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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

Ochsner J 2022 ;22(2):196-198

Department of Pediatrics, Ochsner Louisiana State University Health-Shreveport, Shreveport, LA.

Respiratory distress is a clinical finding often seen in neonates. Common causes of respiratory distress in this population include respiratory distress syndrome, transient tachypnea of the newborn, infection, aspiration, and cardiac etiologies. We present the case of a neonate who presented with respiratory distress with no identifiable cause on initial workup. Read More

Dysphagia 2022 Jun 24. Epub 2022 Jun 24.

Program in Pediatric Pulmonary Medicine, Division of Pulmonology, Department of Pediatrics, University of Tennessee Health Science Center, LeBonheur Children's Hospital, Faculty Office Building, Room 224, 49 North Dunlap Street, Memphis, TN, 38105, USA.

Coronavirus (COVID-19) infection usually causes mild symptoms in children. However, serious complications may occur as a result of both acute infection or in association with the multisystem inflammatory syndrome (MIS-C). Dysphagia may develop as a sequela of COVID-19. Read More

Swiss Med Wkly 2022 05 13;152:w30174. Epub 2022 May 13.

Newborn Research, Department of Neonatology, University of Zurich and Zurich University Hospital, Zurich, Switzerland.

Aims Of The Study: To assess whether the COVID-19 pandemic caused by SARS-CoV-2 had an impact on incidence, treatment or major adverse short-term outcome of preterm-born infants in Switzerland.

Methods: Retrospective cohort study of preterm infants born in 2020 based on two independent data sources from the Swiss Federal Statistics Office (FSO) and SwissNeoNet. Based on FSO data, we calculated the odds ratios for extremely preterm (22-27 weeks gestation), very preterm (28-31 weeks gestation), and late preterm (32-36 weeks gestation) births during the pandemic. Read More

Front Immunol 2022 6;13:890710. Epub 2022 Jun 6.

Department of Pediatrics, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Background: Type II alveolar epithelial cell (AEC II), in addition to its roles in maintaining lung homeostasis, takes an active role in inflammatory response during acute lung injury (ALI). Ca/calmodulin-dependent protein kinase IV (CaMK4) activated by Ca/calmodulin signaling, has been implicated in immune responses. This study was to investigate the roles of CaMK4 in the development of ALI and the underlying mechanisms. Read More

J Matern Fetal Neonatal Med 2022 Jun 22:1-8. Epub 2022 Jun 22.

Department of Pediatrics, Peking University People's Hospital, Beijing, China.

Aim: The study aimed to determine the association between cord plasma levels of apelin and vascular endothelial growth factor (VEGF) with respiratory distress syndrome (RDS) in preterm infants.

Methods: This case-control study included 120 preterm infants admitted to the neonatal intensive care unit of our hospital between January 2019 and January 2020. The infants were divided into RDS ( = 60) and non-RDS groups ( = 60). Read More

Horm Mol Biol Clin Investig 2022 Jun 21. Epub 2022 Jun 21.

Department of Biochemistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India.

Many studies conducted after the pandemic period revealed that, while COVID-19 primarily injured the lungs, it also affects other organs in the form of cardiovascular complications, metabolic derangements, renal damage, and so on. Although we know that inflammatory cascades, complement activation, and pro-inflammatory cytokines are all involved in vasculitic processes that cause organ damage, we do not know the exact mechanism of complications such as acute respiratory distress syndrome (ARDS), cardiovascular ischemia, deep vein thrombosis, pulmonary thromboembolism, and brain injuries (embolism) that are frequently observed in COVID 19. The currently available biomarkers do not predict the severity of the aforementioned complications. Read More

J Antimicrob Chemother 2022 Jun 21. Epub 2022 Jun 21.

Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

Background: Isavuconazole is an antifungal drug used for treatment of invasive fungal infections. Critically ill COVID-19 and influenza patients require extracorporeal membrane oxygenation (ECMO) in cases with severe acute respiratory distress syndrome and have risk factors for invasive pulmonary aspergillosis. Little is known about isavuconazole plasma concentrations during ECMO. Read More

BMC Pediatr 2022 Jun 20;22(1):354. Epub 2022 Jun 20.

Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.

Background: Transient tachypnea of the newborn (TTN), as a common cause of neonatal respiratory distress, needs to be distinguished from respiratory distress syndrome (RDS). Various modalities such as lung ultrasonography, cytokine analysis, and electrical cardiometry for the evaluation of lung fluid can be helpful for the exact diagnosis, however, clinical diagnosis has been applied mainly. This study aimed to evaluate the usefulness of the various tools for the diagnosis of TTN and RDS in neonates. Read More

J Mass Spectrom Adv Clin Lab 2022 Jun 11. Epub 2022 Jun 11.

Department of Pediatrics, Division of Pediatric Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.

Introduction: Remdesivir (GS-5734) is a nucleoside analog prodrug with antiviral activity against several single-stranded RNA viruses, including the novel severe respiratory distress syndrome virus 2 (SARS-CoV-2). It is currently the only FDA-approved antiviral agent for the treatment of individuals with COVID-19 caused by SARS-CoV-2. However, remdesivir pharmacokinetics/pharmacodynamics (PK/PD) and toxicity data in humans are extremely limited. Read More

Front Immunol 2022 1;13:864387. Epub 2022 Jun 1.

Discipline of Paediatrics, Dublin Trinity College, The University of Dublin, Dublin, Ireland.

Unusually for a viral infection, the immunological phenotype of severe COVID-19 is characterised by a depleted lymphocyte and elevated neutrophil count, with the neutrophil-to-lymphocyte ratio correlating with disease severity. Neutrophils are the most abundant immune cell in the bloodstream and comprise different subpopulations with pleiotropic actions that are vital for host immunity. Unique neutrophil subpopulations vary in their capacity to mount antimicrobial responses, including NETosis (the generation of neutrophil extracellular traps), degranulation and production of cytokines and chemokines. Read More

Drugs Context 2022 27;11. Epub 2022 May 27.

Department of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong.

Background: Many syndromes are associated with exaggerated inflammation. Children with hyperinflammatory syndromes often present with vague and non-specific symptoms that pose diagnostic and management challenges. The recent literature seems biased towards referring these syndromes only to the multisystem inflammatory syndrome in children (MIS-C) that is associated with COVID-19. Read More

Front Pediatr 2022 31;10:890755. Epub 2022 May 31.

Department of Pediatrics, Wakayama Medical University, Wakayama, Japan.

Multisystem inflammatory syndrome in children (MIS-C) is a new syndrome involving the development of severe dysfunction in multiple organs after severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection. Because the pathophysiology of MIS-C remains unclear, a treatment strategy has not yet been established. We experienced a 12-year-old boy who developed MIS-C at 56 days after SARS-CoV-2 infection and for whom ciclosporin A (CsA) was effective as a third-line treatment. Read More

Am J Physiol Lung Cell Mol Physiol 2022 Jun 14. Epub 2022 Jun 14.

Department of Bioengineering, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, United States.

Supportive mechanical ventilation is a necessary lifesaving treatment for acute respiratory distress syndrome (ARDS). This intervention often leads to injury exacerbation by ventilator-induced lung injury (VILI). Patterns of injury in ARDS and VILI are recognized to be heterogeneous; however, quantification of these injury distributions remains incomplete. Read More

Am J Physiol Lung Cell Mol Physiol 2022 Jun 14. Epub 2022 Jun 14.

VA San Diego Healthcare System, San Diego, CA, United States.

