Pediatric Lower Respiratory Tract Emergencies: Bronchiolitis, Pneumonia, and Asthma

2018 ◽  
Author(s):  
Amber M Richards
Keyword(s):  
Hospital Admissions ◽  
Significant Proportion ◽  
Respiratory Illness ◽  
Community Acquired Pneumonia ◽  
Emergency Department Visits ◽  
Morbidity And Mortality ◽  
Respiratory Illnesses ◽  
Key Words Antibiotics ◽  
Syncytial Virus ◽  
Management Recommendations

Respiratory illnesses account for a significant proportion of pediatric morbidity and mortality. Respiratory complaints are a common cause of emergency department visits and hospital admissions. They range from mild and self-limited to severe and rapidly progressive. This review discusses the pathophysiology, assessment, stabilization, and management of asthma, community-acquired pneumonia, and bronchiolitis. Given the prevalence of these conditions and the morbidity and mortality attributed to them, it is important for clinicians to be familiar with their presentations and up to date on evidence-based management recommendations. This review contains 7 Figures, 20 Tables and 75 references Key Words: antibiotics, asthma, bronchiolitis, community-acquired pneumonia, pediatric respiratory, pneumonia, respiratory emergency, respiratory illness, respiratory syncytial virus

Pediatric Lower Respiratory Tract Emergencies: Bronchiolitis, Pneumonia, and Asthma

2021 ◽  
Author(s):  
Amber M Richards
Keyword(s):  
Hospital Admissions ◽  
Significant Proportion ◽  
Respiratory Illness ◽  
Community Acquired Pneumonia ◽  
Emergency Department Visits ◽  
Morbidity And Mortality ◽  
Respiratory Illnesses ◽  
Syncytial Virus ◽  
Management Recommendations ◽  
Keywords Antibiotics

Respiratory illnesses account for a significant proportion of pediatric morbidity and mortality. Respiratory complaints are a common cause of emergency department visits and hospital admissions. They range from mild and self-limited to severe and rapidly progressive. This review discusses the pathophysiology, assessment, stabilization, and management of asthma, community-acquired pneumonia, and bronchiolitis. Given the prevalence of these conditions and the morbidity and mortality attributed to them, it is important for clinicians to be familiar with their presentations and up to date on evidence-based management recommendations. This review contains 7 figures, 25 tables and 80 references Keywords: antibiotics, asthma, bronchiolitis, community-acquired pneumonia, pediatric respiratory, pneumonia, respiratory emergency, respiratory illness, respiratory syncytial virus

Respiratory disorders

2013 ◽  
pp. 372-397
Author(s):  
Keith T. Palmer ◽  
Paul Cullinan
Keyword(s):  
Respiratory Disease ◽  
Sickness Absence ◽  
Hospital Admissions ◽  
Respiratory Illness ◽  
Work Capacity ◽  
Chronic Respiratory Disease ◽  
Respiratory Illnesses ◽  
Respiratory Problems ◽  
Work Settings ◽  
Working Age

Respiratory illnesses commonly cause sickness absence, unemployment, medical attendance, illness, and handicap.1 Collectively these disorders cause 19 million days/year of certified sickness absence in men and 9 million days/year in women (with substantial additional lost time from self-certified illness) and, among adults of working age, a general practitioner consultation rate of 48.5 per 100/year with more than 240 000 hospital admissions/year. Prescriptions for bronchodilator inhalers run at some 24 million/year, and mortality from respiratory disease causes an estimated loss of 164 000 working years by age 64 and an estimated annual production loss of £1.6 billion (at prices in 2000). Respiratory disease may be caused, and pre-existing disease may be exacerbated, by the occupational environment. More commonly, respiratory disease limits work capacity and the ability to undertake particular duties. Finally, individual respiratory fitness in ‘safety critical’ jobs can have implications for work colleagues and the public. Within this broad picture, different clinical illnesses pose different problems. For example, acute respiratory illness commonly causes short-term sickness absence, whereas chronic respiratory disease has a greater impact on long-term absence and work limitation; and the fitness implications of respiratory sensitization at work are very different from non-specific asthma aggravated by workplace irritants. Occupational causes of respiratory disease represent a small proportion of the burden, except in some specialized work settings where particular exposures give rise to particular disease excesses. The corollary is that the common fitness decisions on placement, return to work, and rehabilitation more often involve non-occupational illnesses than occupational ones. By contrast, statutory programmes of health surveillance focus on specific occupational risks (e.g. baking) and specific occupational health outcomes (e.g. occupational asthma). In assessing the individual it is important to remember that respiratory problems are often aggravated by other illnesses, particularly disorders of the cardiovascular and musculoskeletal systems.

