanical ventilation at 30 days, with a superiority outcome of the percentage of estimated energy requirements achieved by 72 hours. Cost-effectiveness will be assessed by incremental net monetary benefits at 6 months. Data collection includes baseline, nutritional intake, discharge outcomes, and long-term survival and economic data.
Asthma & wheezing · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
The systematic review of 20 studies found that passive exposure to electronic nicotine delivery systems (ENDS) is associated with asthma, bronchitis, ear, nose and throat symptoms, mental health problems, and increased inflammatory markers. Passive waterpipe exposure is linked to toxicant biomarkers and a higher risk of COPD and childhood cancer. Evidence regarding bidis and heated tobacco products (HTPs) is very limited, with only one poor-quality study each suggesting potential risks such as lung cancer and exposure to volatile organic compounds.
Sleep & OSA · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
This systematic review and meta-analysis of eight studies (seven on myofunctional therapy and one on exercise) in children with persistent obstructive sleep-disordered breathing post-surgery found no statistically significant improvements from active strategies in apnea-hypopnea index (AHI) or oxygen saturation measurements. Among randomized controlled trials, myofunctional therapy showed no significant change in AHI (mean difference -1.68, 95% CI -3.61 to 0.24, p = 0.07) or average SpO2 (mean difference 0.38, 95% CI -6.67 to 7.43, p = 0.62). Non-randomized studies similarly showed no significant changes in AHI or SpO2 nadir.
Sleep & OSA · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
Multi-level airway surgery in paediatric patients with obstructive sleep apnoea significantly improved Apnoea-Hypopnea Index (AHI) and SpO2 sleep nadir. In non-syndromic children, AHI improved by -10.13 and SpO2 nadir increased by 4.39, with an AHI normalization rate of 66.4%. In children with Down syndrome, AHI improved by -14.58 and SpO2 nadir increased by 3.75.
Ventilation & respiratory support · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
A meta-analysis of four studies showed no difference in mortality between children with and without CNS disorders using LT-NIV (OR 1.23, 95% CI: 0.40-3.79). Hospitalization rates were higher in children with CNS disorders across four studies, and meta-analysis of three studies showed reductions in the apnoea-hypopnoea index following LT-NIV use, though responses varied.
Other pulmonary · Paediatric · Randomized controlled trial · AI summary available · Priority 94/100
In this single-center pilot randomized controlled trial involving 53 critically ill neonates and children on ECMO, delivering nitric oxide into the sweep gas (sNO) at 20 ppm was safe and feasible with no major adverse events. There were no significant differences between the sNO and control groups in survival free of ECMO or PICU at 30 and 90 days, blood product use, circuit duration before replacement, free plasma hemoglobin levels, oxygenator thrombus degree, or incidence of methemoglobinemia.
Respiratory infection & TB · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
The study protocol outlines an international collaborative meta-analysis to assess the real-world effectiveness of nirsevimab in preventing RSV infections by infant age and time since administration, using individual-participant-level data and aggregated data through a test-negative design.
Asthma & wheezing · Paediatric · Randomized controlled trial · AI summary available · Priority 94/100
HDM subcutaneous immunotherapy (SCIT) in children with allergic rhinitis and allergic rhinitis plus asthma significantly reduced total IgE, TGF-β1, Combined Symptom Medication Score (CSMS), and Visual Analogue Scale (VAS), while specific IgE and IL-10 levels showed no statistically significant changes. No significant differences in treatment effect were observed between the two groups.
Ventilation & respiratory support · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
This systematic review and meta-analysis of 95 studies involving 4,831,379 septic shock patients found an early hospital mortality rate of 33.2%. Several prognostic factors were significantly associated with increased early mortality: patient factors such as increasing age (adjusted OR 1.02 per year), Black race (OR 1.23), hepatic cirrhosis (OR 1.85), malignancy (OR 1.43), and higher Charlson comorbidity index (OR 1.22 per point); presentation factors including acute kidney injury (OR 1.88) and higher severity-of-illness scores (APACHE II: OR 1.10 per point, SAPS II: OR 1.08 per point, SOFA: OR 1.21 per point); and treatment/biochemical factors like invasive mechanical ventilation (OR 2.12), norepinephrine use (OR 3.60), and elevated serum lactate (OR 1.13 per 1 mmol/L). Certainty of evidences ranged from moderate to high.
Other pulmonary · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
Prenatal antibiotic exposure was associated with an increased risk of any offspring infection (OR 1.33, 95% CI 1.01 to 1.76, p=0.04) and a stronger association was found in high-quality studies (OR 1.48, 95% CI 1.13 to 1.95, p<0.01). Specifically, ear, nose, and throat infections were significantly increased (OR 1.40, 95% CI 1.18 to 1.65, p<0.0001).
