Labajos, Joshua Hanes B. What’s New In Pediatrics?

BSN - 2

Annotated Readings: International Pediatric Ward Updates

High-flow nasal cannula oxygen therapy for children with bronchiolitis (July 2019)

High-flow nasal cannula (HFNC) oxygen therapy is frequently used for respiratory support in
children hospitalized with bronchiolitis despite limited evidence of efficacy. A recent systematic review
of nine randomized trials that compared HFNC with other modes of oxygen therapy in >2100 children
concluded that HFNC does not substantially benefit children with bronchiolitis, although it appears to be
safe. In pooled analysis of four randomized trials that included >1600 children, length of stay, length of
oxygen supplementation, and rates of transfer to the intensive care unit were similar among children
assigned to HFNC and standard oxygen therapy. We reserve HFNC for children hospitalized with
bronchiolitis who have failed standard oxygen therapy and are at risk for respiratory failure.

Albuterol for children undergoing tonsillectomy (July 2019)

Perioperative respiratory complications are common in children undergoing tonsillectomy. A

randomized placebo-controlled trial in almost 480 children demonstrated that pretreatment with
albuterol reduced the frequency of respiratory adverse events, including laryngospasm, coughing, and
oxygen desaturation, with the greatest benefit seen in children with moderate to severe obstructive
sleep apnea (OSA). Albuterol did not reduce time in the post-anesthesia care unit, suggesting that most
respiratory complications were likely mild. Additional data are needed before albuterol pretreatment
can be routinely recommended for all children undergoing tonsillectomy. However, these findings
support a single dose of albuterol as a reasonable intervention for children who are at risk for
perioperative respiratory difficulties (eg, individuals with moderate to severe OSA, recent upper
respiratory tract infection, or recent asthma symptoms).

Long-term benefits of muscle fitness for children (July 2019)

While a number of systematic reviews have assessed the benefits of physical activity for
children, none has assessed muscular fitness obtained through strength training. In a systematic review
of 30 studies involving over 21,000 children and adolescents with a follow-up period of 1 to 27 years,
better muscular fitness was associated with lower BMI, less insulin resistance, lower cardiovascular risk,
and greater bone density in later life

Sources:

 High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis. Lin J, Zhang Y, Xiong L, Liu S,
Gong C, Dai J
 Effect of Albuterol Premedication vs Placebo on the Occurrence of Respiratory Adverse Events in Children Undergoing
Tonsillectomies: The REACT Randomized Clinical Trial. von Ungern-Sternberg BS, Sommerfield D, Slevin L, Drake-Brockman TFE,
Zhang G, Hall GL
 Is Muscular Fitness Associated with Future Health Benefits in Children and Adolescents? A Systematic Review and Meta-Analysis of
Longitudinal Studies. García-Hermoso A, Ramírez-Campillo R, Izquierdo M