scholarly journals Use of Multiple Imputation to Estimate the Proportion of Respiratory Virus Detections Among Patients Hospitalized With Community-Acquired Pneumonia

2018 ◽  
Vol 5 (4) ◽  
Author(s):  
Catherine H Bozio ◽  
W Dana Flanders ◽  
Lyn Finelli ◽  
Anna M Bramley ◽  
Carrie Reed ◽  
...  
Keyword(s):  
Multiple Imputation ◽  
Population Based ◽  
Community Acquired Pneumonia ◽  
Influenza Viruses ◽  
Absolute Difference ◽  
Respiratory Illnesses ◽  
Active Population ◽  
Syncytial Virus ◽  
Using Data ◽  
Relative Differences

Abstract Background Real-time polymerase chain reaction (PCR) on respiratory specimens and serology on paired blood specimens are used to determine the etiology of respiratory illnesses for research studies. However, convalescent serology is often not collected. We used multiple imputation to assign values for missing serology results to estimate virus-specific prevalence among pediatric and adult community-acquired pneumonia hospitalizations using data from an active population-based surveillance study. Methods Presence of adenoviruses, human metapneumovirus, influenza viruses, parainfluenza virus types 1–3, and respiratory syncytial virus was defined by positive PCR on nasopharyngeal/oropharyngeal specimens or a 4-fold rise in paired serology. We performed multiple imputation by developing a multivariable regression model for each virus using data from patients with available serology results. We calculated absolute and relative differences in the proportion of each virus detected comparing the imputed to observed (nonimputed) results. Results Among 2222 children and 2259 adults, 98.8% and 99.5% had nasopharyngeal/oropharyngeal specimens and 43.2% and 37.5% had paired serum specimens, respectively. Imputed results increased viral etiology assignments by an absolute difference of 1.6%–4.4% and 0.8%–2.8% in children and adults, respectively; relative differences were 1.1–3.0 times higher. Conclusions Multiple imputation can be used when serology results are missing, to refine virus-specific prevalence estimates, and these will likely increase estimates.

scholarly journals Lessons from 40 years' surveillance of influenza in England and Wales

2007 ◽  
Vol 136 (7) ◽  
pp. 866-875 ◽  
Author(s):  
D. M. FLEMING ◽  
A. J. ELLIOT
Keyword(s):  
Influenza Virus ◽  
General Practitioners ◽  
Hospital Admissions ◽  
Care Delivery ◽  
Influenza Virus Infection ◽  
Respiratory Illness ◽  
The Elderly ◽  
Surveillance Network ◽  
England And Wales ◽  
Syncytial Virus

SUMMARYThe influenza virus continues to pose a significant threat to public health throughout the world. Current avian influenza outbreaks in humans have heightened the need for improved surveillance and planning. Despite recent advances in the development of vaccines and antiviral drugs, seasonal epidemics of influenza continue to contribute significantly to general practitioner workloads, emergency hospital admissions, and deaths. In this paper we review data produced by the Royal College of General Practitioners Weekly Returns Service, a sentinel general practice surveillance network that has been in operation for over 40 years in England and Wales. We show a gradually decreasing trend in the incidence of respiratory illness associated with influenza virus infection (influenza-like illness; ILI) over the 40 years and speculate that there are limits to how far an existing virus can drift and yet produce substantial new epidemics. The burden of disease caused by influenza presented to general practitioners varies considerably by age in each winter. In the pandemic winter of 1969/70 persons of working age were most severely affected; in the serious influenza epidemic of 1989/90 children were particularly affected; in the millennium winter (in which the NHS was severely stretched) ILI was almost confined to adults, especially the elderly. Serious confounders from infections due to respiratory syncytial virus are discussed, especially in relation to assessing influenza vaccine effectiveness. Increasing pressure on hospitals during epidemic periods are shown and are attributed to changing patterns of health-care delivery.

scholarly journals Aetiology of influenza-like illness in adults includes parainfluenzavirus type 4

2009 ◽  
Vol 58 (4) ◽  
pp. 408-413 ◽  
Author(s):  
Hatice Hasman ◽  
Constance T. Pachucki ◽  
Arife Unal ◽  
Diep Nguyen ◽  
Troy Devlin ◽  
...  
Keyword(s):  
Influenza A ◽  
Respiratory Illness ◽  
The Elderly ◽  
Respiratory Viruses ◽  
Influenza Viruses ◽  
Morbidity And Mortality ◽  
Mixed Infections ◽  
Parainfluenza Viruses ◽  
Syncytial Virus ◽  
Human Parainfluenza Viruses

