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Carrara M, Aubertin G, Khirani S, Massenavette B, Bierme P, Griffon L, Ioan I, Schweitzer C, Binoche A, Lampin ME, Mordacq C, Rubinsztajn R, Debeilleix S, Galode F, Bui S, Hullo E, Becourt A, Lubrano M, Moreau J, Renoux MC, Matecki S, Stremler N, Baravalle-Einaudi M, Mazenq J, Sigur E, Labouret G, Genevois AL, Heyman R, Pomedio M, Masson A, Hangard P, Menetrey C, Le Clainche L, Bokov P, Dudoignon B, Fleurence E, Bergounioux J, Mbieleu B, Breining A, Giovannin-Chami L, Fina A, Ollivier M, Gachelin E, Perisson C, Pervillé A, Barzic A, Cros P, Jokic M, Labbé G, Diaz V, Coutier L, Fauroux B, Taytard J. Pediatric long-term noninvasive respiratory support in children with central nervous system disorders. Pediatr Pulmonol 2024; 59:642-651. [PMID: 38088209 DOI: 10.1002/ppul.26796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 10/31/2023] [Accepted: 11/27/2023] [Indexed: 02/16/2024]
Abstract
RATIONALE The use of long-term noninvasive respiratory support is increasing in children along with an extension of indications, in particular in children with central nervous system (CNS) disorders. OBJECTIVE The aim of this study was to describe the characteristics of children with CNS disorders treated with long-term noninvasive respiratory support in France. METHODS Data were collected from 27 French pediatric university centers through an anonymous questionnaire filled for every child treated with noninvasive ventilatory support ≥3 months on 1st June 2019. MAIN RESULTS The data of 182 patients (55% boys, median age: 10.2 [5.4;14.8] years old [range: 0.3-25]) were collected: 35 (19%) patients had nontumoral spinal cord injury, 22 (12%) CNS tumors, 63 (35%) multiple disabilities, 26 (14%) central alveolar hypoventilation and 36 (20%) other CNS disorders. Seventy five percent of the patients were treated with noninvasive ventilation (NIV) and 25% with continuous positive airway pressure (CPAP). The main investigations performed before CPAP/NIV initiation were nocturnal gas exchange recordings, alone or coupled with poly(somno)graphy (in 29% and 34% of the patients, respectively). CPAP/NIV was started in an acute setting in 10% of the patients. Median adherence was 8 [6;10] hours/night, with 12% of patients using treatment <4 h/day. Nasal mask was the most common interface (70%). Airway clearance techniques were used by 31% of patients. CONCLUSION CPAP/NIV may be a therapeutic option in children with CNS disorders. Future studies should assess treatment efficacy and patient reported outcome measures.
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Affiliation(s)
- Marion Carrara
- Department of Pediatric Pulmonology, AP-HP, Hôpital Armand Trousseau, Paris, France
| | - Guillaume Aubertin
- Department of Pediatric Pulmonology, AP-HP, Hôpital Armand Trousseau, Paris, France
- Sorbonne Université, INSERM UMR-S 938, Centre de Recherche Saint-Antoine (CRSA), Paris, France
- Centre de pneumologie de l'enfant, Ramsay Générale de Santé, Paris, France
| | - Sonia Khirani
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants malades, Paris, France
- Université Paris Cité, VIFASOM, Paris, France
- ASV Santé, Gennevilliers, France
| | - Bruno Massenavette
- Pediatric Intensive Care Unit, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Bron, France
| | - Priscille Bierme
- Pediatric Pulmonology and Allergology Unit, Hospices Civils de Lyon, Bron, France
| | - Lucie Griffon
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants malades, Paris, France
- Université Paris Cité, VIFASOM, Paris, France
| | - Iulia Ioan
- Department of Pediatric, University Children's Hospital, CHRU Nancy; Université de Lorraine, DevAH, Nancy, France
| | - Cyril Schweitzer
- Department of Pediatric, University Children's Hospital, CHRU Nancy; Université de Lorraine, DevAH, Nancy, France
| | - Alexandra Binoche
- Pediatric Intensive Care Unit, Hôpital Jeanne de Flandre, CHU Lille, Lille, France
| | - Marie-Emilie Lampin
- Pediatric Intensive Care Unit, Hôpital Jeanne de Flandre, CHU Lille, Lille, France
| | - Clémence Mordacq
- Pediatic Pulmonology and Allergology Unit, Hôpital Jeanne de Flandre, CHU Lille, Lille, France
