Trial tests dornase alfa, a cystic fibrosis drug, for severe COVID pneumonia
Boston Children’s Hospital and Brigham and Women’s Hospital will soon begin testing an existing drug, dornase alfa, in patients with severe COVID-19 pneumonia and respiratory failure. The randomized, controlled clinical trial aims to enroll 60 adults and children over age 3 who require mechanical ventilation. Key takeaways:· A randomized trial is testing whether a cystic ... Read More
Utilizing engineering tools from the aerospace industry to repair hearts
When an 18-year-old patient from North Carolina recently presented at Boston Children’s Heart Center with an enlarged right atrium that made the flow through his Fontan circulation very inefficient, David Hoganson, MD, decided to utilize a new set of tools borrowed from the aerospace industry. “We have been collaborating with Dassault Systemes for over a ... Read More
Guidance for assessing treatment response in pediatric brain tumors
Assessing patients’ response to cancer therapy can be challenging, especially in neuro-oncology. Generally, we assess treatment response by a change in tumor size on MRI scan. However, with brain tumors, changes on MRI scan can be difficult to interpret. A decrease in tumor size may indicate treatment is having an effect; however, a drug can ... Read More
Caring for pediatric ADHD patients through telehealth
Key takeaways· In the current health crisis, online visits should be used to monitor current patients and make new diagnoses.· Providers should guide families to resources for at-home behavioral modification techniques.· Telehealth office visits are likely to remain after the current crisis subsides. It comes as no surprise to the pediatric neurology community at Boston ... Read More
Treating inflammation in MIS-C: An evidence-based approach
Multisystem inflammatory syndrome in children (MIS-C) is a complex, post-COVID-19 spectrum of illness that has affected a small number of children and adolescents. Symptoms can include features of Kawasaki disease, cardiac dysfunction, hypotension and toxic-shock-like signs, abnormal blood coagulation, and prominent GI symptoms. At its core is a hyperinflammatory response that we do not yet ... Read More
Radiology of COVID-19 infection in children: Imaging findings and recommendations
Key takeaways:· Lung images in children with COVID-19 show unique features, including the halo sign.· Chest X-ray and CT images differ significantly from early to late infection.· New imaging guidelines recommend when to perform imaging studies on children with COVID-19. As more children become infected with the coronavirus causing COVID-19, lung imaging shows that the ... Read More
COVID-19 and a serious inflammatory syndrome in children: Unpacking recent warnings
On April 27, an alert circulated from the U.K. about multi-system inflammatory disease in children with COVID-19, based on a small rise in the number of critically ill children with this illness in England. Picked up by multiple media outlets, the alert cited features of toxic shock syndrome and incomplete Kawasaki disease, with some children ... Read More
Vascular rings: A complex cause of noisy breathing
Patients who present with noisy breathing, wheezing, a barking cough, and frequent respiratory infections are often misdiagnosed with asthma or croup, but a more complex problem could be responsible. Such symptoms can signal tracheomalacia (also known as tracheobronchomalacia), a condition in which the airway narrows or collapses when a child breathes. But clinicians should consider ... Read More
How do you implement change? Lessons from a QI project in the NICU
Kristen Leeman, MD, is Director of Quality in the Division of Newborn Medicine and Associate Medical Director of the Neonatal Intensive Care Unit at Boston Children’s Hospital. What if you were taught to do things a certain way, the way things were always done, and then a randomized clinical trial comes out supporting a different ... Read More
New treatment guidelines for complex ADHD
Approximately 7.5 percent of children and adolescents in the U.S. have attention deficit hyperactivity disorder (ADHD), and about two-thirds of them have one or more co-existing conditions such as learning disorders or mental health problems. Treatment for these more complex forms of ADHD has focused largely on medical interventions. But now, a new clinical guideline ... Read More