Cystic fibrosis · Paediatric · Randomized controlled trial · AI summary available · Priority 94/100
Stopping long-term azithromycin in children with non-cystic fibrosis bronchiectasis who had been treated for an average of 3 years can lead to early respiratory exacerbations.
Respiratory infection & TB · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
In this meta-analysis of 405 children treated for drug-susceptible tuberculosis, 21% experienced unfavourable outcomes, which were significantly associated only with lower body mass index for age z-score (BAZ). Isoniazid exposure was influenced by NAT2 genotype, weight, age, and nutritional status, with pharmacokinetic target attainment at 71.7% for slow metabolisers and 29.5% for fast metabolisers. Malnourished children achieved lower target attainment compared to those with normal BAZ.
Asthma & wheezing · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
Maternal autoimmune diseases are associated with increased risks of asthma (OR 1.25), eczema (OR 1.30), and allergic rhinitis (OR 1.04) in offspring, while paternal autoimmune diseases are linked to higher risks of asthma (OR 1.16) and eczema (OR 1.13) in children.
Asthma & wheezing · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
The meta-analysis identified significant associations between filaggrin (FLG) loss-of-function mutations and atopic dermatitis (AD) with odds ratios (OR) of 2.426 (95% CI 1.890-3.114) in cohort studies and 4.44 (95% CI 2.42-8.12) in case-control studies, as well as associations with asthma (OR 1.90, 95% CI 1.33-2.71) and food allergy (OR 1.79, 95% CI 1.11-2.88) in cohort studies. No significant associations were found between FLG mutations and food allergy in case-control studies or respiratory allergies. Other skin barrier-related genes showed no quantitative evidence of a clinically significant role in childhood allergy.
Asthma & wheezing · Paediatric · Randomized controlled trial · AI summary available · Priority 94/100
This study is a cluster-randomised trial designed to assess whether screening for asthma symptoms among children and adolescents with respiratory symptoms at primary care health facilities in Uganda increases the proportion of asthma diagnoses. The intervention involves screening 1050 children aged 2 months to 17 years using a standardized verbal questionnaire, followed by history and physical examination for those who screen positive. The study will compare asthma diagnosis rates before and during the intervention in both intervention and control sites, analyze cost-effectiveness, and evaluate feasibility and acceptability through qualitative methods. However, results and numerical outcomes are not yet reported.
Sleep & OSA · Paediatric · Systematic review / meta-analysis · AI summary available · Priority 94/100
The Pediatric Sleep Questionnaire (PSQ) and OSA-18 questionnaire showed moderate sensitivity but low specificity for detecting pediatric obstructive sleep apnea (OSA) at apnea-hypopnea index (AHI) cut-offs of ≥1 and ≥5. For AHI ≥1, PSQ sensitivity was 0.70 and specificity 0.43; OSA-18 sensitivity was 0.63 and specificity 0.74. For AHI ≥5, PSQ sensitivity was 0.75 and specificity 0.41; OSA-18 sensitivity was 0.73 and specificity 0.34. After excluding children with cranio-facial anomalies and certain chronic conditions, sensitivity improved slightly but specificity remained low. Correlations between questionnaire scores and AHI were weak to moderate (ρ = 0.28 for PSQ and 0.34 for OSA-18).
Asthma & wheezing · Paediatric · Systematic review / meta-analysis · Indexed abstract only · Priority 89/100
No abstract or quantitative findings available from this index record.
Asthma & wheezing · Paediatric · Systematic review / meta-analysis · Indexed abstract only · Priority 89/100
No abstract or quantitative findings available from this index record.
Other pulmonary · Paediatric · Consensus statement · AI summary available · Priority 88/100
Consensus was obtained for 25 recommendations across five domains: clinical application, quality assurance, equipment, education, and research regarding point-of-care ultrasound (POCUS) in pediatric critical care medicine.
Other pulmonary · Paediatric · Consensus statement · AI summary available · Priority 88/100
Using a modified Delphi method with a 74% response rate from an expert panel of 23 members across 17 institutions, fourteen entrustable professional activities (EPAs) were developed for pediatric critical care ultrasound (CCUS) spanning five domains: Cardiac, Pulmonary, Abdomen, Procedures, and Vascular. These EPAs were refined and evaluated with a requirement of a median score ≥4.5 on 5-point Likert scales for consensus.
Other pulmonary · Paediatric · Consensus statement · AI summary available · Priority 88/100
An international panel of 15 neonatologist experts developed and reached consensus on 10 statements to standardize lung ultrasound training for neonatologists, with median agreement scores of 8.5 to 9 and agreement levels between 80% and 100%.