| | - Robert Rubinsztajn
- Department of Pediatric orthopedic surgery, Hôpital Necker-Enfants malades, Paris, France
| | | | - François Galode
- Pediatric Pulmonology Unit, Hôpital Pellegrin-Enfants, Bordeaux, France
| | - Stéphanie Bui
- Pediatric Pulmonology Unit, Hôpital Pellegrin-Enfants, Bordeaux, France
| | - Eglantine Hullo
- Pediatric Pulmonology Unit, Hôpital Couple-Enfant, CHU Grenoble, Grenoble, France
| | - Arnaud Becourt
- Pediatric Pulmonology Department, CHU Amiens Picardie, Amiens, France
| | - Marc Lubrano
- Respiratory Diseases, Allergy and CF Unit, Department of Pediatric, University Hospital Charles Nicolle, Rouen, France
| | - Johan Moreau
- Department of Pediatric Cardiology and Pulmonology, Montpellier University Hospital, Montpellier, France
- Physiology and Experimental Biology of Heart and Muscles Laboratory-PHYMEDEXP, UMR CNRS 9214, INSERM U1046, University of Montpellier, Montpellier, France
| | - Marie-Catherine Renoux
- Department of Pediatric Cardiology and Pulmonology, Montpellier University Hospital, Montpellier, France
| | - Stefan Matecki
- Department of Pediatric Cardiology and Pulmonology, Montpellier University Hospital, Montpellier, France
- Functional Exploration Laboratory, University Hospital, Montpellier, France
| | - Nathalie Stremler
- Pediatric Ventilation Unit, Department of Pediatric, AP-HM, Hôpital La Timone, Marseille, France
| | | | - Julie Mazenq
- Pediatric Ventilation Unit, Department of Pediatric, AP-HM, Hôpital La Timone, Marseille, France
| | - Elodie Sigur
- Pediatric Pulmonology and Allergology Unit, Hôpital des Enfants, Toulouse, France
| | - Géraldine Labouret
- Pediatric Pulmonology and Allergology Unit, Hôpital des Enfants, Toulouse, France
| | - Anne-Laure Genevois
- Pediatric Pulmonology and Allergology Unit, Hôpital des Enfants, Toulouse, France
| | - Rachel Heyman
- Pediatric Unit, Department of Physical Medicine and Rehabilitation, Hôpital Pontchaillou, Rennes, France
| | - Michael Pomedio
- Pediatric Intensive Care Unit, American Memorial Hospital, CHU Reims, Reims, France
| | - Alexandra Masson
- Pediatric Unit, Hôpital de la Mère et de l'Enfant, Limoges, France
| | - Pauline Hangard
- Pediatric Unit, Hôpital de la Mère et de l'Enfant, Limoges, France
| | - Céline Menetrey
- Pediatric Unit, Hôpital de la Mère et de l'Enfant, Limoges, France
| | - Laurence Le Clainche
- Pediatric Noninvasive Ventilation Unit, AP-HP, Hôpital Robert Debré, Paris, France
| | - Plamen Bokov
- Pediatric Noninvasive Ventilation Unit, AP-HP, Hôpital Robert Debré, Paris, France
- Université Paris Cité, INSERM NeuroDiderot, Paris, France
| | - Benjamin Dudoignon
- Pediatric Noninvasive Ventilation Unit, AP-HP, Hôpital Robert Debré, Paris, France
| | | | - Jean Bergounioux
- Pediatric Intensive Care Unit, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - Blaise Mbieleu
- Pediatric Intensive Care Unit, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | | | - Lisa Giovannin-Chami
- Department of Pediatric Pulmonology and Allergology, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France
| | - Agnes Fina
- Department of Pediatric Pulmonology and Allergology, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France
| | | | - Elsa Gachelin
- Department of Pediatric, CHU Félix Guyon, Saint Denis, La Réunion, France
| | - Caroline Perisson
- Department of Pediatric, CHU Sud Réunion, Saint Pierre, La Réunion, France
| | - Anne Pervillé
- Department of Pédiatrics, Hôpital d'Enfants-ASFA, Saint Denis, La Réunion, France
| | | | | | - Mickaël Jokic
- Pediatric Intensive Care Unit, CHU de Caen Normandie, Caen, France
| | - Guillaume Labbé
- Pediatric Pulmonology and Allergology Unit, CHU d'Estaing, Clermont-Ferrand, France
| | - Véronique Diaz
- Department of Respiratory Physiology, CHU Poitiers, Poitiers, France
| | - Laurianne Coutier
- Pediatric Pulmonology and Allergology Unit, Hospices Civils de Lyon, Bron, France
| | - Brigitte Fauroux
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants malades, Paris, France
- Université Paris Cité, VIFASOM, Paris, France
| | - Jessica Taytard
- Department of Pediatric Pulmonology, AP-HP, Hôpital Armand Trousseau, Paris, France
