Virtual International Pediatric Pulmonary Network (VIPPN)

Editor's Choice

Ozge Yilmaz, MD

Two pediatric articles were published in Annals of ATS this month.

Hysinger et al. has enrolled 974 neonates with BPD in this multicenter study and they compared the in-hospital morbidity of babies with and without tracheobronchomalacia (TBM). They demonstrated that hospital length of stay was three weeks longer and duration of mechanical ventilation was nearly 15 days longer in neonates with TBM. Moreover, subjects with TBM required more treatment at discharge.  TBM that is a common comorbidity in BPD increases in-hospital and discharge morbidity (1).

The second paper by Ramsey et al was about the utility of lung clearance index (LCI) to detect the presence and extent of lower respiratory tract infection in preschool children with cystic fibrosis. Lung clearance index, that measures ventilation distribution using multiple-breath washout technique, was demonstrated to be significantly correlated with inflammation such as the number of inflammatory cells. Moreover, LCI was higher in subjects with a lower respiratory tract infection. Thus the atuhors suggest that LCI with the multiple breath washout technique may be used for monitoring early lung disease in children with CF (2).


1. Ramsey KA, Foong RE, Grdosic J, Harper A, Skoric B, Clem C, Davis M, Turkovic  L, Stick SM, Davis SD, Ranganathan SC, Hall GL; Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST CF) * . Multiple-Breath Washout Outcomes Are Sensitive to Inflammation and Infection in Children with Cystic Fibrosis. Ann Am Thorac Soc. 2017;14:1436-1442.

2. Hysinger EB, Friedman NL, Padula MA, Shinohara RT, Zhang H, Panitch HB, Kawut  SM; Children's Hospitals Neonatal Consortium. Tracheobronchomalacia Is Associated with Increased Morbidity in Bronchopulmonary Dysplasia. Ann Am Thorac Soc. 2017 Jun 16.