Cystic fibrosis · Paediatric · Consensus statement · AI summary available · Priority 88/100
An international Delphi consensus was achieved involving 106 to 107 panellists from 26 countries, including clinicians with a median of 18 years' experience and people with cystic fibrosis, resulting in agreement on 73 follow-up recommendations for children exposed to CFTR modulators in utero or through breastfeeding. Key areas of consensus included follow-up settings, liver function monitoring, cataract screening, and awareness of potential false-negative cystic fibrosis newborn screening results.
Sleep & OSA · Paediatric · Prospective cohort · AI summary available · Priority 87/100
In children aged 5-11 years with primary monosymptomatic nocturnal enuresis (PMNE) and clinically diagnosed sleep-disordered breathing (SDB) undergoing adenoidectomy or adenotonsillectomy, there was a significant median reduction in wet-night frequency from 3 nights/week to 0 nights/week at 3 months postoperatively, with 52.9% achieving complete response (no wet nights). Daytime sleepiness measured by the modified Epworth Sleepiness Scale also decreased significantly. Higher baseline wet-night frequency was associated with lower odds of complete response, while age and type of surgery were not.
Cystic fibrosis · Paediatric · Retrospective cohort · Indexed abstract only · Priority 87/100
Abstract excerpt (not a validated results extraction): Published data on cystic fibrosis (CF) among Egyptian people with cystic fibrosis (pwCF) are limited, and most previous reports have been from single centers. This study describes the demographic, clinical, and CFTR variant characteristics of a large multicenter cohort of Egyptian pwCF. We conducted a multicenter retrospective descriptive cohort study including pwCF treated at seven Egyptian university children's hospitals from 2020 through 2024. Eligible participants had clinical features consistent with CF and positive sweat chloride testing. Demographic, clinical, sweat chloride, and genetic testing data were collected from medical records. All participants underwent limited CFTR variant testing; participants with one or no identified variants were eligible for additional CFTR sequencing when available. A total of 475 Egyptian pwCF were included. Participants were recruited from Cairo University, Ain Shams University, Zagazig University, Mansoura University, Tanta University, Alexandria University, and Assiut University. Among the …
Cystic fibrosis · Paediatric · Cohort study · Indexed abstract only · Priority 87/100
Abstract excerpt (not a validated results extraction): Health-related quality of life (HRQoL) is an important outcome in cystic fibrosis (CF), but pediatric data from Latin America are limited. We described HRQoL in a Colombian multicenter cohort and explored whether CFQ-R domains differed across treating-center/site-altitude categories and were associated with selected clinical and functional measures. We analyzed a prospective multicenter cohort of 94 children and adolescents with CF aged 6-18 years followed for 12 months at four Colombian centers. HRQoL was assessed with age-specific Spanish-language CFQ-R forms and the caregiver-proxy version. Site/altitude categories were assigned by treating center and therefore represent combined center, regional and altitude context rather than an isolated altitude exposure. Between-category and paired longitudinal comparisons used non-parametric methods with Benjamini-Hochberg correction. Secondary multivariable analyses were deliberately limited and considered exploratory. Ninety-four participants were included; 81 (86.2%) completed the 12-month…
Neonatal & BPD · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
In a study of 437 very-low-birth-weight or very preterm infants, 39.4% developed bronchopulmonary dysplasia (BPD), and among those, 51.7% had coexisting retinopathy of prematurity (ROP). Factors associated with BPD included lower gestational age, prolonged invasive ventilation and oxygen therapy, and delayed first feeding. For infants with BPD, longer respiratory support duration, lower platelet distribution width at 24 hours and day 14, male sex, and shorter birth length were linked to ROP. Prediction models based on data available by postnatal day 14 showed moderate discrimination for BPD (held-out AUC 0.789) and for ROP among infants with BPD (AUC 0.690), with mean AUCs of 0.846 and 0.752 across nested cross-validation, respectively.
Other pulmonary · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
In a cohort of 2,482 allergic rhinitis patients in Beijing, 91.74% were sensitized to inhalant allergens and 48.07% to food allergens. Sensitization patterns varied by gender, age, and season: males showed higher Alternaria sensitization; school-aged children and adolescents were more commonly sensitized to dust mites, animal dander, and weed pollen; preschool children had higher sensitization to Alternaria and several food allergens. Seasonal peaks occurred with mugwort and ragweed in autumn and Alternaria in summer. From 2020 to 2024, Alternaria sensitization increased, while sensitization to house dust, dog epithelium, and D. farinae increased between 2020 and 2022 before declining. Three inhalant allergen clusters were identified, and high-grade sensitization was more frequent for Alternaria and mugwort.
Lung transplantation · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
In Spain, combined heart transplantation (HTx) with other organs represents 3.9% of total HTx procedures. For simultaneous combined HTx, 30-day survival rates were 84% for HTx+kidney, 88% for HTx+liver, and 73% for HTx+lung; 5-year survival rates were 64%, 74%, and 41%, respectively. Delayed combined HTx showed low early mortality and 5-year survival rates of 73% for HTx+kidney, 67% for HTx+liver, and 59% for HTx+hematopoietic stem cells. Elective isolated HTx demonstrated better 10-year survival than both simultaneous and delayed combined HTx.