- INSERM UMR-S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Sorbonne Université, Paris, France, Paris, France
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Marguet C, Petat H, Michelet I, Lubrano M, Couderc L. Synthèse N° 3 : Bronchites chroniques obstructives de l’enfant : un concept émergent. Rev Malad Respir Actual 2017; 9:73-82. [PMID: 32362958 PMCID: PMC7185827 DOI: 10.1016/s1877-1203(17)30036-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- C. Marguet
- Pneumologie, allergologie & CRCM pédiatrique. Département de pédiatrie médicale, Centre hospitalier universitaire de Rouen, EA2656 université de Normandie, UNIRouen, F-7600 Rouen, France
| | - H. Petat
- Pneumologie, allergologie & CRCM pédiatrique. Département de pédiatrie médicale, Centre hospitalier universitaire de Rouen, EA2656 université de Normandie, UNIRouen, F-7600 Rouen, France
| | - I. Michelet
- Pneumologie, allergologie & CRCM pédiatrique. Département de pédiatrie médicale, Centre hospitalier universitaire de Rouen, EA2656 université de Normandie, UNIRouen, F-7600 Rouen, France
| | - M. Lubrano
- Pneumologie, allergologie & CRCM pédiatrique. Département de pédiatrie médicale, Centre hospitalier universitaire de Rouen, EA2656 université de Normandie, UNIRouen, F-7600 Rouen, France
| | - L. Couderc
- Pneumologie, allergologie & CRCM pédiatrique. Département de pédiatrie médicale, Centre hospitalier universitaire de Rouen, EA2656 université de Normandie, UNIRouen, F-7600 Rouen, France
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Inrad Y, Couderc L, Lubrano M, Michelet I, Anfray F, Fisson S, Vanhabost G, Marguet C. SFP PC-25 - Intérêt de l’exploration fonctionnelle respiratoire du nourrisson dans l’évaluation clinique de l’asthme et devenir à moyen terme: une série de 92 cas. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)72175-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Aubertin G, Marguet C, Delacourt C, Houdouin V, Leclainche L, Lubrano M, Marteletti O, Pin I, Pouessel G, Rittié JL, Saulnier JP, Schweitzer C, Stremler N, Thumerelle C, Toutain-Rigolet A, Beydon N. Recommandations pour l’oxygénothérapie chez l’enfant en situations aiguës et chroniques : évaluation du besoin, critères de mise en route, modalités de prescriptions et de surveillance. Rev Mal Respir 2013; 30:903-11. [DOI: 10.1016/j.rmr.2013.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Taytard J, Nathan N, de Blic J, Fayon M, Epaud R, Deschildre A, Troussier F, Lubrano M, Chiron R, Reix P, Cros P, Mahloul M, Michon D, Clement A, Corvol H. New insights into pediatric idiopathic pulmonary hemosiderosis: the French RespiRare(®) cohort. Orphanet J Rare Dis 2013; 8:161. [PMID: 24125570 PMCID: PMC3852822 DOI: 10.1186/1750-1172-8-161] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 10/11/2013] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of alveolar hemorrhage in children and its pathophysiology remains obscure. Classically, diagnosis is based on a triad including hemoptysis, diffuse parenchymal infiltrates on chest X-rays, and iron-deficiency anemia. We present the French pediatric cohort of IPH collected through the French Reference Center for Rare Lung Diseases (RespiRare®, http://www.respirare.fr). METHODS Since 2008, a national network/web-linked RespiRare® database has been set up in 12 French pediatric respiratory centres. It is structured as a medical recording tool with extended disease-specific datasets containing clinical information relevant to all forms of rare lung diseases including IPH. RESULTS We identified 25 reported cases of IPH in children from the database (20 females and 5 males). Among them, 5 presented with Down syndrome. Upon diagnosis, median age was 4.3 [0.8-14.0] yrs, and the main manifestations were: dyspnea (n = 17, 68%), anemia (n = 16, 64%), cough (n = 12, 48%), febrile pneumonia (n = 11, 44%) and hemoptysis (n = 11, 44%). Half of the patients demonstrated diffuse parenchymal infiltrates on chest imaging, and diagnosis was ascertained either by broncho-alveolar lavage indicating the presence of hemosiderin-laden macrophages (19/25 cases), or lung biopsy (6/25). In screened patients, initial auto-immune screening revealed positive antineutrophilic