European Respiratory Society guideline on long-term management of children with bronchopulmonary dysplasia
Por:
Duijts, L, van Meel, ER, Moschino, L, Baraldi, E, Barnhoorn, M, Bramer, WM, Bolton, CE, Boyd, J, Buchval, F, del Cerro, MJ, Colin, AA, Ersu, R, Greenough, A, Gremmen, C, Halvorson, T, Kamphuis, J, Kotecha, S, Rooney-Otero, K, Schulzke, S, Wilson, A, Rigau, D, Morgan, RL, Tonia, T, Roehr, CC, Pijnenburg, MW
Publicada:
1 ene 2020
Resumen:
This document provides recommendations for monitoring and treatment of children in whom bronchopulmonary dysplasia (BPD) has been established and who have been discharged from the hospital, or who were >36 weeks of postmenstrual age. The guideline was based on predefined Population, Intervention, Comparison and Outcomes (PICO) questions relevant for clinical care, a systematic review of the literature and assessment of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. After considering the balance of desirable (benefits) and undesirable (burden, adverse effects) consequences of the intervention, the certainty of the evidence, and values, the task force made conditional recommendations for monitoring and treatment of BPD based on very low to low quality of evidence. We suggest monitoring with lung imaging using ionising radiation in a subgroup only, for example severe BPD or recurrent hospitalisations, and monitoring with lung function in all children. We suggest to give individual advice to parents regarding daycare attendance. With regards to treatment, we suggest the use of bronchodilators in a subgroup only, for example asthma-like symptoms, or reversibility in lung function; no treatment with inhaled or systemic corticosteroids; natural weaning of diuretics by the relative decrease in dose with increasing weight gain if diuretics are started in the neonatal period; and treatment with supplemental oxygen with a saturation target range of 90-95%. A multidisciplinary approach for children with established severe BPD after the neonatal period into adulthood is preferable. These recommendations should be considered until new and urgently needed evidence becomes available.
Filiaciones:
Duijts, L:
Erasmus MC, Dept Pediat, Div Resp Med & Allergol, Univ Med Ctr Rotterdam, Rotterdam, Netherlands
Erasmus MC, Dept Pediat, Div Neonatol, Univ Med Ctr Rotterdam, Rotterdam, Netherlands
van Meel, ER:
Erasmus MC, Dept Pediat, Div Resp Med & Allergol, Univ Med Ctr Rotterdam, Rotterdam, Netherlands
Moschino, L:
Univ Padua, Dept Womens & Childrens Hlth, Padua, Italy
Baraldi, E:
Univ Padua, Dept Womens & Childrens Hlth, Padua, Italy
Barnhoorn, M:
Lung Fdn Netherlands, Amersfoort, Netherlands
Bramer, WM:
Erasmus MC, Univ Med Ctr Rotterdam, Med Lib, Rotterdam, Netherlands
Bolton, CE:
Univ Nottingham, NIHR Nottingham BRC Resp Theme, Nottingham, England
Univ Nottingham, Div Resp Med, Nottingham, England
Boyd, J:
European Lung Fdn, Sheffield, S Yorkshire, England
Buchval, F:
Rigshosp, Pediat Pulm Serv, DBLC, Copenhagen, Denmark
del Cerro, MJ:
Ramon y Cajal Univ Hosp, Pediat Cardiol, Madrid, Spain
Colin, AA:
Univ Miami, Miller Sch Med, Div Pediat Pulmonol, Miami, FL 33136 USA
Ersu, R:
Marmara Univ Istanbul, Div Respirol, Istanbul, Turkey
Univ Ottowa, Childrens Hosp Eastern Ontario, Div Respirol, Ottawa, ON, Canada
Greenough, A:
Kings Coll London, Fac Life Sci & Med, Sch Life Course Sci, Women & Childrens Hlth, London, England
Gremmen, C:
Lung Fdn Netherlands, Amersfoort, Netherlands
Halvorson, T:
Haukeland Hosp, Dept Pediat, Bergen, Norway
Univ Bergen, Dept Clin Sci, Bergen, Norway
Kamphuis, J:
European Lung Fdn, Sheffield, S Yorkshire, England
Kotecha, S:
Cardiff Univ, Sch Med, Dept Child Hlth, Cardiff, Wales
Rooney-Otero, K:
Nemours Childrens Hosp, Div Hosp Med, Orlando, FL USA
Schulzke, S:
Univ Childrens Hosp Basel UKBB, Dept Neonatol, Basel, Switzerland
Wilson, A:
Princess Margaret Hosp Children, Dept Resp & Sleep Med, Perth, WA, Australia
Rigau, D:
Iberoamer Cochrane Ctr, Barcelona, Spain
Morgan, RL:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Tonia, T:
Univ Bern, Inst Social & Prevent Med, Bern, Switzerland
Roehr, CC:
Univ Oxford, Dept Paediat, Med Sci Div, Oxford, England
Oxford Univ Hosp, John Radcliffe Hosp, Newborn Serv, Oxford, England
Pijnenburg, MW:
Erasmus MC, Dept Pediat, Div Resp Med & Allergol, Univ Med Ctr Rotterdam, Rotterdam, Netherlands
Green Accepted, Bronze
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