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EDITORIAL
Year : 2018  |  Volume : 2  |  Issue : 1  |  Page : 1

Pollution, infection and high flow


Division of Pediatric Pulmonology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan

Date of Web Publication5-Apr-2018

Correspondence Address:
Kin-Sun Wong
Division of Pediatric Pulmonology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/prcm.prcm_4_18

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How to cite this article:
Wong KS. Pollution, infection and high flow. Pediatr Respirol Crit Care Med 2018;2:1

How to cite this URL:
Wong KS. Pollution, infection and high flow. Pediatr Respirol Crit Care Med [serial online] 2018 [cited 2018 Jul 21];2:1. Available from: http://www.prccm.org/text.asp?2018/2/1/1/229322

High-flow nasal cannula (HFNC) is a safe and well-tolerated noninvasive therapy in neonates and young children who required respiratory support not severe enough for mechanical ventilation. In this issue, Franklin and Schibler provided an excellent review of the mechanisms and rationale of HFNC.[1] Promotion of this patient-friendly respiratory support would help improve service delivery in children with respiratory distress, acute, or otherwise.

Traffic-related pollution has been found to be related with the development of asthma and exacerbation.[2],[3] Siu et al. studied the risk factors of preschool children with wheeze in Hong Kong such as environmental nitrogen dioxide concentration, sulfur dioxide, particulate matter, and preterm delivery rate of gestational age <36 weeks.[4] In the report, they found that the annual average NO2 concentration was the only independent factor associated with preschool wheeze admission using the multivariable regression analysis model. This finding suggests that environmental control is crucial for respiratory health in children with underlying diseases and clean air campaign should be targeted to ensure a decline in the admission of preschool wheeze in the forthcoming years.

Mycoplasma pneumoniae accounted for 7%–40% of all community-acquired pneumonia in children between 3 and 15 years of age.[5] Early targeted antibiotic therapy obviates unnecessary and overuse of antibiotics. The use of polymerase chain reaction may help early detection of M. Pneumoniae; however, it is not readily available, especially in resource-poor facilities; other alternative rapid diagnostic tests would be desirable. Liu et al. used the BioCard Mycoplasma IgM for the early diagnosis of Mycoplasma pneumonia in children comparing with standard IgM titers, they reported a sensitivity of 62.2% and specificity of 100%.[6] Despite the availability of BioCard test, it must be remember that a positive IgM titer may persist for up to 6 months after acute infections.[7]

I wish to take this opportunity to wish all readers a Happy Easter.



 
  References Top

1.
Franklin D, Schibler A. Nasal high-flow therapy in infants and children. Pediatr Respirol Crit Care Med 2018;2:2-6.  Back to cited text no. 1
  [Full text]  
2.
Esposito S, Galeone C, Lelii M, Longhi B, Ascolese B, Senatore L, et al. Impact of air pollution on respiratory diseases in children with recurrent wheezing or asthma. BMC Pulm Med 2014;14:130.  Back to cited text no. 2
[PUBMED]    
3.
Brunst KJ, Ryan PH, Brokamp C, Bernstein D, Reponen T, Lockey J, et al. Timing and duration of traffic-related air pollution exposure and the risk for childhood wheeze and asthma. Am J Respir Crit Care Med 2015;192:421-7.  Back to cited text no. 3
    
4.
Siu KK, Wong CP, Lee RS, Chan JP, Leung SY, Chan EY, et al. Air pollution as a risk factor for increasing hospitalizations of preschool wheeze in Hong Kong. Pediatr Respirol Crit Care Med 2018;2:11-5.  Back to cited text no. 4
  [Full text]  
5.
Juvén T, Mertsola J, Waris M, Leinonen M, Meurman O, Roivainen M, et al. Etiology of community-acquired pneumonia in 254 hospitalized children. Pediatr Infect Dis J 2000;19:293-8.  Back to cited text no. 5
    
6.
Liu TY, Yu HR, Lee WJ, Tsai CM, Kuo KC, Chang CH, et al. Role of BioCard Mycoplasm immunoglobulin M rapid test in the diagnosis of Mycoplasma pneumoniae infection. Pediatr Respirol Crit Care Med 2018;2:7-10.  Back to cited text no. 6
  [Full text]  
7.
Eun BW, Kim NH, Choi EH, Lee HJ. Mycoplasma pneumoniae in Korean children: The epidemiology of pneumonia over an 18-year period. J Infect 2008;56:326-31.  Back to cited text no. 7
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