Publications by authors named "Jacob A Kaslow"
Background: Children with tracheostomies require skilled medical care performed by trained caregivers or home health nursing (HHN). HHN services are often limited, resulting in increased caregiver responsibilities. We aim to evaluate HHN availability, healthcare utilization, and mortality in tracheostomy dependent children, pre and post-COVID-19 pandemic.
View Article and Find Full Text PDFObjectives: To characterize an observational cohort of ventilator-dependent infants and children with bronchopulmonary dysplasia (BPD) with or without tracheobronchomalacia (TBM) and determine the impact of TBM on the need for ventilator support, liberation from the ventilator and tracheostomy decannulation.
Methods: Demographics and clinical outcomes were obtained by retrospective review from 12 centers participating in the outpatient BPD Collaborative registry. The cohort consisted of infants born between 2016 and 2021 who were dependent on invasive mechanical ventilation at home.
Article Synopsis
- The study focused on ventilator-dependent infants and children with bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) to assess their health outcomes.
- Approximately 60% of the 154 subjects had pulmonary hypertension, with many requiring specific medications; those with PH tended to transition to home ventilation and discharge at older ages.
- Despite the challenges, most subjects improved over time, successfully weaning off oxygen and ventilators by age 5, with a low mortality rate after discharge.
Article Synopsis
- The study aimed to assess the link between indoor air pollution and respiratory issues in children with bronchopulmonary dysplasia (BPD) under 3 years old.
- It involved 1,011 participants, with over 40% exposed to indoor pollutants like tobacco smoke and gas stoves, revealing higher odds of emergency visits and antibiotic use associated with secondhand smoke exposure.
- While acute respiratory problems were related to indoor air pollution, chronic respiratory symptoms and rescue medication use showed no significant association.
Article Synopsis
- The study aimed to identify factors affecting when infants with severe bronchopulmonary dysplasia (sBPD) can be liberated from ventilators and successfully decannulated.
- Results showed that on average, ventilation liberation occurred at 27 months and decannulation at 49 months, with factors like age at discharge, ventilator pressure, and respiratory readmissions influencing these timings.
- Conclusions highlighted that individual factors predominantly drive the differences in timing, while aggressive management of gastroesophageal reflux affected decannulation timelines.
Objectives: In adults, an isolated low FEV pattern (an FEV below the lower limit of normal with a preserved FVC and FEV/FVC) has been associated with the risk of developing airway obstruction. Our objective was to examine the prevalence, stability, and clinical significance of an isolated low FEV pattern in the pediatric population.
Methods: We conducted a retrospective study of spirometries from children ages 6-21 years and categorized tests into spirometry patterns according to published guidelines and recent literature.
Article Synopsis
- Bronchopulmonary dysplasia (BPD) is more common in premature infants and linked to increased outpatient health issues, especially with daycare attendance, prompting a study on the impact of other children in the household on these risks.
- A study involving 933 children with BPD revealed that each additional child in the household raises the risk for various respiratory-related health issues, such as hospital admissions and medication use, particularly when there are three or more children present.
- The findings suggest increased risks of adverse respiratory outcomes due to possible viral infections spreading among household members, indicating a need for strategies to reduce these risks.
Cardiovascular Measures of All-Cause Mortality in Duchenne Muscular Dystrophy.
Circ Heart Fail
August 2023
Article Synopsis
- Cardiopulmonary failure is the leading cause of death in Duchenne muscular dystrophy (DMD), and this study aims to identify cardiac measures that correlate with all-cause mortality to improve future therapeutic trials.
- Seventy-eight DMD patients underwent extensive cardiac assessments, including cardiac magnetic resonance imaging and blood biomarker analysis, with a focus on metrics like left ventricular ejection fraction and specific protein levels.
- The findings indicate that left ventricular ejection fraction, indexed volumes, certain strain measures, and the biomarker NT-proBNP are significantly associated with all-cause mortality, suggesting they are viable endpoints for future DMD treatments.
Article Synopsis
- The study focuses on outpatient respiratory outcomes in children with severe bronchopulmonary dysplasia (BPD) who require tracheostomy and long-term mechanical ventilation.
- Researchers analyzed data from 155 patients born between 2016 and 2021 across 12 care centers, using methods like Kaplan-Meier analysis to track key respiratory events and assess timing differences among centers.
- Findings showed significant variability in outcomes such as age at tracheostomy, hospital discharge, and ventilator liberation across different centers, highlighting the need for further research to understand contributing factors to these differences.
Validation of an outpatient questionnaire for bronchopulmonary dysplasia control.
Pediatr Pulmonol
May 2023
Article Synopsis
- A standardized questionnaire was developed to assess respiratory control in preterm infants and children with bronchopulmonary dysplasia (BPD) during outpatient visits, addressing the lack of valid tools for this purpose.
- Most caregivers (86.2%) reported feeling their child's symptoms were controlled, regardless of BPD severity or history of pulmonary hypertension, indicating broad perceived stability across the population.
- The questionnaire proved internally reliable and effectively differentiated between levels of symptom control, correlating with healthcare utilization metrics like emergency visits and hospital admissions, suggesting it may be useful for clinical and research applications.
Background: Duchenne muscular dystrophy (DMD) is associated with progressive muscle weakness and respiratory decline. To date, studies have focused on respiratory decline and loss of ambulation as a metric of loss of skeletal muscle strength. However, new functional measures can assess skeletal muscle disease regardless of ambulatory status.
View Article and Find Full Text PDFDuchenne muscular dystrophy (DMD) is characterized by muscle deterioration and progressive weakness. As a result, patients with DMD have significant cardiopulmonary morbidity and mortality that worsens with age and loss of ambulation. Since most validated muscle assessments require ambulation, new functional measures of DMD progression are needed.
View Article and Find Full Text PDFBackground: Duchenne muscular dystrophy (DMD) is a devastating, progressive neuromuscular disease that results in cardiopulmonary failure and death. In 2018, the DMD Care Considerations guidelines were updated to improve the multidisciplinary approach to care and promote early respiratory management. We sought to evaluate the impact of a multidisciplinary clinic on access to pulmonary care and adherence to respiratory care guidelines.
View Article and Find Full Text PDFUse of electronic nicotine delivery systems (ENDS), also known as e-cigarettes, in the adolescent population has significantly increased over the past several years. This rise led to an outbreak of e-cigarette or vaping product use-associated lung injury (EVALI) in the summer of 2019. Since that time, numerous case reports and case series on vaping and EVALI have been published but the majority of literature highlights the adult population with few articles focusing on pediatric patients.
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