0
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      ERS International Congress 2020: highlights from the Paediatric Assembly

      review-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          In this review, the Paediatric Assembly of the European Respiratory Society (ERS) presents a summary of the highlights and most relevant findings in the field of paediatric respiratory medicine presented at the virtual ERS International Congress 2020. Early Career Members of the ERS and Chairs of the different Groups comprising the Paediatric Assembly discuss a selection of the presented research. These cover a wide range of research areas, including respiratory physiology and sleep, asthma and allergy, cystic fibrosis, respiratory infection and immunology, neonatology and intensive care, epidemiology, bronchology and lung and airway development. Specifically, we describe the long-term effect in lung function of premature birth, mode of delivery and chronic respiratory conditions such as cystic fibrosis. In paediatric asthma, we present risk factors, phenotypes and their progression with age, and the challenges in diagnosis. We confirm the value of the lung clearance index to detect early lung changes in cystic fibrosis. For bronchiectasis treatment, we highlight the importance of identifying treatable traits. The use of biomarkers and genotypes to identify infants at risk of long-term respiratory morbidity is also discussed. We present the long-term impact on respiratory health of early life and fetal exposures to maternal obesity and intrauterine hypoxia, mechanical ventilation hyperoxia, aeroallergens, air pollution, vitamin A deficient intake and bronchitis. Moreover, we report on the use of metabolomics and genetic analysis to understand the effect of these exposures on lung growth and alveolar development. Finally, we stress the need to establish multidisciplinary teams to treat complex airway pathologies.

          Abstract

          Highlights from the Paediatrics Assembly at the #ERSCongress 2020 https://bit.ly/3ptcnFr

          Related collections

          Most cited references79

          • Record: found
          • Abstract: found
          • Article: not found

          Bronchopulmonary dysplasia

          In the absence of effective interventions to prevent preterm births, improved survival of infants who are born at the biological limits of viability has relied on advances in perinatal care over the past 50 years. Except for extremely preterm infants with suboptimal perinatal care or major antenatal events that cause severe respiratory failure at birth, most extremely preterm infants now survive, but they often develop chronic lung dysfunction termed bronchopulmonary dysplasia (BPD; also known as chronic lung disease). Despite major efforts to minimize injurious but often life-saving postnatal interventions (such as oxygen, mechanical ventilation and corticosteroids), BPD remains the most frequent complication of extreme preterm birth. BPD is now recognized as the result of an aberrant reparative response to both antenatal injury and repetitive postnatal injury to the developing lungs. Consequently, lung development is markedly impaired, which leads to persistent airway and pulmonary vascular disease that can affect adult lung function. Greater insights into the pathobiology of BPD will provide a better understanding of disease mechanisms and lung repair and regeneration, which will enable the discovery of novel therapeutic targets. In parallel, clinical and translational studies that improve the classification of disease phenotypes and enable early identification of at-risk preterm infants should improve trial design and individualized care to enhance outcomes in preterm infants.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            European Respiratory Society guidelines for the management of adult bronchiectasis.

            Bronchiectasis in adults is a chronic disorder associated with poor quality of life and frequent exacerbations in many patients. There have been no previous international guidelines.The European Respiratory Society guidelines for the management of adult bronchiectasis describe the appropriate investigation and treatment strategies determined by a systematic review of the literature.A multidisciplinary group representing respiratory medicine, microbiology, physiotherapy, thoracic surgery, primary care, methodology and patients considered the most relevant clinical questions (for both clinicians and patients) related to management of bronchiectasis. Nine key clinical questions were generated and a systematic review was conducted to identify published systematic reviews, randomised clinical trials and observational studies that answered these questions. We used the GRADE approach to define the quality of the evidence and the level of recommendations. The resulting guideline addresses the investigation of underlying causes of bronchiectasis, treatment of exacerbations, pathogen eradication, long term antibiotic treatment, anti-inflammatories, mucoactive drugs, bronchodilators, surgical treatment and respiratory physiotherapy.These recommendations can be used to benchmark quality of care for people with bronchiectasis across Europe and to improve outcomes.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              The bronchiectasis severity index. An international derivation and validation study.

