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Pediatr Surg Int 2022 Jul 2. Epub 2022 Jul 2.

Department of Surgery, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.

Purpose: Radical surgery for congenital tracheal stenosis (CTS) is technically demanding. CTS combined with tracheal bronchus (TB) and pulmonary artery (PA) sling is a particularly challenging condition. We herein report our successfully modified surgical techniques for CTS combined with TB and PA sling. Read More

Semin Respir Crit Care Med 2022 Jun 27. Epub 2022 Jun 27.

Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.

Acute Respiratory Distress Syndrome (ARDS) accounts for 10% of ICU admissions and affects 3 million patients each year. Despite decades of research, it is still associated with one of the highest mortality rates in the critically ill. Advances in supportive care, innovations in technologies and insights from recent clinical trials have contributed to improved outcomes and a renewed interest in the scope and use of Extracorporeal life support (ECLS) as a treatment for severe ARDS, including high flow veno-venous Extracorporeal Membrane Oxygenation (VV-ECMO) and low flow Extracorporeal Carbon Dioxide Removal (ECCO2R). Read More

Front Pediatr 2022 31;10:885405. Epub 2022 May 31.

Paediatric Respiratory Medicine, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

Objective: To evaluate the immediate and sustained knowledge retention and sense of self-efficacy of homecare nurses following completion of a standardized competency-based tracheostomy education course. Safe discharge of children requiring tracheostomy with or without ventilation relies on the competence of homecare nurses.

Study Design: Pragmatic, randomized controlled trial of 44 homecare nurses. Read More

J Pediatr Rehabil Med 2022 Jun 23. Epub 2022 Jun 23.

St. Mary's Hospital for Children, Bayside, NY, USA.

Purpose: The need for pediatric post-acute facility care (PAC) is growing due to technological advances that extend the lives of many children, especially those with complex medical needs. The objectives were to describe [1] the types and settings of PAC; [2] the clinical characteristics of the pediatric patients requiring PAC; and [3] perceptions of PAC care delivery by clinical staff.

Methods: An online survey was administered between 6/2018 to 12/2018 to administrative leaders in PAC facilities that have licensed beds for children and who were active members of the Pediatric Complex Care Association. Read More

Laryngoscope 2022 Jun 17. Epub 2022 Jun 17.

Department of Otolaryngology - Head & Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Objectives: To determine the incidence of tracheostomy accidental decannulations (AD) among pediatric inpatients and identify risks for these events.

Study Design: Prospective cohort.

Methods: All tracheostomy patients (≤18 years) admitted at a tertiary children's hospital between August 2018 and April 2021 were included. Read More

J Neuromuscul Dis 2022 Jun 7. Epub 2022 Jun 7.

Astellas Gene Therapies (formerly Audentes Therapeutics), San Francisco, CA, USA.

BackgroundX-linked myotubular myopathy (XLMTM) is a life-threatening congenital myopathy that, in most cases, is characterized by profound muscle weakness, respiratory failure, need for mechanical ventilation and gastrostomy feeding, and early death.ObjectiveWe aimed to characterize the neuromuscular, respiratory, and extramuscular burden of XLMTM in a prospective, longitudinal study.MethodsThirty-four participants <  4 years old with XLMTM and receiving ventilator support enrolled in INCEPTUS, a prospective, multicenter, non-interventional study. Read More

Pediatr Crit Care Med 2022 Jun 10. Epub 2022 Jun 10.

Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA.

Objectives: To describe epidemiology, interventions, outcomes, and the health services experience for a cohort of children with pulmonary hypertension (PH) who underwent tracheostomy placement and to identify risk factors for inhospital mortality and 30-day readmissions.

Design: Retrospective cohort study of the Pediatric Health Information System database.

Setting: Thirty-seven freestanding U. Read More

Plast Reconstr Surg Glob Open 2022 Jun 6;10(6):e4361. Epub 2022 Jun 6.

Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.

Pierre Robin sequence (PRS) is characterized by mandibular micrognathia, glossoptosis, and airway obstruction. We report a case of a female infant with PRS in combination with deletion of chromosome 4q and cardiac insufficiency due to an atrioventricular septum defect. The child was transferred to our center from a peripheral hospital with respiratory insufficiency. Read More

Braz J Otorhinolaryngol 2022 May 20. Epub 2022 May 20.

Hospital de Clínicas de Porto Alegre (HCPA), Serviço de Otorrinolaringologia e Cirurgia Cérvico-Facial, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.

Objectives: To evaluate the bacterial microbiome found in tracheostomy cannulas of a group of children diagnosed with glossoptosis secondary to Robin Sequence (RS), and its clinical implications.

Methods: Pediatric patients were enrolled in the study at the time of the cannula change in the hospital. During this procedure, the removed cannula was collected and stored for amplicon sequencing of 16s rRNA. Read More

J Perinatol 2022 Jun 8. Epub 2022 Jun 8.

Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.

Objective: To evaluate factors associated with discontinuation of pulmonary vasodilator therapy in bronchopulmonary dysplasia-related pulmonary hypertension (BPD-PH).

Study Design: Retrospective study of neonatal, echocardiographic, and cardiac catheterization data in 121 infants with BPD-PH discharged on pulmonary vasodilator therapy from 2009-2020 and followed into childhood.

Result: After median 4. Read More

Pediatr Pulmonol 2022 Jun 4. Epub 2022 Jun 4.

Section of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA.

We report a series of four patients with severe bronchopulmonary dysplasia (BPD) who underwent posterior tracheopexy for severe tracheomalacia (TM). While posterior tracheopexy is an established surgical treatment for TM associated with tracheoesophageal fistula, it has not been previously described in TM associated with BPD. There were no significant intraoperative or postoperative complications from the surgeries. Read More

Iran J Otorhinolaryngol 2022 Mar;34(121):127-130

Deparment of Pathology & Lab Medicine, AIIMS, Bhubaneswar, India.

Introduction: Benign lymphoid hyperplasia uncommonly involves the larynx. Involvement of glottis and subglottis is even rare, considering sparse lymphatic supply compared to supraglottis.

Case Report: A young female presented to emergency with worsening breathing difficulty. Read More

Int J Pediatr Otorhinolaryngol 2022 Jul 27;158:111192. Epub 2022 May 27.

Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos körút 111, Szeged, 6725, Hungary.

Objectives: Slide laryngotracheoplasty is an effective, single-step procedure without tracheostomy and stenting for treating high-grade congenital subglottic stenosis in neonates and infants. Long-term outcomes were evaluated to assess the reliability of the procedure performed in this age of rapid development of the laryngeal structures.

Methods: We report five children who underwent slide laryngotracheoplasty before the age of 4 months, each with >3 years follow-up. Read More

Int J Pediatr Otorhinolaryngol 2022 Jul 12;158:111135. Epub 2022 Apr 12.

Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.

Objective: To describe our institutional experience in implementing a pre-tracheostomy multidisciplinary conference and assess its effects on patient selection and communication between team members and with families.

Methods: Descriptive study and retrospective review of patient outcomes in a period prior to (4/2016-1/2018) and following (2/2018-11/2019) implementation of the conference and conference participant survey.

Results: In the 21 months prior to the conference, 53 patients out of 67 consults (79%) went on to have a tracheostomy. Read More

Turk Arch Otorhinolaryngol 2022 Mar 12;60(1):1-8. Epub 2022 May 12.

Department of Otolaryngology, Head and Neck Surgery, Bursa Uludağ University School of Medicine, Bursa, Turkey.

Objective: The purpose of this study was to analyze the treatment outcomes and postoperative complications of tracheal resection in patients under the age of 19 years with post-intubation tracheal stenosis, and to compare the results with those of adults.