Influenza viruses cause significant morbidity and mortality in adults each winter. At the same time, other respiratory viruses circulate and cause respiratory illness with influenza-like symptoms. Human respiratory syncytial virus (HRSV), human parainfluenza viruses (HPIV) and human metapneumovirus have all been associated with morbidity and mortality in adults, including nosocomial infections. This study evaluated 154 respiratory specimens collected from adults with influenza-like/acute respiratory illness (ILI) seen at the Edward Hines Jr VA Hospital, Hines, IL, USA, during two successive winters, 1998–1999 and 1999–2000. The samples were tested for ten viruses in two nested multiplex RT-PCRs. One to three respiratory viruses were detected in 68 % of the samples. As expected, influenza A virus (FLU-A) infections were most common (50 % of the samples), followed by HRSV-A (16 %). Surprisingly, HPIV-4 infections (5.8 %) were the third most prevalent. Mixed infections were also relatively common (11 %). When present, HPIV infections were approximately three times more likely to be included in a mixed infection than FLU-A or HRSV. Mixed infections and HPIV-4 are likely to be missed using rapid diagnostic tests. This study confirms that ILI in adults and the elderly can be caused by HRSV and HPIVs, including HPIV-4, which co-circulate with FLU-A.

RESPIRATORY DISEASE IN GROUP DAY CARE

PEDIATRICS ◽  
1972 ◽  
Vol 49 (3) ◽  
pp. 428-437 ◽  
Author(s):  
Frank A. Loda ◽  
W Paul Glezen ◽  
Wallace A. Clyde
Keyword(s):  
Respiratory Disease ◽  
Day Care ◽  
Care Center ◽  
Care Program ◽  
Respiratory Illness ◽  
Respiratory Illnesses ◽  
Day Care Center ◽  
Syncytial Virus ◽  
Sick Children ◽  
Type 3

The frequency of occurrence and etiology of respiratory disease during a 40-month period in a day care center is reported. The day care center had a maximum enrollment of 39 children ranging in age from 1 month to 5 years. Sick children were not excluded from the center. During the period of the study there was not an excessive amount of respiratory illness in the children in day care when compared with the reported illness occurrence in children receiving home care. In the total group there were 8.4 respiratory illnesses per child-year with the highest rate in infants under 1 year of age. The agents responsible for the respiratory disease in the day care center were similar to those reported as significant in the community, and the patterns of virus isolation were similar to those in the community in age incidence, seasonal occurrence, and illness association. Respiratory syncytial virus and parainfluenza virus type 3 were the agents most often implicated in lower respiratory disease. Adenovirus types 2 and 5 frequently caused febrile upper respiratory illness in infants. The study suggests group day care is safe medically for infants and that exclusion of sick children is unnecessary in a day care program with adequate space and staffing.

Evidence-Based Smoking Cessation Interventions for Patients With Acute Respiratory Disorders

2009 ◽  
Vol 27 (1) ◽  
pp. 273-296 ◽  
Author(s):  
Janie Heath ◽  
Sara Young ◽  
Sharon Bennett ◽  
Mary Beth Ginn ◽  
Geoffrey Cox
Keyword(s):  
Respiratory Diseases ◽  
Tobacco Cessation ◽  
Hospital Admissions ◽  
Models Of Care ◽  
Community Acquired Pneumonia ◽  
Chronic Obstructive ◽  
Evidence Based ◽  
Obstructive Pulmonary Disease ◽  
Respiratory Illnesses ◽  
The One

Worldwide, tobacco use continues to be the most significant preventable cause of death and hospital admissions, particularly related to respiratory diseases. Acute respiratory illnesses requiring hospitalization provide an opportunity for nurses to intervene and help smokers quit. Of the three top hospital admissions related to respiratory diseases, chronic obstructive pulmonary disease (COPD) is the one that continues to have increased mortality whereas community acquired pneumonia and asthma have decreased over the past 5 years. The course of all three can be caused or exacerbated by continued smoking. This review describes the state of the science of nursing research focused on tobacco cessation interventions for hospitalized patients with COPD, asthma, or community acquired pneumonia. Additionally, we describe two evidence-based, nurse-driven, hospital protocols to treat tobacco dependence that can serve as models of care. Recommendations are made as to how to effectively promote nursing interventions for tobacco cessation in the acute care setting.

scholarly journals Identifying frequency and associated factors with respiratory illnesses in children with cerebral palsy.