cytoplasmic antibodies (ANCA) (n = 6, 40%), antinuclear antibodies (ANA) (n = 5, 45%) and specific coeliac disease antibodies (n = 4, 28%). All the patients were initially treated by corticosteroids. In 13 cases, immunosuppressants were introduced due to corticoresistance and/or major side effects. Median length of follow-up was 5.5 yrs, with a satisfactory respiratory outcome in 23/25 patients. One patient developed severe pulmonary fibrosis, and another with Down syndrome died as a result of severe pulmonary hemorrhage. CONCLUSION The present cohort provides substantial information on clinical expression and outcomes of pediatric IPH. Analysis of potential contributors supports a role of auto-immunity in disease development and highlights the importance of genetic factors.
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Affiliation(s)
- Jessica Taytard
- Pediatric Pulmonary Department, AP-HP, Hôpital Trousseau, Université Pierre et Marie Curie-Paris6, Inserm U938, 26, avenue du Docteur Arnold-Netter, 75012 Paris, France
| | - Nadia Nathan
- Pediatric Pulmonary Department, AP-HP, Hôpital Trousseau, Université Pierre et Marie Curie-Paris6, Inserm U938, 26, avenue du Docteur Arnold-Netter, 75012 Paris, France
| | - Jacques de Blic
- Pediatric Pulmonary Department, AP-HP, Hôpital Necker Enfants Malades, Paris, France
| | - Mickael Fayon
- CHU de Bordeaux, Centre d’Investigation Clinique (CIC 0005), F-33076 Bordeaux, France
| | - Ralph Epaud
- Pediatric Department, Centre Hospitalier Inter-communal de Créteil, Créteil, France
| | - Antoine Deschildre
- Pediatric Department, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Françoise Troussier
- Pediatric Department, Centre Hospitalier Universitaire d’Angers, Angers, France
| | - Marc Lubrano
- Pediatric Department, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Raphaël Chiron
- Pediatric Department, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Philippe Reix
- Pediatric Pulmonary Department, Centre Hospitalier Universitaire de Lyon, Lyon, France
| | - Pierrick Cros
- Pediatric Department, Centre Hospitalier Universitaire de Brest, Brest, France
| | - Malika Mahloul
- Pediatric Pulmonary Department, AP-HP, Hôpital Trousseau, Université Pierre et Marie Curie-Paris6, Inserm U938, 26, avenue du Docteur Arnold-Netter, 75012 Paris, France
| | - Delphine Michon
- Pediatric Pulmonary Department, AP-HP, Hôpital Trousseau, Université Pierre et Marie Curie-Paris6, Inserm U938, 26, avenue du Docteur Arnold-Netter, 75012 Paris, France
| | - Annick Clement
- Pediatric Pulmonary Department, AP-HP, Hôpital Trousseau, Université Pierre et Marie Curie-Paris6, Inserm U938, 26, avenue du Docteur Arnold-Netter, 75012 Paris, France
| | - Harriet Corvol
- Pediatric Pulmonary Department, AP-HP, Hôpital Trousseau, Université Pierre et Marie Curie-Paris6, Inserm U938, 26, avenue du Docteur Arnold-Netter, 75012 Paris, France
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Taytard J, Nathan N, de Blic J, Fayon M, Epaud R, Deschildre A, Troussier F, Lubrano M, Chiron R, Reix P, Cros P, Mahloul M, Michon D, Clement A, Corvol H. New insights into pediatric idiopathic pulmonary hemosiderosis: the French RespiRare(®) cohort. Orphanet J Rare Dis 2013. [PMID: 24125570 DOI: 10.1186/1750-1172-9-161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of alveolar hemorrhage in children and its pathophysiology remains obscure. Classically, diagnosis is based on a triad including hemoptysis, diffuse parenchymal infiltrates on chest X-rays, and iron-deficiency anemia. We present the French pediatric cohort of IPH collected through the French Reference Center for Rare Lung Diseases (RespiRare®, http://www.respirare.fr). METHODS Since 2008, a national network/web-linked RespiRare® database has been set up in 12 French pediatric respiratory centres. It is structured as a medical recording tool with extended disease-specific datasets containing clinical information relevant to all forms of rare lung diseases including IPH. RESULTS We identified 25 reported cases of IPH in children from the database (20 females and 5 males). Among them, 5 presented with Down syndrome. Upon diagnosis, median age was 4.3 [0.8-14.0] yrs, and the main manifestations were: dyspnea (n = 17, 68%), anemia (n = 16, 64%), cough (n = 12, 48%), febrile pneumonia (n = 11, 44%) and hemoptysis (n = 11, 44%). Half of the patients demonstrated diffuse parenchymal infiltrates on chest imaging, and diagnosis was ascertained either by broncho-alveolar lavage indicating the presence of hemosiderin-laden macrophages (19/25 cases), or lung biopsy (6/25). In screened patients, initial auto-immune screening revealed positive antineutrophilic cytoplasmic antibodies (ANCA) (n = 6, 40%), antinuclear antibodies (ANA) (n = 5, 45%) and specific coeliac disease antibodies (n = 4, 28%). All the patients were initially treated by corticosteroids. In 13 cases, immunosuppressants were introduced due to corticoresistance and/or major side effects. Median length of follow-up was 5.5 yrs, with a satisfactory respiratory outcome in 23/25 patients. One patient developed severe pulmonary fibrosis, and another with Down syndrome died as a result of severe pulmonary hemorrhage. CONCLUSION The present cohort provides substantial information on clinical expression and outcomes of pediatric IPH. Analysis of potential contributors supports a role of auto-immunity in disease development and highlights the importance of genetic factors.
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Affiliation(s)
- Jessica Taytard
- Pediatric Pulmonary Department, AP-HP, Hôpital Trousseau, Université Pierre et Marie Curie-Paris6, Inserm U938, 26, avenue du Docteur Arnold-Netter, 75012 Paris, France.
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Aubertin G, Marguet C, Delacourt C, Houdouin V, Leclainche L, Lubrano M, Marteletti O, Pin I, Pouessel G, Rittié JL, Saulnier JP, Schweitzer C, Stremler N, Thumerelle C, Toutain-Rigolet A, Beydon N. Recommandations pour l’oxygénothérapie chez l’enfant en situations aiguës et chroniques : évaluation du besoin, critères de mise en route, modalités de prescription et de surveillance. Arch Pediatr 2012; 19:528-36. [DOI: 10.1016/j.arcped.2012.02.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 02/26/2012] [Indexed: 10/28/2022]
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Ghdifan S, Verin E, Couderc L, Lubrano M, Michelet I, Marguet C. Exhaled nitric oxide fractions are well correlated with clinical control in recurrent infantile wheeze treated with inhaled corticosteroids. Pediatr Allergy Immunol 2010; 21:1015-20. [PMID: 20977500 DOI: 10.1111/j.1399-3038.2010.01076.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Fractional exhaled nitric oxide (FeNO) is a non-invasive marker of bronchial inflammation in asthma. However, the interest of FeNO measurement remained limited in infantile wheeze. The aim of this prospective study was to evaluate the feasibility and reproducibility of FeNO off-line measurement in very young children with recurrent wheeze and to assess whether clinical control of infantile wheeze correlates with FeNO levels. Two exhalation samples were collected in mylar balloon during quite tidal breathing. FeNO measurements were performed off-line by a NO analyzer. The participating patients were aged ≤36 months, wheezes had started before the age of 24 months, and they were receiving maintenance treatment with inhaled corticosteroids for at least 3 months duration. The studied population comprised of 40 uncontrolled infants with persistent wheezy respiratory symptoms, median age 14.5 months, and 40 with optimal controlled infantile wheeze, median age 14 months. The reproducibility was excellent (r = 0.95; p < 0.0001). There was a significant difference in FeNO levels between the groups of persistent wheeze and well-controlled infants: 19.8 (2.5-99.3) ppb vs. 7.7 (0.6-29.5) ppb, p < 0.0001. At a FeNO level >15 ppb, the predictive values for uncontrolled disease were as follows: positive predictive value = 65%, negative predictive value = 90%. FeN0 levels were not increased by atopy or passive tobacco. Off-line assessment of FeNO is feasible, reproducible, and well accepted in wheezy very young children. Optimal clinical control of infantile wheeze appeared to be associated with the control of bronchial inflammation when evaluated by FeNO measurements.