Neonatal & BPD · Paediatric · Cohort study · AI summary available · Priority 87/100
In very preterm infants, a birth weight Z-score below -0.35 is associated with an increased risk of bronchopulmonary dysplasia or mortality at 36 weeks postmenstrual age or discharge. Specifically, infants with a BW Z-score less than -1 have an odds ratio of 3.10 (95% CI 2.53 to 3.79) for these adverse outcomes, while those with a BW Z-score between -1 and -0.35 have an increased risk with an odds ratio of 1.81 (95% CI 1.52 to 2.15).
Asthma & wheezing · Paediatric · Cohort study · AI summary available · Priority 87/100
Maternal asthma is associated with a higher risk of offspring asthma compared to paternal asthma from early childhood (age 3) through adolescence (age 14). Adjusted odds ratios for offspring asthma with maternal asthma only were 3.11 at age 3, 2.96 at age 7, and 3.03 at age 14, whereas with paternal asthma only the odds ratios were 2.25 at age 3, 2.36 at age 7, and 1.95 at age 14. Asthma prevalence among offspring was 6.5% at age 3, 5.2% at age 7, and 5.4% at age 14. At age 3, maternal asthma was associated with higher odds in boys (OR 3.30) compared to girls (OR 2.82), with absolute risks of 19.2% versus 12.2%, though sex interaction was not statistically significant.
Sleep & OSA · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
Children with Prader-Willi syndrome (PWS) exhibit a diverse spectrum of sleep-disordered breathing (SDB), predominantly obstructive sleep apnea syndrome (OSAS), with 75% presenting moderate-to-severe OSAS. Compared to age- and gender-matched OSAS controls, PWS children have higher body mass index (BMI), fewer awakenings, reduced NREM3 sleep, and increased central sleep apnea, mixed apnea, and hypoventilation events. Respiratory event indices, oxygen desaturation index, and obstructive apnea-hypopnea index are significantly higher in PWS, while mean and lowest oxygen saturation are significantly lower. BMI positively correlates with obstructive apnea-hypopnea and hypopnea indices and negatively correlates with lowest oxygen saturation.
Cystic fibrosis · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
Young children with cystic fibrosis and tracheobronchomalacia have significantly more frequent hospital admissions and longer hospital stays compared to those without tracheobronchomalacia. Specifically, the risk of all hospital admissions increased by factors of 2.00 in the first two years and 1.89 in the first four years, while respiratory admissions increased by factors of 3.06 and 2.17 for the same periods. Total hospital days increased by factors of 2.3 and 2.05, and respiratory bed days increased by a factor of 3.14 in the first two years.
Cystic fibrosis · Paediatric · Prospective cohort · AI summary available · Priority 87/100
In adolescents with cystic fibrosis treated with elexacaftor-tezacaftor-ivacaftor (ETI) for 12 months, there was a significant reduction in lung structural damage, including a 10.7% decrease in the mean percentage of severely dilated bronchi (from 40.3% to 29.6%; p<0.0001). Improvements were also observed in lung function (mean ppFEV1 increase of 14.0%, 95% CI 12.4-15.7), lung hyperinflation, mucus plugs, bronchial wall thickening, sweat chloride levels, weight Z scores, lung clearance index, quality of life, and proinflammatory biomarkers. Among 188 participants with imaging at both baseline and 12 months, 17% improved from severe to moderate bronchial dilatation and 10% from moderate to normal dilatation, whereas 7% showed progression.
Respiratory infection & TB · Paediatric · Cohort study · AI summary available · Priority 87/100
Baseline malnutrition in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD), as assessed by the Prognostic Nutritional Index and Mini Nutritional Assessment Short Form, was associated with increased disease severity indicators such as higher odds of dyspnoea, acid-fast bacilli smear positivity, cavitary lesions, higher BACES scores, reduced physical function, and poorer health-related quality of life. Additionally, poor nutritional status was linked to a lower likelihood of respiratory symptom improvement at 6 months and a higher risk of premature treatment discontinuation within one year.
Sleep & OSA · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
The study introduced the Retrospective Analysis of Sleep in Pediatric (RASP) cohorts, comprising 1527 clinical pediatric overnight polysomnographies, developed a pediatric-specific automated sleep stage classifier with superior performance over adult-trained models, and identified consistent sleep architecture disruptions in children with Down's syndrome across independent cohorts. Additionally, a model predicting brain age from sleep EEG metrics revealed younger predicted brain age in children with Down's syndrome.
