Pediatric Respirology and Critical Care Medicine

EDITORIAL
Year
: 2019  |  Volume : 3  |  Issue : 4  |  Page : 65--66

From acute respiratory infection, chronic atelectasis, to intensive hemodynamic assessment


Yu-Tsun Su 
 Department of Pediatrics, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan

Correspondence Address:
Yu-Tsun Su
Department of Pediatrics, E-Da Hospital/I-Shou University, Kaohsiung
Taiwan




How to cite this article:
Su YT. From acute respiratory infection, chronic atelectasis, to intensive hemodynamic assessment.Pediatr Respirol Crit Care Med 2019;3:65-66


How to cite this URL:
Su YT. From acute respiratory infection, chronic atelectasis, to intensive hemodynamic assessment. Pediatr Respirol Crit Care Med [serial online] 2019 [cited 2022 Aug 10 ];3:65-66
Available from: https://www.prccm.org/text.asp?2019/3/4/65/296480


Full Text



The current issue includes three very solid articles, from acute illness, chronic sequelae, to intensive care of critical illness, which are all related to the scope of the journal, namely technical and clinical studies in the field of basic and clinical research on pediatric respirology and pediatric critical care medicine. The first article evaluated the prevalence of viral and atypical bacterial infections in young children hospitalized due to acute lower respiratory tract infections in southern Thailand. The second article studied the clinical characteristics and outcomes of ambulatory children with chronic middle-lobe atelectasis (MLA). The third article assessed the correlations among three key noninvasive hemodynamic parameters in ventilated children, including aortic peak blood flow velocity variation (ΔVpeak), inferior vena cava diameter variation (ΔIVC), and stroke volume variation (SVV).

Acute lower respiratory tract infections (ALTIs) are the most common cause of hospitalization in children, and identifying the pathogen is very important because it determines the clinical course and treatment strategy. Several studies have investigated the pathogens that cause ALTIs in young children in Asian countries. Nathan et al. reported that the most common viruses identified in children with ALTIs below 2 years of age in Malaysia were respiratory syncytial virus (RSV), human rhinovirus (hRV), and parainfluenza virus.[1] Sung et al. reported that RSV was the most common pathogen causing ALTIs in young children <3 years of age in Taiwan.[2] Because the pathogens in Thailand have not been well established, Ruangnapa et al. conducted a retrospective study to determine the prevalence of viral and atypical bacterial infections in young children hospitalized due to ALTIs.[3] In their study, the viral pathogens such as RSV B (39.0%), RSV A (20.7%), and hRV (12.2%) were detected in 76% of the patients, while atypical bacteria were not found. These data help to understand the similarity of RSV in ALTIs in younger children in Thailand and other countries, such as Malaysia and Taiwan.

It is usually challenging for pediatricians to identify the etiology and make treatment strategies for atelectasis. Wong and Chiu conducted a retrospective chart analysis study to present their experience of ambulatory children with chronic MLA at a pediatric facility.[4] They found that only 13.3% of the patients were diagnosed with isolated MLA, and the other 86.7% had associated atelectasis or bronchiectasis in other parts of the lung. The most common causes of chronic MLA were postinfectious bronchiectasis (40%) and immunodeficiency (23.3%). The authors concluded that in certain MLA cases, a chronic suppurative lung disease with or without bronchiectasis should be considered, either postinfectious or related to recurrent aspiration.

Assessing hemodynamics is essential in critical patients and helps to improve outcomes. Recent noninvasive parameters including ΔVpeak, ΔIVC, and SVV assessed using ultrasound or Doppler have been shown to assist in rapidly assessing hemodynamics in critical care. Boonjindasup and Samransamruajkit conducted a prospective cohort study on mechanically ventilated children to assess correlations among ΔVpeak, ΔIVC, and SVV.[5] They found significantly positive correlations among ΔVpeak, ΔIVC, and SVV, which supports the interchange of monitoring. ΔVpeak and SVV in particular provided the best, though moderate, correlation (Pearson's correlation coefficient, r = 0.539; P < 0.001). These two parameters may be a surrogate of each other for hemodynamic monitoring in mechanically ventilated children.

These three articles are related to and expand the knowledge on “Pediatric Respirology and Critical Care Medicine.” To share your research with a wide audience, we invite you to submit to this expanding and well-respected journal.

During the COVID-19 pandemic, we hope you are safe and well!

References

1Nathan AM, Qiao YL, Jafar FL, Chan YF, Eg KP, Thavagnanam S, et al. Viruses and hospitalization for childhood lower respiratory tract infection in Malaysia: A prospective study. Pediatr Respirol Crit Care Med 2017;1:46-51.
2Sung CC, Chi H, Chiu NC, Huang DT, Weng LC, Wang NY, et al. Viral etiology of acute lower respiratory tract infections in hospitalized young children in Northern Taiwan. J Microbiol Immunol Infect 2011;44:184-90.
3Ruangnapa K, Kaeotawee P, Surasombatpattana P, Kemapunmanus M, Intusoma U, Saelim K, et al. Viral and atypical bacterial infection in young children hospitalized due to acute lower respiratory tract infection in Southern Thailand. Pediatr Respirol Crit Care Med 2020;3:67-71.
4Wong KS, Chiu CY. Chronic right middle lobe atelectasis in ambulatory children. Pediatr Respirol Crit Care Med 2019;3:72-5.
5Boonjindasup W, Samransamruajkit R. Correlation between variation of aortic peak blood flow velocity, inferior vena cava diameter variation and stroke volume variation in children. Pediatr Respirol Crit Care Med 2019;3:76-80.