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Affiliation(s)
- Sufian Ghdifan
- Division of Pediatric Pulmonology, Allergy, and Cystic Fibrosis Division of Respiratory Physiology, Charles Nicolle University Hospital, INSERM CIC 204, Rouen University, Rouen, France
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Vanhabost J, Michelet I, Blanc T, Couderc L, Lubrano M, Marguet C. P156 - Syndrome de détresse respiratoire aiguë et Myxovirus Parainfluenza, à propos de 2 cas. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70556-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Affiliation(s)
- C Marguet
- Unité de Pneumologie et Allergologie, CRCM, Département de Pédiatrie Médicale, CHU Charles-Nicolle, 76031 Rouen cedex, France.
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Legru E, Lubrano M, Lemée L, Marguet C. [Acute RSV bronchiolitis: should we be looking for pertussis?]. Arch Pediatr 2009; 16:283-4. [PMID: 19186038 DOI: 10.1016/j.arcped.2008.12.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2007] [Revised: 04/15/2008] [Accepted: 12/11/2008] [Indexed: 11/27/2022]
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Abstract
Pulmonary function tests remain the best method to assess underlying bronchial inflammation, particularly distal airway flow. However, these tests are limited in their ability to differentiate treatment-reversible small airway obstruction from definitive remodeling related to a viral infection. The increased availability of the exhaled fraction of nitric oxide (FeNO) measurement means that this method is accessible and attractive. In spite of a number of studies, mainly in adults, its use in the management of asthma needs more investigation. Threshold values that permit optimum management are poorly defined, and strategies based on variations of FeNO do not result in reduction of the number of exacerbations, although they do permit better control of drug use and better control of inflammation. Sputum eosinophil counts are of interest for the prevention of exacerbations, although while not well validated they may be useful in some asthmatic children. Also, they require an experienced cytology laboratory. Finally, recent data on bronchial biopsies in children with difficult-to-treat asthma will be summarized.
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Affiliation(s)
- C Marguet
- Unité de pneumologie et allergologie pédiatrique, hôpital universitaire Charles-Nicolle, 76031 Rouen cedex, France.
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Rimet Y, Brusquet Y, Ronayette D, Dageville C, Lubrano M, Mallet E, Rambaud C, Terlaud C, Silve J, Lerda O, Netchiporouk LI, Weber JL. Surveillance of infants at risk of apparent life threatening events (ALTE) with the BBA bootee: a wearable multiparameter monitor. ACTA ACUST UNITED AC 2007; 2007:4997-5000. [DOI: 10.1109/iembs.2007.4353462] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Abstract
The adverse events of the inhaled steroids on growth and bone mineralization concern the pediatricians. From the available current data, we exposed the following conclusions: 1) Inhaled steroids must be preferred to oral steroids; 2) Short, middle and long-term adverse effects of inhaled steroids have to be differentiated. Only the long-term effects reflect possible sequela; 3) The adverse effects are specific from the considered inhaled steroids, the most recent available drugs having less adverse effects on bone and growth; 4) Recent data did not show consequences on the adult height and bone mineralization; 5) Recommendations in the use of inhaled steroids must be known by the practitioners in order to limit the adverse events of these drugs. Growth need to be surveyed in children with inhaled steroids and more studies are still necessary. In addition, we enhanced that local adverse effects should be sought by the physicians. Cough after inhalation was frequent and might be a negative factor of compliance.
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Affiliation(s)
- C Marguet
- Unité de pneumologie et allergologie pédiatrique, hôpital Charles-Nicolle, CHU, 76031 Rouen cedex, France.
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Mallet E, Grout B, Lubrano M. [Continuous glucose monitoring in children with glycogen storage diseases]. Arch Pediatr 2004; 11:371-2. [PMID: 15051096 DOI: 10.1016/j.arcped.2003.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2003] [Accepted: 12/03/2003] [Indexed: 11/19/2022]
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Affiliation(s)
- C Marguet
- Unité de pneumo-allergologie pédiatrique, hôpital Charles-Nicolle, CHU, 76031 Rouen, France.
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