Pediatric Respirology and Critical Care Medicine

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This review highlights and summarizes the current evidence and knowledge of nasal high flow therapy management in infants and children. This review outlines the distinct differences in the use of NHF therapy between children and adults. A comprehensive literature review has been performed reviewing the relevant physiological studies and current evidence of support measures in these children. Despite the quick uptake of nasal high flow therapy in the clinical area there has been limited high-grade evidence, with new studies showing beneficial results with the use of nasal high flow therapy in acute respiratory disease and children.

Background: Mycoplasma pneumoniae is an important pathogenic bacterium that causes community-acquired pneumonia in children. Rapid and dependable laboratory diagnosis of M. pneumoniae infection is important for starting an appropriate antibiotic treatment. Currently, the serological testing for detection of M. pneumoniae immunoglobulin M (IgM) has been used to determine the presence of an acute infection, the results of which, depending on the laboratory facility, are not available immediately. Therefore, an optimal and instant detection method is needed to facilitate a more accurate diagnosis, which leads to the appropriate treatment of patients with M. pneumoniae-related pneumonia and reduces rates of resistance to antibiotics because of their misuse. Aims: Here, we investigated the clinical diagnostic value of a rapid detection kit for M. pneumoniae-specific IgM antibody, the BioCard Mycoplasma IgM rapid test, in the detection of a Mycoplasma infection in children. Material and Method: 44 pediatric patients with clinically suspected Mycoplasma infection were enrolled for study. Result: Among 82 Mycoplasma IgM-positive samples, 51 samples were detected to be positive using the BioCard rapid test. The sensitivity and specifi city of the kit were 62.20% (51/82) and 100% (16/16), respectively. The positive and negative predictive values were 100% (51/51) and 34.04% (16/47), respectively. Conslusion: In conclusion, the BioCard Mycoplasma IgM rapid test provides an accurate point-of-care diagnosis for M. pneumonia infection.

Background: Wheeze has been reported to affect one-third of preschoolchildren. While different wheeze patterns have been shown to predict future asthma risk, limited data are available on the risk factors for preschool wheeze in Asia. Methods: Preschool children admitted to hospitals through emergency departments for wheeze, from 2004 to 2015 in Hong Kong, were retrospectively identified. Potential risk factors for admissions over the same period were retrieved (i.e., air pollutants, preterm delivery, and maternal age). Results: A total of 46,258 patients meeting the inclusion criteria were identified during the 12-year period. The preschool wheeze admission rate increased by 34% over the past 12 years, with an average year-on-year rise of 4.2%. Environmental nitrogen dioxide (NO₂) concentration was significantly associated with an increase in admission for preschool wheeze (r = 0.63, P = 0.028). Univariate regression analysis was performed on potential risk factors. Annual average NO₂concentration (P = 0.007) and maternal age more than 40 years (P = 0.012) were significant risk factors. For multivariable regression analysis, annual average NO₂concentration (β = 0.18, 95% confidence interval = 0.06–0.30) was the only independent factor associated with preschool wheeze admission. Conclusions: The increase of NO₂concentration is a significant risk factor for the increase in hospitalizations for preschool wheeze in Hong Kong.

Online since 1^st July, 2016