G. Pérez

Guía de diagnóstico y tratamiento del síndrome de apneas-hipopneas del sueño en el niño

El sindrome de apneas-hipopneas del sueno (SAHS) esun problema muy frecuente en los ninos que hasta los ul-timos anos ha sido poco reconocido. El SAHS infantil di-fiere del SAHS del adulto, tanto en su etiologia como ensus manifestaciones clinicas, diagnostico y tratamiento. Seha comprobado que el SAHS produce complicaciones im-portantes en los ninos que lo padecen que pueden evi-tarse con un tratamiento adecuado. Desgraciadamente lospediatras con frecuencia no reconocen esta patologia porlo que esta muy infradiagnosticada e infratratada en losninos de nuestro pais. Por este motivo la Sociedad Espa-nola de Neumologia Pediatrica, a traves de su Grupo deTrabajo de Tecnicas, nos ha encomendado la tarea derealizar esta guia que pretende ser una herramienta sen-cilla para que el pediatra conozca mas a fondo este pro-blema, lo que esperamos redundara en beneficio de losninos que lo sufren y sus familias.

Etiología y diagnóstico de la neumonía adquirida en la comunidad y sus formas complicadas

Community Acquired Pneumonia (CAP) is a common childhood disease, involving several paediatric subspecialties in its diagnosis and treatment. This has prompted the Spanish Society of Paediatric Pulmonology (SENP) and the Spanish Society of Paediatric Infectious Diseases (SEIP) to prepare a consensus document on the diagnosis of CAP, assessing the practical aspects by means of evidence-based medicine. It discusses the aetiology and epidemiology, with the current changes and the validity of certain laboratory tests, such as acute phase reactants, microbiological and imaging techniques, guiding the paediatricians in the real value of these tests.

Displasia broncopulmonar y prematuridad. Evolución respiratoria a corto y a largo plazo

Bronchopulmonary dysplasia (BPD) is the most frequent chronic lung disease in premature children. With the inclusion of antenatal steroid therapy, surfactant use and novel mechanical ventilation strategies, survival of premature newborns has increased, whereupon the incidence of BPD has not only decreased but has also risen in extremely premature newborns. This has led to a high respiratory morbidity in the first 2-3 years of life, with numerous admissions to hospital and respiratory exacerbations mostly due to viral infections. Although there is a trend towards improvement, during school age and adolescence, respiratory symptoms may persist, due to changes in pulmonary function often showing a lower exercise capacity. Although BPD symptoms are similar to those of asthma, as there is limitation in airflow and bronchial hyperresponsiveness (BHR), pathophysiological mechanisms could be different in both diseases. On the other hand, isolated prematurity plays an important role in the childs respiratory pathology, proving that pulmonary function alterations in preterm children are present since the first months of life. A higher respiratory morbidity has also been observed in these children when compared to full-term newborns, not only during the first years of life but also subsequently. In this study, different aspects of chronic respiratory disease associated with prematurity will be analysed, drawing special attention to clinical symptoms, respiratory function changes, BHR and exercise capacity. All these aspects will be reviewed from early childhood until adolescence and young adult age. Similarities and differences between BPD and asthma will also be discussed.

Protocolo de seguimiento de los pacientes con displasia broncopulmonar

Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth, and remains a major problem in pediatric pulmonology units. The decision of discharging from the Neonatal Unit should be based on a thorough assessment of the condition of the patient and compliance with certain requirements, including respiratory and nutritional stability, and caregiver education on disease management. For proper control of the disease, a schedule of visits and complementary tests should be established prior to discharge, and guidelines for prevention of exacerbations and appropriate treatment should be applied. In this paper, the Working Group in Perinatal Respiratory Diseases of the Spanish Society of Pediatric Pulmonology proposes a protocol to serve as a reference for the follow up of patients with BPD among different centers and health care settings. Key factors to consider when planning discharge from the Neonatal Unit and during follow up are reviewed. Recommendations on treatment and prevention of complications are then discussed. The final section of this guide aims to provide a specific schedule for follow-up and diagnostic interventions to be performed in patients with BPD.

Asociación Española de PediatríaEtiología y diagnóstico de la neumonía adquirida en la comunidad y sus formas complicadasAetiology and diagnosis of community acquired pneumonia and its complicated forms

Community Acquired Pneumonia (CAP) is a common childhood disease, involving several paediatric subspecialties in its diagnosis and treatment. This has prompted the Spanish Society of Paediatric Pulmonology (SENP) and the Spanish Society of Paediatric Infectious Diseases (SEIP) to prepare a consensus document on the diagnosis of CAP, assessing the practical aspects by means of evidence-based medicine. It discusses the aetiology and epidemiology, with the current changes and the validity of certain laboratory tests, such as acute phase reactants, microbiological and imaging techniques, guiding the paediatricians in the real value of these tests.