Pediatric Respirology and Critical Care Medicine

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Background: Respiratory distress in children must be promptly recognized and aggressively treated because they decompensate quickly leading to adverse outcomes. Objectives: To determine the outcomes of children admitted with respiratory distress based on PRESS score. Study Design: A prospective study which was done between September 2018 and March 2020. A total of 90 children of age group 1 month to 10 years with respiratory distress at the time of admission. Intervention: The PRESS scoring was done and outcomes measured which included use of Respiratory support [nasal cannula, high flow nasal cannula (HFNC), mechanical ventilation (MV)], duration of ICU and hospital stay. Results: Compared to moderate PRESS score, children with severe PRESS score had significantly more admission in PICU (91.30% vs 64.18%, P = 0.016); significantly more number of days of hospital stay (7 vs 5, P = 0.001); significantly more number of days of ICU stay (5 vs 3, P<.0001); significantly more median days of respiratory support (4 vs 3, P<.0001); significantly more use of respiratory support (67 vs 23patients, P < 0.0003) and more HFNC usage (73.91% vs 20.90%, P<.0001). However there was comparable requirement of mechanical ventilation between the two groups (8.7% vs 0%, P = 0.063). Conclusion: PRESS score can be a useful respiratory scoring system in triaging the children at the time of admission and in predicting the requirement of respiratory support and duration of hospital stay. It probably may serve as a useful tool at the community level to consider referral to an appropriate health facility in view of its simplicity.

Objective: In this study, we primarily evaluated the effects of IMMUPHYLA LCW23 on symptoms of allergic rhinitis. IMMUPHYLA LCW23 is a commercial probiotic product containing the Lactobacillus paracasei LCW23 strain. Materials and Methods: Sixty 5–18-year-old children with allergic rhinitis positive for the dust mite-specific bivalent antibody and meeting the inclusion criteria were enrolled in this double-blind, randomized, placebo-controlled trial. They were administered 2–4 g of the probiotic product containing L. paracasei LCW23 (2.5 × 10⁹ cells/g; n = 28) or a placebo supplement (n = 32) according to their body weights for 12 weeks. After the treatment period, a self-assessment of allergic rhinitis symptoms in the nose and eyes was performed. Results: This study results revealed that 12-week supplementation with IMMUPHYLA LCW23 is safe, with no side effects. In addition, the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) assessment revealed that the probiotic significantly alleviated general discomfort (P = 0.003) and common symptoms of allergic rhinitis, such as nasal congestion (P = 0.033), runny nose (P = 0.001), and blowing nose (P = 0.008). Conclusion: Administration of IMMUPHYLA LCW23 was safe in the long-term follow-up study. The probiotic likely reduced the risk of allergy prevalence, without any major side effects.

Introduction: Pulse oximetry is currently used to screen for obstructive sleep apnoea (OSA) in children. However, its use in infant has not yet been well studied. Aim: The aim of this study was to develop a screening criterion using pulse oximetry to identify infant with probable OSA. Materials and Methods: This was a retrospective cross-sectional study including infants <1 year of age with features of upper airway obstruction or requiring home oxygen to find associations between obstructive apnoea hypopnoea index (OAHI) in infant polysomnography (PSG) and parameters in pulse oximetry by Spearman Rho’s correlation. The factor with the strongest correlation is further analysed by receiver-operating characteristic (ROC) curve to identify a cutoff with highest Youden index to screen for probable OSA (OAHI >2 per hour). Results: A total of 27 infants were studied. The index of oxygen desaturation with SpO2 <90% per sampled hour (ODI<90%) had the best correlation with OAHI (r = 0.52, P = 0.005). Using the cutoff of ODI<90% more than 1.3 per hour, the sensitivity and specificity for identifying OAHI >2 per hour was 77% and 71%, respectively. Conclusion: Infant pulse oximetry can be a useful tool to screen for probable infant OSA especially for paediatric units not offering infant PSG service.

Online since 1^st July, 2016