Diagnosis and management of nasal obstruction in the athlete. A narrative review by subgroup B of the IOC Consensus Group on "Acute Respiratory Illness in the Athlete"

Purpose Infants hospitalized for an acute respiratory illness often require the use of noninvasive respiratory support during the initial stage to improve their breathing. High flow oxygen therapy (HFOT) is becoming a more popular means of noninvasive respiratory support, often used to treat respiratory syncytial virus/bronchiolitis. These infants present with tachypnea and coughing, resulting in difficulties in coordinating sucking and swallowing. However, they are often allowed to feed orally despite having high respiratory rate, increased work of breathing and on HFOT, placing them at risk for aspiration. Feeding therapists who work with these infants have raised concerns that HFOT creates an additional risk factor for swallowing dysfunction, especially with infants who have compromised airways or other comorbidities. There is emerging literature concluding changes in pharyngeal pressures with HFOT, as well as aspiration in preterm neonates who are on nasal continuous positive airway pressure. However, there is no existing research exploring the effect of HFOT on swallowing in infants with acute respiratory illness. This discussion will present findings from literature on HFOT, oral feeding in the acutely ill infant population, and present clinical practice guidelines for safe feeding during critical care admission for acute respiratory illness. Conclusion Guidelines for safety of oral feeds for infants with acute respiratory illness on HFOT do not exist. However, providers and parents continue to want to provide oral feeds despite clinical signs of respiratory distress and coughing. To address this challenge, we initiated a process change to use clinical bedside evaluation and a “cross-systems approach” to provide recommendations for safer oral feeds while on HFOT as the infant is recovering from illness. Use of standardized feeding evaluation and protocol have improved consistency of practice within our department. However, further research is still necessary to develop clinical practice guidelines for safe oral feeding for infants on HFOT.

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Supplemental Material for Subjective Social Status Predicts Wintertime Febrile Acute Respiratory Illness Among Women Healthcare Personnel

Health Psychology ◽

10.1037/a0032764.supp ◽

2013 ◽

Keyword(s):

Social Status ◽

Respiratory Illness ◽

Subjective Social Status ◽

Healthcare Personnel ◽

Acute Respiratory Illness

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Atypical epidemic of influenza and acute respiratory illness (ARI) in Ukraine in 2009/2010

Das Gesundheitswesen ◽

10.1055/s-0030-1266558 ◽

2010 ◽

Vol 72 (08/09) ◽

Author(s):

A Zanuzdana ◽

M Khan ◽

A Krämer

Keyword(s):

Respiratory Illness ◽

Acute Respiratory Illness

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Severity of respiratory signs and symptoms and virus profiles in Japanese children with acute respiratory illness

Microbiology and Immunology ◽

10.1111/1348-0421.12102 ◽

2013 ◽

Vol 57 (12) ◽

pp. 811-821 ◽

Cited By ~ 9

Author(s):

Yumiko Miyaji ◽

Miho Kobayashi ◽

Kazuko Sugai ◽

Hiroyuki Tsukagoshi ◽

Shoichi Niwa ◽

...

Keyword(s):

Signs And Symptoms ◽

Respiratory Illness ◽

Acute Respiratory Illness ◽

Japanese Children ◽

Respiratory Signs And Symptoms

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Symptom cluster is associated with prolonged return-to-play in symptomatic athletes with acute respiratory illness (including COVID-19): a cross-sectional study—AWARE study I

British Journal of Sports Medicine ◽

10.1136/bjsports-2020-103782 ◽

2021 ◽

pp. bjsports-2020-103782

Author(s):

Martin Schwellnus ◽

Nicola Sewry ◽

Carolette Snyders ◽

Kelly Kaulback ◽

Paola Silvia Wood ◽

...

Keyword(s):

Online Survey ◽

Severe Disease ◽

Univariate Analysis ◽

Respiratory Illness ◽

Symptom Cluster ◽

Return To Play ◽

Whole Body ◽

Multiple Model ◽

Acute Respiratory Illness ◽

Cross Sectional

BackgroundThere are no data relating symptoms of an acute respiratory illness (ARI) in general, and COVID-19 specifically, to return to play (RTP).ObjectiveTo determine if ARI symptoms are associated with more prolonged RTP, and if days to RTP and symptoms (number, type, duration and severity) differ in athletes with COVID-19 versus athletes with other ARI.DesignCross-sectional descriptive study.SettingOnline survey.ParticipantsAthletes with confirmed/suspected COVID-19 (ARICOV) (n=45) and athletes with other ARI (ARIOTH) (n=39).MethodsParticipants recorded days to RTP and completed an online survey detailing ARI symptoms (number, type, severity and duration) in three categories: ‘nose and throat’, ‘chest and neck’ and ‘whole body’. We report the association between symptoms and RTP (% chance over 40 days) and compare the days to RTP and symptoms (number, type, duration and severity) in ARICOV versus ARIOTH subgroups.ResultsThe symptom cluster associated with more prolonged RTP (lower chance over 40 days; %) (univariate analysis) was ‘excessive fatigue’ (75%; p<0.0001), ‘chills’ (65%; p=0.004), ‘fever’ (64%; p=0.004), ‘headache’ (56%; p=0.006), ‘altered/loss sense of smell’ (51%; p=0.009), ‘Chest pain/pressure’ (48%; p=0.033), ‘difficulty in breathing’ (48%; p=0.022) and ‘loss of appetite’ (47%; p=0.022). ‘Excessive fatigue’ remained associated with prolonged RTP (p=0.0002) in a multiple model. Compared with ARIOTH, the ARICOV subgroup had more severe disease (greater number, more severe symptoms) and more days to RTP (p=0.0043).ConclusionSymptom clusters may be used by sport and exercise physicians to assist decision making for RTP in athletes with ARI (including COVID-19).

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