Other pulmonary · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
In a 10-year retrospective study of 316 PICU deaths (1.35% mortality from 23,434 admissions), 74% involved end-of-life events, which is 9% higher than the national average. Among 234 deaths after 24 hours of admission, terminal CPR occurred in 8%. Pre-admission pediatric palliative care consultation was involved in 34% of cases and was the strongest factor associated with reduced terminal CPR occurrence. Factors linked with PPC involvement included baseline disability, nontrauma diagnosis, primary admission diagnosis, home medical equipment use, death not by neurologic criteria, and sex. Qualitative analysis highlighted a complex, dynamic decision-making process in families choosing to forego terminal CPR.
Ventilation & respiratory support · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
Among 127 neonates undergoing the Norwood procedure, 47% experienced prolonged post-extubation noninvasive respiratory support (NRS) lasting 72 hours or more. Factors independently associated with prolonged NRS included the presence of airway anomalies (aOR 3.6), unplanned surgical or catheter-based reintervention (aOR 3.2), and longer duration of postoperative mechanical ventilation (aOR 1.1). Neonates with prolonged NRS had lower weight-for-age z scores at CICU discharge (-2.11 vs. -1.14), longer CICU stays (25.1 vs. 11.1 days), and extended postoperative sedative exposure (59.8 vs. 16.8 days).
Ventilation & respiratory support · Paediatric · Prospective cohort · AI summary available · Priority 87/100
The fine-tuned GPT-4o model (FSS-AI) analyzed 428 patient notes and showed moderate agreement with manually determined Functional Status Scale (FSS) scores at baseline (weighted Cohen's Kappa 0.59), hospital discharge (0.51), and lower agreement at PICU transfer (0.45). It demonstrated high accuracy and positive predictive value for discriminating normal from abnormal FSS scores at baseline (accuracy 0.90, PPV 0.95) and hospital discharge (accuracy 0.81, PPV 0.75). The model identified new morbidities at discharge with an accuracy of 0.75 and sensitivity of 0.56.
Other pulmonary · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
In neonates undergoing cardiac surgery for congenital heart disease, a higher postoperative electroencephalography discontinuity index between 15 and 24 hours post-surgery is associated with lower motor scores at 24 months. Additionally, higher early postoperative opioid doses are linked to better motor outcomes, including improvements in global motor composite, fine motor, and gross motor scores.
Asthma & wheezing · Paediatric · Cohort study · AI summary available · Priority 87/100
In a Danish cohort of 14,005 individuals followed for up to 25 years, neonatal 25-hydroxyvitamin D and vitamin D-binding protein levels were not associated with asthma risk after age 5 years (HR = 1.04, 95% CI: 0.99-1.09 for 25(OH)D; HR = 1.01, 95% CI: 0.97-1.05 for DBP). Similarly, polygenic scores for these vitamin D traits did not predict asthma risk, while a polygenic score for asthma itself was strongly associated with increased risk (HR = 1.42, 95% CI: 1.36-1.47).
Asthma & wheezing · Paediatric · Prospective cohort · AI summary available · Priority 87/100
The study aims to determine whether adding WheezeScan, a digital device using artificial intelligence to objectively detect wheeze and assess reversibility after bronchodilator use, to routine clinical assessments improves the rate of definitive asthma diagnoses in preschool children suspected of asthma. The study involves 102 children aged 0.5-6 years monitored over 6 weeks, with primary outcome being the proportion of children diagnosed with asthma using WheezeScan data compared to baseline.
Asthma & wheezing · Paediatric · Cohort study · AI summary available · Priority 87/100
Among perinatal stressors, only maternal marital status at birth had a direct effect on adolescents' sleep quality (coef = 0.14; p = 0.027). Depression (coef = 0.38; p = 0.001) and asthma (coef = 0.19; p = 0.030) were also directly associated with poorer sleep quality. No mediation by socioeconomic status, lifestyle, or comorbidities was observed, and other perinatal stressors, screen time, and physical activity were not linked to sleep quality.
Other pulmonary · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
In a cohort of 65 surgically naïve children with severe OSA, differences in upper airway endotypes were observed among five phenotypic groups. Adenotonsillar obstruction was the main pattern across all groups, but multilevel collapse involving the supraglottic region was common especially in children under 2 years (63%) and those with Down syndrome (73%). Obese children showed airway obstruction limited to adenoids and tonsils. Young and obese children exhibited more severe OSA with higher obstructive apnea/hypopnea indices (mean 15.6 events/h) and worse hypoxemia.
ILD & pulmonary fibrosis · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
In a European multicenter study of 378 children with PTI/NEHI, treatments varied significantly across countries. Common therapies included oxygen supplementation (75.9%), inhaled bronchodilators and/or glucocorticoids (62.4%), systemic glucocorticoids (37.0%), and nutritional support (33.8%). Among those receiving oxygen, 53.6% were weaned off by a median age of 24 months. Longitudinal data from 48.9% of patients showed a decline in symptoms over time, particularly by age 4, with improvements in imaging and pulmonary function; however, some patients experienced persistent respiratory abnormalities into adolescence.