Methods: Data were retrospectively retrieved from the medical records, including demographic characteristics, perioperative features, any postoperative complications and follow-up statuses of the patients. Treatment results and postoperative complications were compared between adolescent and adult groups. Read More

ATS Sch 2022 Mar 11;3(1):135-143. Epub 2022 Mar 11.

Center for Research, Innovation, and Scholarship in Medical Education, Texas Children's Hospital.

Background: The pandemic poses challenges for in-person procedural skills training. We developed a virtual module for teaching hands-on tracheostomy skills.

Objective: To develop and evaluate a virtual module prototype grounded in deliberate practice using tracheostomy change as an example. Read More

Children (Basel) 2022 Apr 29;9(5). Epub 2022 Apr 29.

Department of Medicine, MacKay Medical College, New Taipei 25160, Taiwan.

Enterovirus infection is endemic in many areas, especially in Southeast Asia. Enterovirus infection with severe complications (EVSC) is life-threatening, and timely diagnosis and management are crucial for successful management. Here, we report on a 2-year-old boy with hand, foot, and mouth disease. Read More

Clin Nutr ESPEN 2022 06 9;49:114-120. Epub 2022 Apr 9.

Post Graduate Program in Pediatrics and Child Health of PUCRS - Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6681 - Partenon, Porto Alegre, 90619-900, RS, Brazil; Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6681 - Partenon, Porto Alegre, 90619-900 - RS, Brazil. Electronic address:

Background & Aims: Concomitantly to the coronavirus disease 2019 (COVID-19), in the child population there was already another pandemic wave in progress: childhood obesity. Numerous studies in adults have been carried out and describe obesity as an independent risk and prognostic factor for the severity of COVID-19. This study aims to systematically review the literature on the relation between weight excess and the severity of COVID-19 in children and adolescents. Read More

JAMA Otolaryngol Head Neck Surg 2022 May 26. Epub 2022 May 26.

Department of Otolaryngology-Head and Neck Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Importance: Button batteries (BBs) are commonly found in many household items and present a risk of severe injury to children if ingested. The direct apposition of the trachea and recurrent laryngeal nerves with the esophagus puts children at risk of airway injury secondary to the liquefactive necrotic effects of BB impactions.

Objective: To review airway injuries, including long-term sequelae, after BB ingestion in children. Read More

Otolaryngol Head Neck Surg 2022 May 24:1945998221100829. Epub 2022 May 24.

Department Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA.

Objective: To determine how often children with airway injury at the time of tracheostomy develop airway stenosis.

Study Design: A 7-year retrospective review of a prospectively maintained database of pediatric patients who underwent endotracheal intubation followed by tracheostomy with concurrent and follow-up direct laryngoscopy.

Setting: Tertiary care hospital. Read More

Crit Care Med 2022 May 16. Epub 2022 May 16.

Division of Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI.

Objectives: The use of extracorporeal membrane oxygenation (ECMO) in patients with COVID-19 has been supported by major healthcare organizations, yet the role of specific management strategies during ECMO requires further study. We sought to characterize tracheostomy practices, complications, and outcomes in ECMO-supported patients with acute respiratory failure related to COVID-19.

Design: Retrospective cohort study. Read More

Int J Pediatr Otorhinolaryngol 2022 Jul 14;158:111181. Epub 2022 May 14.

Department of Otolaryngology, Head and Neck Surgery, Jacobs School Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, USA. Electronic address:

Background: Pediatric benign laryngeal tumors can often be treated as same-day surgeries. This study identified factors associated with prolonged hospital stay in children undergoing laryngeal surgery for benign tumors.

Methods: A retrospective analysis of records of pediatric patients who underwent laryngeal surgery with a post-op diagnosis of benign tumor was performed with the American College of Surgeons Pediatric National Surgery Quality Improvement Program (ACS-NSQIP-P) database (2014-2018). Read More

Am J Case Rep 2022 May 20;23:e936072. Epub 2022 May 20.