Increased plasma mitochondrial DNA concentrations are associated with poor outcomes in multiple critical illnesses, including COVID-19. However, current methods of cell-free mitochondrial DNA quantification in plasma are time-consuming and lack reproducibility. Here, we used next-generation sequencing to characterize the size and genome location of circulating mitochondrial DNA in critically ill subjects with COVID-19 to develop a facile and optimal method of quantification by droplet digital PCR. Read More

Fertil Steril 2022 Jun 10. Epub 2022 Jun 10.

Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Objective: To evaluate reproductive, obstetric, and long-term health of the first completed study of uterus transplantation (UTx).

Design: Prospective.

Setting: University hospital. Read More

Front Pediatr 2022 25;10:867171. Epub 2022 May 25.

Department of Pediatrics, Albany Medical College, Albany, NY, United States.

Maternal obesity has been associated with pregnancy-related complications and neonatal morbidities. The primary aim of this study was to evaluate early neonatal morbidities associated with maternal obesity from the infant-mother dyad data set at a single, large Regional Perinatal Center (RPC) in NY. A retrospective chart review of all mother-infant dyads born from January 2009 to December 2019 was done. Read More

Front Pediatr 2022 27;10:877200. Epub 2022 May 27.

Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Introduction: In 2020, over 6,500 newborn deaths occured every day, resulting in 2.4 million children dying in their 1st month of life. Ethiopia is one of the countries that will need to step up their efforts and expedite progress to meet the 2030 sustainable development goal. Read More

Cell Rep 2022 Jun 25;39(11):110945. Epub 2022 May 25.

Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Center for CF and Airways Disease Research, Children's Healthcare of Atlanta, Atlanta, GA, USA. Electronic address:

SARS-CoV-2-infected subjects are generally asymptomatic during initial viral replication but may suffer severe immunopathology after the virus has receded and monocytes have infiltrated the airways. In bronchoalveolar lavage fluid from severe COVID-19 patients, monocytes express mRNA encoding inflammatory mediators and contain SARS-CoV-2 transcripts. We leverage a human small airway model of infection and inflammation, whereby primary blood monocytes transmigrate across SARS-CoV-2-infected lung epithelium to characterize viral burden, gene expression, and inflammatory mediator secretion by epithelial cells and monocytes. Read More

Am J Respir Cell Mol Biol 2022 Jun 9. Epub 2022 Jun 9.

Harvard Medical School, 1811, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States.

Clinical and molecular heterogeneity are common features of human disease. Understanding the basis for heterogeneity has led to major advances in therapy for many cancers and pulmonary diseases such as cystic fibrosis and asthma. Although heterogeneity of risk factors, disease severity and outcomes in survivors are common features of the Acute Respiratory Distress Syndrome (ARDS), many challenges exist in understanding the clinical and molecular basis for disease heterogeneity and using heterogeneity to tailor therapy for individual patients. Read More

Front Med (Lausanne) 2022 23;9:805680. Epub 2022 May 23.

Department of Critical Care Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Purpose: To investigate the difference in the positive end-expiratory pressure (PEEP) selected with chest electrical impedance tomography (EIT) and with global dynamic respiratory system compliance (C) in moderate-to-severe pediatric acute respiratory distress syndrome (pARDS).

Methods: Patients with moderate-to-severe pARDS (PaO/FiO < 200 mmHg) were retrospectively included. On the day of pARDS diagnosis, two PEEP levels were determined during the decremental PEEP titration for each individual using the best compliance (PEEP) and EIT-based regional compliance (PEEP) methods. Read More

Am J Physiol Lung Cell Mol Physiol 2022 Jun 7. Epub 2022 Jun 7.

Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado, Aurora, CO, United States.

The Acute Respiratory Distress Syndrome (ARDS) is a major healthcare problem, accounting for significant mortality and long-term disability. Approximately 25% of patients with ARDS will develop an over-exuberant fibrotic response, termed fibroproliferative ARDS (FP-ARDS) that portends a poor prognosis and increased mortality. The cellular pathologic processes that drive FP-ARDS remain incompletely understood. Read More

Sci Rep 2022 Jun 4;12(1):9331. Epub 2022 Jun 4.