Other pulmonary · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
Bivalirudin use in pediatric ECMO patients was associated with fewer total laboratory tests ordered and lower costs compared with unfractionated heparin (UFH) across multiple time points. The dilute thrombin time (dTT) assay used for bivalirudin monitoring can be run at equivalent cost to activated partial thromboplastin time (aPTT), which is used for UFH monitoring.
Respiratory infection & TB · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
In a study of 908 children hospitalized with Mycoplasma pneumoniae pneumonia (MPP), 30.5% developed severe MPP (SMPP). Five independent predictors of SMPP were identified: higher neutrophil percentage (OR=1.02 per %), older age (OR=1.21 per year), longer pre-admission azithromycin exposure (OR=1.34 per day), higher peak temperature (OR=1.37 per °C), and elevated lactate dehydrogenase (OR=1.24 per 100 U/L). A nomogram incorporating these parameters showed good internal validity with an optimism-corrected AUC of 0.75, calibration slope of 0.96, intercept 0.02, and Brier score of 0.04.
Asthma & wheezing · Paediatric · Cohort study · AI summary available · Priority 87/100
Children from the lowest income class in the Netherlands had twice the odds of severe asthma and were 2.6 times more likely to be admitted to the paediatric intensive care unit compared to those from the highest income class. Additional socioeconomic disadvantage factors associated with severe asthma included living in a rental house, having a migration background, and having a lower socioeconomic status score based on income, education, and employment history.
Cystic fibrosis · Paediatric · Cohort study · AI summary available · Priority 87/100
The ENHANCE study is a multicentre, longitudinal research project designed to track early manifestations of cystic fibrosis in children, with three cohorts totaling 550 participants (250 infants diagnosed via newborn screening, 200 children aged 0-6 years with CF, and 100 healthy newborn controls). It employs various health assessments including lung function and structure tests, gastrointestinal and pancreatic evaluations, liver function tests, sweat chloride measurements, and mental health questionnaires over an initial 5-year period.
Asthma & wheezing · Paediatric · Prospective cohort · AI summary available · Priority 87/100
The study protocol aims to evaluate whether integrating the WheezeScan™, an AI-based device for objective wheeze detection, into routine clinical care changes parental assessment of asthma control in children aged 4-11 years with specialist-confirmed asthma. The study also intends to assess the impact of WheezeScan™ on patient-reported outcomes, parent self-efficacy in asthma management, healthcare costs, and device usability. Outcomes will be measured at baseline, week 1, and week 5 in a cohort of 125 children using the device twice daily and as needed.
Neonatal & BPD · Paediatric · Prospective cohort · AI summary available · Priority 87/100
In preterm infants, the development of bronchopulmonary dysplasia (BPD) is associated with increased oxidative mitochondrial DNA damage and airway microbial dysbiosis characterized by reduced microbial diversity, higher relative abundance of Proteobacteria including genera such as Stenotrophomonas, Acinetobacter, and Serratia, and decreased Firmicutes. Proteobacteria abundance positively correlated with oxidative mtDNA damage (r=0.49, p<0.01). Functional pathway predictions showed enrichment in bacterial motility, circadian rhythm, MAPK signalling, and α-linolenic acid metabolism by day 28 in infants with BPD.
Respiratory infection & TB · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
Among 205 pediatric patients receiving ECMO for severe viral respiratory infections, 39% had adenoviral infections. There was no significant difference in 28-day survival between adenoviral (77.6%) and non-adenoviral groups (73.6%). Factors independently associated with increased mortality included Vasoactive-Inotropic Score greater than 15 (aOR 3.18), arterial pH below 7.2 (aOR 3.79), and more than 13 hours delay from meeting ECMO criteria to cannulation (aOR 4.04). Hemorrhagic complications occurred in 40% of patients, most commonly CNS hemorrhage and cannulation site bleeding; higher risk of bleeding was linked to age under 36 months, previous severe COVID-19 infection, ECMO duration over 10 days, and use of continuous renal replacement therapy.
Other pulmonary · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
In a cohort of 47 infants supported on ECMO, higher impaired oxygen delivery index (iD o2) values and increased time spent above iD o2 thresholds of 25%, 50%, and 75% within 6 hours before ECMO initiation were associated with adverse neurologic outcomes, including EEG abnormalities and abnormal imaging. The overall mortality was 55%, with nonsurvivors more likely to have congenital heart disease and pre-ECMO cardiac arrest. A logistic regression model using iD o2 metrics predicted poor outcomes with an AUC of 0.81.