Division of Pediatric Anesthesiology, Children's Health System of Dallas, Dallas, TX, USA.

BACKGROUND A wide variety of emergency scenarios associated with tracheostomy tubes have been reported in patients with complex airway disease. Fracture of a tracheostomy tube is a rare complication with a potential for catastrophic outcome. The aim of this case report is to present clinical features and management of airway compromise due to a fractured tracheostomy tube in a patient with subglottic and tracheal stenosis. Read More

Pediatr Pulmonol 2022 May 16. Epub 2022 May 16.

Department of Pediatrics, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Objective: To describe characteristics, outcomes, and risk factors for death or tracheostomy with home mechanical ventilation in full-term infants with chronic lung disease (CLD) admitted to regional neonatal intensive care units.

Study Design: This was a multicenter, retrospective cohort study of infants born ≥37 weeks of gestation in the Children's Hospitals Neonatal Consortium.

Results: Out of 67,367 full-term infants admitted in 2010-2016, 4886 (7%) had CLD based on receiving respiratory support at either 28 days of life or discharge. Read More

Arch Dis Child 2022 May 16. Epub 2022 May 16.

Pediatric Neurology Unit and Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Lazio, Italy

Introduction: The aim of the study was to longitudinally assess swallowing abilities in nusinersen-treated patients with type 1 spinal muscular atrophy.

Methods: Twenty infants with type 1 SMA (11 female and 9 male) treated with nusinersen between 3 weeks and 15 months of age, were assessed using the Oral and Swallowing Abilities Tool (OrSAT). The duration of the follow-up after treatment ranged between 12 months and 62 months. Read More

JAMA Pediatr 2022 May 16. Epub 2022 May 16.

Department of Paediatric Otolaryngology, Great North Children's Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.

Ear Nose Throat J 2022 May 14:1455613221102869. Epub 2022 May 14.

OtorhinoLaryngology-Head and Neck Surgery Department, 48103Asir Central Hospital, Abha, Saudi Arabia.

Complete laryngotracheal separation is a rare life-threatening trauma that may occur due to road traffic accidents. Unfortunately, this injury may be missed if emergency physicians were not aware of its possibility. We present a pediatric patient who had complete laryngotracheal separation and esophageal injury caused by strangulation with a headscarf while riding a four-wheeled motorcycle. Read More

Sleep Breath 2022 May 13. Epub 2022 May 13.

Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.

Purpose: Patients with congenital central hypoventilation syndrome (CCHS) have autonomic dysfunction and lack ventilatory responses to hypoxemia and hypercarbia and thus are prone to adverse events during general anesthesia. The objective of this study was to describe the perioperative outcomes of patients with CCHS who were undergoing diaphragm pacer (DP) implantation surgeries under general anesthesia.

Methods: A retrospective cohort study was conducted on patients with CCHS who underwent DP implantation surgeries at CHLA between January 2000 and May 2016. Read More

Pediatr Pulmonol 2022 Jul 21;57(7):1826-1829. Epub 2022 May 21.

Department of Paediatrics, Respiratory Medicine Service, KK Women's & Children's Hospital, Singapore, Singapore.

Background: HIDEA (hypotonia, hypoventilation, intellectual disability, dysautonomia, epilepsy and eye abnormalities) syndrome is a rare and novel disease. We describe a premature patient who required extensive work up for his hypoventilation with a diagnosis of HIDEA syndrome.

Case Description: The patient was born to a pair of consanguineous parents at 32-week gestation. Read More

Laryngoscope 2022 May 12. Epub 2022 May 12.

Department of Otolaryngology - Head & Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Objectives: To determine the incidence of tracheocutaneous fistula (TCF) and identify characteristics associated with persistence.

Study Design: Prospective cohort.

Methods: All successfully decannulated children (<18 years) between 2014 and 2020 at a tertiary children's hospital were included. Read More