Departmenet of Emergency Medicine, Shizuoka General Hospital, 4-27-1, Kitaando, Aoiku, Shizuoka, Japan.

The effects of lower tidal volume ventilation (LTV) were controversial for patients with acute respiratory distress syndrome (ARDS). This systematic review and meta-analysis aimed to evaluate the use of LTV strategy in patients with ARDS. We performed a literature search on MEDLINE, CENTRAL, EMBASE, CINAHL, "Igaku-Chuo-Zasshi", clinical trial registration sites, and the reference of recent guidelines. Read More

BMC Pediatr 2022 Jun 3;22(1):327. Epub 2022 Jun 3.

Department of Surgery, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.

Background: Despite the relative prevalence of small bowel and proximal colon perforation in the neonatal period, recto-sigmoid perforation is extremely rare. Full-term neonates experience intestinal perforation less frequently than premature infants. Here we report a neonate with sigmoid perforation and simultaneous Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. Read More

Pediatr Res 2022 Jun 2. Epub 2022 Jun 2.

Department of Pediatrics, Division of Neonatology, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.

Background: Sedation to preterm neonates receiving less invasive surfactant administration (LISA) for respiratory distress syndrome is controversial.

Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies (OS) to evaluate the effect of sedative drugs for LISA on respiratory outcomes and adverse effects.

Results: One RCT (78 neonates) and two OS (519 neonates) were analyzed in pairwise meta-analysis and 30 studies (2164 neonates) in proportion-based meta-analysis. Read More

Sci Rep 2022 Jun 1;12(1):9158. Epub 2022 Jun 1.

Department of Pediatrics, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.

Indian J Pediatr 2022 Jun 1. Epub 2022 Jun 1.

Department of Neonatology, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, Gujarat, 388325, India.

Objectives: To compare the clinical efficacy and the cost of treatment between the newborns who received either a natural or a protein-free synthetic surfactant for respiratory distress syndrome (RDS) of prematurity.

Methods: This is a retrospective analytical study incorporating comparisons of clinical parameters and cost in newborns having RDS of prematurity who received either Survanta (bovine lung extract), a natural surfactant or Surfact (protein-free colfosceril palmitate), a synthetic surfactant.

Results: There were 100 newborns who received either of the natural (n = 52) or synthetic (n = 48) surfactant with mean (SD) gestational age and mean (SD) birth weight of 31. Read More

Zhongguo Dang Dai Er Ke Za Zhi 2022 May;24(5):514-520

Department of Pediatrics, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China.

Objectives: To study the effect of sex on the clinical outcome of extremely preterm infants (EPIs)/extremely low birth weight infants (ELBWIs) by propensity score matching.

Methods: A retrospective analysis was performed for the medical data of 731 EPIs or ELBWIs who were admitted from January 1, 2011 to December 31, 2020. These infants were divided into two groups: male and female. Read More

Pediatr Rev 2022 Jun;43(6):322-337

As mentioned in the January 2022 Pediatrics in Review Commentary, we now present three patients who have a common chief complaint followed by 5 questions for CME credit. All three cases have discussions on presentation, the differential diagnosis, and management that collectively serve as a Review article. The common theme here is that all three patients have difficulty breathing. Read More

Pediatr Pulmonol 2022 May 30. Epub 2022 May 30.

Department of Neurosciences Psychology Drug Research and Child Health, Careggi University Hospital of Florence, Florence, Italy.

Introduction: Lung ultrasound (LU) is a noninvasive, bedside imaging technique that is attracting growing interest in the evaluation of neonatal respiratory diseases. We conducted a nationwide survey of LU usage in Italian neonatal intensive care units (NICUs).

Methods: A structured questionnaire was developed and sent online to 114 Italian NICUs from June to September 2021. Read More