2020 ◽  
Vol 27 (06) ◽  
pp. 1187-1193
Author(s):  
Dilshad Qureshi ◽  
Shazia Bano ◽  
Hira Idrees ◽  
Saima Iram
Keyword(s):  
Cerebral Palsy ◽  
Parent Education ◽  
Associated Factors ◽  
Hospital Admissions ◽  
Respiratory Illness ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Respiratory Illnesses ◽  
Children With Cerebral Palsy

Objectives: To identify the frequency and associated factors with respiratory illnesses in children with cerebral palsy. Study Design: Cross-sectional study. Setting: Department of Paediatrics, Unit I. Sandeman Provincial Hospital, Quetta. Period: 8th May 2018 to 7th May, 2019. Material & Methods: was to determine frequency of hospital admissions due to respiratory illnesses and factors leading to respiratory illnesses in children with cerebral palsy. The study considered 207 patients who were suffering with cerebral palsy. Weight and height/length were taken. Chest was inspected for in drawing of ribs and respiratory rate was counted for a minute. CP child further investigated for having drooling of saliva, chewing difficulties, impaired speech, seizures, GERD, mode of food intake, scoliosis and malnutrition. Descriptive statistics were calculated. Stratification was done and post stratification Chi square test was applied considering p-value ≤0.05 as significant. Conclusion: Among total patients admitted, respiratory illness was observed in 16.4% patients. It was observed that problem to eat by mouth, oromotor dysfunction and Malnutrition were mostly observed leading factors. Multidisciplinary approach should always be provided to CP children at hospital as well as community level along with parent education related to disease problem. These factors need to be addressed thoroughly. Preventive measurements and treatments should be individualized for each leading factors.

scholarly journals Estimating the burden of adult hospital admissions due to RSV and other respiratory pathogens in England

2021 ◽  
Author(s):  
Ashley Sharp ◽  
Mehdi Minaji ◽  
Nikolaos Panagiotopoulos ◽  
Rachel Reeves ◽  
Andre Charlett ◽  
...  
Keyword(s):  
Respiratory Virus ◽  
Hospital Admissions ◽  
Therapeutic Interventions ◽  
Respiratory Pathogens ◽  
Annual Average ◽  
Respiratory Illnesses ◽  
Significant Burden ◽  
Study Population ◽  
Syncytial Virus ◽  
Adult Hospital

Respiratory Syncytial Virus (RSV) is a common seasonal respiratory virus and an important cause of illness among infants, but the burden of RSV disease is not well described among the older population. The objective of this study was to estimate the age-specific incidence of hospital admission among over 65s due to respiratory illnesses attributable to RSV in England to inform optimal vaccine and therapeutic interventions. We used linear multiple regression to examine the effect of changes in weekly counts of respiratory pathogens on the weekly counts of respiratory hospital admissions. The study population was all patients aged 65 years or over admitted to English hospitals between 2nd August 2010 and 30th July 2017. RSV was estimated to account for a seasonal annual average of 71 (95% CI 52-90) respiratory admissions per 100,000 in adults age 65-74 and 251 (95% CI 186-316) admissions per 100,000 adults age 75+. Pneumococcus was the pathogen responsible for highest annual average respiratory admission with 448 (95% CI 310-587) admissions per 100,000 adults age 65-74 and 1010 (95%CI 527-1493) admissions per 100,000 adults aged 75+. This study shows that RSV continues to exert a significant burden of disease among older adults in England. These findings will support development of policy for the use of RSV therapeutics and vaccines in this age group.

scholarly journals RSV: perspectives to strengthen the need for protection in all infants

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jose Antonio Navarro Alonso ◽  
Louis J. Bont ◽  
Elena Bozzola ◽  
Egbert Herting ◽  
Federico Lega ◽  
...  
Keyword(s):  
Young Children ◽  
Hospital Admissions ◽  
Health Care Systems ◽  
Implementation Strategies ◽  
Respiratory Illness ◽  
Health Decision ◽  
Care Systems ◽  
Syncytial Virus ◽  
Multi Stakeholder ◽  
First Year Of Life

AbstractRespiratory syncytial virus (RSV)—the most common viral cause of bronchiolitis—is a significant cause of serious illness among young children between the ages of 0–5 years and is especially concerning in the first year of life. Globally, RSV is a common cause of childhood acute lower respiratory illness (ALRI) and a major cause of hospital admissions in young children and infants and represents a substantial burden for health-care systems. This burden is strongly felt as there are currently no effective preventative options that are available for all infants. However, a renaissance in RSV prevention strategies is unfolding, with several new prophylactic options such as monoclonal antibodies and maternal vaccinations that are soon to be available. A key concern is that health decision makers and systems may not be ready to take full advantage of forthcoming technological innovations. A multi-stakeholder approach is necessary to bridge data gaps to fully utilise upcoming options. Knowledge must be made available at multiple levels to ensure that parents and doctors are aware of preventative options, but also to ensure that stakeholders and policymakers are given the necessary information to best advise implementation strategies.

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