Other pulmonary · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
In a study of 178 newborns, the overall proportion of endotracheal tube (ET) malposition was 63.5% (95% CI 56.4 - 70.6), including 17.4% mainstem intubations. Weight at intubation, particularly below 1000 g, was identified as an independent determinant for ET malposition (adjusted odds ratio [aOR] 10.3; 95% CI 2.06 - 63.7). However, ET malposition was not independently associated with increased risk of death (aOR 1.93; 95% CI 0.65 - 6.54).
Cystic fibrosis · Paediatric · Prospective cohort · AI summary available · Priority 87/100
Longitudinal liver stiffness measurement (LSM) by FibroScan® in children with cystic fibrosis hepato-biliary involvement (CFHBI) showed considerable intra-individual variability, with changes ranging from a 48% decrease to a 93% increase within expected variation. No incremental changes in LSM were detected in CFHBI patients. LSM changes were significantly associated with clinical variables including GGT (r=0.64), spleen size z-score (r=0.42), platelets (r=-0.38), and APRI (r=0.34).
Other pulmonary · Paediatric · Prospective cohort · AI summary available · Priority 87/100
In healthy term infants, the end-expiratory lung volume (EELV) increases rapidly within the first five breaths after birth, with tidal volumes (VT) approximately three times higher than post-transitional values. The first two breaths show distinct regional ventilation inhomogeneities, with preferential ventilation sequentially occurring in the right and left lungs, which quickly resolve to a more even distribution. Additionally, the lung periphery is initially less ventilated during the first ten breaths but improves over the next ten minutes.
Other pulmonary · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
In a cohort of 74 pediatric patients undergoing 83 ECMO runs for cardiac indications, arrhythmias occurred in 33% of runs and ventricular arrhythmias in 17%. Ventricular arrhythmias were associated with a significantly increased hazard of death or heart transplantation (HR 5.7), increased hazard of ECMO wean failure (HR 18.8), and longer ECMO duration (335 vs. 94 hours). Any arrhythmia was also linked to longer ECMO duration (189 vs. 90.1 hours). No associations were found between any arrhythmia and death or transplantation overall.
Other pulmonary · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
Among 62 pediatric ECMO patients over a 6-year period, 84% underwent early mobility (EM) during ECMO, with 35% of those achieving level II or III activity. In patients on ECMO for 10 days or more, 61% reached level II or III activity. Signs of intolerance occurred in 6.1% of 297 EM sessions, affecting 19.2% of patients, with no serious adverse events attributed to EM; however, one case was followed by detection of neurologic changes and stroke.
Other pulmonary · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
Stopping routine surveillance cultures in pediatric ECMO patients reduced the number of cultures obtained from 1.8 to 0.4 per ECMO day (p < 0.0001), decreased antimicrobial prescriptions from 88% to 69% of ECMO days (mean difference 19%, 95% CI 13-25%, p = 0.002), and led to estimated cost savings of $136,000 over 12 months, without changes in ECMO run duration (211 vs. 181 hours, p = 0.48) or 30-day mortality (15/47 vs. 15/47).
Asthma & wheezing · Paediatric · Prospective cohort · AI summary available · Priority 87/100
Asthma diagnosed at age 4 was associated with a higher risk of incident obesity measured by body fat percentage during adolescence (aHR = 1.91, 95% CI: 1.16-3.16), but not significantly associated with BMI-defined obesity. This association was significant only among girls, who showed increased risks of obesity (aHR = 1.97, 95% CI: 1.19-3.26) and overweight/obesity (aHR = 1.75, 95% CI: 1.02-3.01) using body fat percentage; no significant associations were found in boys.
Other pulmonary · Paediatric · Retrospective cohort · AI summary available · Priority 87/100
In children with cystic fibrosis treated with Elexacaftor/Tezacaftor/Ivacaftor (ETI), lean mass index decreased by a mean of 0.64 SDS (p = 0.02), lumbar spine bone mineral apparent density declined by 0.45 SDS (p = 0.009), and VO2peak % predicted decreased by a median of 12% (p = 0.0018). Anaerobic threshold also reduced by 14% (p < 0.01), and breathing reserve increased by 15% (p < 0.01). These changes were not observed in the matched control group not receiving modulators. Lung function (FEV1 % predicted) remained stable in both groups.
Sleep & OSA · Paediatric · Cohort study · AI summary available · Priority 87/100
Children with non-surgically treated pediatric obstructive sleep apnea (OSA) have higher long-term risks of growth failure (HR: 1.97), delayed developmental milestones (HR: 2.48), obesity (HR: 1.51), precocious puberty (HR: 1.59), and ADHD (HR: 1.66), with these risks appearing early after diagnosis and persisting over time. Younger children were more vulnerable to growth and developmental delays, obesity risk increased with age, and ADHD risk remained elevated throughout childhood and adolescence.
