CHEST Guidelines-Probiotics-in-the-Pediatric-ICU

Probiotics-in-the-Pediatric-ICU_chest

Pdf Summary

The study highlights the development of bronchiectasis in patients with hematologic malignancy, indicating a significant drop in forced vital capacity (FVC) values and worsening of bronchial dilatation and airway thickening over time. The cohort is notable for being the first reported group experiencing clinically significant bronchiectasis in this context. The study finds a link between bronchiectasis development and hematologic malignancy, noting that this condition arises irrespective of graft-versus-host disease (GVHD), stem cell transplantation (SCT), or immunoglobulin deficiency, signifying that these are not sole causes. Although most patients had received multiple chemotherapy courses known for pulmonary toxicities, none specifically linked to bronchiectasis, the condition might result from a synergy of contributing factors and potentially unidentified mechanisms tied to the malignancy.<br /><br />The second section discusses the role of probiotics in critically ill children, especially in pediatric intensive care. Despite evidence suggesting potential benefits for preventing or reducing complications like nosocomial infections and candidiasis, studies show mixed results. While some indicate no significant impact, others reveal benefits like reduced ventilator-associated pneumonia and hospital stays in children under broad-spectrum antibiotics. The need for larger, well-designed clinical trials to confirm probiotics' effectiveness in these settings is emphasized.<br /><br />Lastly, the document briefly touches upon the potential role of thiamine in treating severe sepsis. Despite its limited noted benefit in all septic shock patients, thiamine, a crucial cofactor for energy metabolism, might reduce lactate levels and mortality in thiamine-deficient patients, emphasizing the necessity for further analysis to confirm its efficacy in severe sepsis treatment. Overall, these studies underscore the need for further research to delineate precise mechanisms and treatment pathways for these conditions.

Keywords

bronchiectasis

hematologic malignancy

forced vital capacity

chemotherapy

probiotics

pediatric intensive care

nosocomial infections

thiamine

severe sepsis

clinical trials