              There are no risk stratification tools for morbidity and mortality in bronchiectasis. Identifying patients at risk of exacerbations, hospital admissions, and mortality is vital for future research. This study describes the derivation and validation of the Bronchiectasis Severity Index (BSI). Derivation of the BSI used data from a prospective cohort study (Edinburgh, UK, 2008-2012) enrolling 608 patients. Cox proportional hazard regression was used to identify independent predictors of mortality and hospitalization over 4-year follow-up. The score was validated in independent cohorts from Dundee, UK (n = 218); Leuven, Belgium (n = 253); Monza, Italy (n = 105); and Newcastle, UK (n = 126). Independent predictors of future hospitalization were prior hospital admissions, Medical Research Council dyspnea score greater than or equal to 4, FEV1 < 30% predicted, Pseudomonas aeruginosa colonization, colonization with other pathogenic organisms, and three or more lobes involved on high-resolution computed tomography. Independent predictors of mortality were older age, low FEV1, lower body mass index, prior hospitalization, and three or more exacerbations in the year before the study. The derived BSI predicted mortality and hospitalization: area under the receiver operator characteristic curve (AUC) 0.80 (95% confidence interval, 0.74-0.86) for mortality and AUC 0.88 (95% confidence interval, 0.84-0.91) for hospitalization, respectively. There was a clear difference in exacerbation frequency and quality of life using the St. George's Respiratory Questionnaire between patients classified as low, intermediate, and high risk by the score (P < 0.0001 for all comparisons). In the validation cohorts, the AUC for mortality ranged from 0.81 to 0.84 and for hospitalization from 0.80 to 0.88. The BSI is a useful clinical predictive tool that identifies patients at risk of future mortality, hospitalization, and exacerbations across healthcare systems.
                Bookmark

                Author and article information

                Journal
                ERJ Open Res
                ERJ Open Res
                ERJOR
                erjor
                ERJ Open Research
                European Respiratory Society
                2312-0541
                January 2021
                22 March 2021
                : 7
                : 1
                : 00893-2020
                Affiliations
                [1 ]Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
                [2 ]Division of Cancer and Stem Cells, Biodiscovery Institute, School of Medicine, University of Nottingham, University Park, Nottingham, UK
                [3 ]Dept of General Paediatrics, Neonatology and Paediatric Cardiology, University Childreńs Hospital, Heinrich-Heine-University, Duesseldorf, Germany
                [4 ]Paediatric Dept, 424 General Military Hospital, Thessaloniki, Greece
                [5 ]Dept of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK
                [6 ]Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
                [7 ]Dept of Paediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
                [8 ]Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, London, UK
                [9 ]Women and Children's Health, School of Life course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
                [10 ]Dept of Paediatrics, Division of Neonatology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
                [11 ]Division of Respirology, University of Ottawa Children's Hospital of Eastern Ontario, Ottawa, Canada
                [12 ]Department of Respiratory Sciences, University of Leicester, Leicester, UK
                [13 ]Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
                [14 ]Dept of Paediatrics, University Hospitals Leuven, Leuven, Belgium
                [15 ]Dept of Paediatric Surgery, Erasmus Medical Centre – Sophia Children's Hospital, Rotterdam, The Netherlands
                [16 ]Dept of Cell Biology, Erasmus MC, Rotterdam, the Netherlands
                [17 ]Division of Paediatric Pulmonology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
                [18 ]Department of Paediatrics, Division of Paediatric Respiratory Medicine and Allergology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
                Author notes
                Cristina Ardura-Garcia, Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland. E-mail: cristina.ardura@ 123456ispm.unibe.ch
                Author information
                https://orcid.org/0000-0001-7924-518X
                https://orcid.org/0000-0001-7047-9449
                https://orcid.org/0000-0003-0511-5352
                https://orcid.org/0000-0003-1695-7141
                https://orcid.org/0000-0001-6731-9452
                https://orcid.org/0000-0003-1828-0058
                https://orcid.org/0000-0002-9291-4971
                https://orcid.org/0000-0001-7284-4251
                Article
                00893-2020
                10.1183/23120541.00893-2020
                7983204
                fe22ce04-f276-4d47-a919-27b44ffd02fc
                ©The authors 2021

                This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org

                History
                : 30 November 2020
                : 24 January 2021
                Categories
                Congress Highlights
                9

                Comments

                Comment on this article