Respiratory infection & TB · Mixed · Systematic review / meta-analysis · AI summary available · Priority 84/100
Isoniazid tuberculosis preventive treatment (TPT) among 6668 household contacts of multidrug-resistant tuberculosis (MDR-TB) cases from 17 countries was associated with a 57% reduction in incident TB (adjusted hazard ratio [aHR] 0.43, 95% CI 0.26-0.71). The protective effect was greater among contacts under 20 years old (aHR 0.51, 95% CI 0.28-0.92) compared to adults (aHR 0.69, 95% CI 0.22-2.20), and was strongest within the first year of follow-up with 73% reduction (aHR 0.27, 95% CI 0.11-0.70). Effectiveness decreased over time, dropping to 60% (aHR 0.40, 95% CI 0.15-1.06) in months 12 to 23 and becoming nonsignificant after 2 years (28% effectiveness; aHR 0.72, 95% CI 0.33-1.54).
Respiratory infection & TB · Mixed · Randomized controlled trial · AI summary available · Priority 84/100
In a randomized controlled trial of 1068 adult patients undergoing emergency intubation, the use of a polyurethane-cuffed endotracheal tube with subglottic suction (PU-EVAC) did not reduce infection-related ventilator-associated complications (8% vs 6%, risk difference 0.02) or possible ventilator-associated pneumonia (6% vs 5%, risk difference 0.01) compared with a standard polyvinylchloride-cuffed tube (PVC). At 6 months, there were no statistically significant differences between groups in laryngeal injury (83% vs 70%, p=0.098), quality of life scores (PCS mean difference -0.52, p=0.78; MCS mean difference -2.98, p=0.15), or cognitive impairment (85% vs 81%, p=0.44). The follow-up was limited by high mortality and a small number of survivors completing assessments.
Other pulmonary · Mixed · Systematic review / meta-analysis · AI summary available · Priority 84/100
The meta-analysis of 16 studies involving 52,612 events found that cough frequency monitors have a sensitivity of 89% (95% CI 84%-93%) and a specificity of 99% (95% CI 98%-100%), with an area under the curve of 0.96 indicating excellent discriminative ability. Across 11 devices and 4 applications, individual accuracy was above 0.9.
Cystic fibrosis · Mixed · Systematic review / meta-analysis · AI summary available · Priority 84/100
Paediatric cystic fibrosis patients have a caries risk comparable or lower than controls but show a higher prevalence of developmental enamel defects and altered salivary function. Adult cystic fibrosis patients have increased DMFT scores with more untreated decay, although severe periodontitis is rare despite high plaque accumulation.
Respiratory infection & TB · Paediatric · Cohort study · Indexed abstract only · Priority 82/100
No abstract or quantitative findings available from this index record.
Sleep & OSA · Paediatric · Prospective cohort · Indexed abstract only · Priority 82/100
No abstract or quantitative findings available from this index record.
Bronchiectasis & PCD · Mixed · Consensus statement · AI summary available · Priority 78/100
A national expert panel in England developed a consensus statement outlining 15 minimum standards of care for children and adults with primary ciliary dyskinesia (PCD), covering pulmonary, ear, nose and throat, fertility care, screening for situs abnormalities, and transition from pediatric to adult services. The consensus was reached using a modified Delphi process requiring at least 80% agreement among experts.
Bronchiectasis & PCD · Mixed · Prospective cohort · AI summary available · Priority 77/100
The study found an incidence rate of 3.1 pulmonary exacerbations per person per year among persons with primary ciliary dyskinesia (PCD), with higher incidence in adult females (IRR 2.0, 95% CI 1.4-2.7) and in patients with Pseudomonas aeruginosa isolated (children IRR 1.9, 95% CI 1.1-3.6; adults/adolescents IRR 1.4, 95% CI 1.0-1.9). Despite frequent exacerbations, healthcare professional visits occurred in only 13% of exacerbation weeks. P. aeruginosa was the most commonly observed pathogen during exacerbations, found in 15% of samples in children and 44% in adults/adolescents.
Asthma & wheezing · Paediatric · Not specified in indexed abstract · AI summary available · Priority 76/100
The study found that 47.74% of pediatric Kawasaki disease patients later developed allergic diseases, including asthma. Multi-omics integration revealed shared susceptibility genes significantly enriched in immune processes and signaling pathways. Single-cell RNA sequencing of KD-asthma children showed distinct immune cell compositions and expression profiles compared to controls, with both diseases exhibiting enrichment of inflammatory and extracellular vesicle-related genes. Asthma-related genes were primarily involved in antigen binding and MHC class II protein complex binding, whereas Kawasaki disease genes were associated with Toll-like receptor binding and calcium-dependent protein binding.