ATS Issues Guidance for Managing Postprematurity Respiratory Disease

Recommendations address the outpatient management of postprematurity respiratory disease in infants, children, and adolescents

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THURSDAY, Dec. 30, 2021 (HealthDay News) -- In a clinical practice guideline issued by the American Thoracic Society and published in the December issue of the American Journal of Respiratory and Critical Care Medicine, recommendations are presented for the outpatient management of postprematurity respiratory disease (PPRD) in infants, children, and adolescents.

A. Ioana Cristea, M.D., from the Riley Hospital for Children and Indiana University in Indianapolis, and colleagues conducted a systematic review of the relevant literature and developed evidence-based guidelines on outpatient management of infants, children, and adolescents with PPRD.

The authors suggest that short-acting inhaled bronchodilator therapy not be routinely prescribed for infants, children, and adolescents with PPRD who do not have recurrent respiratory symptoms. A trial of a short-acting inhaled bronchodilator with monitoring to assess for clinical improvement in symptoms is suggested for those with recurrent respiratory symptoms. Routine prescribing of inhaled corticosteroids is not suggested for those who do not have chronic cough or recurrent wheezing. A trial of inhaled corticosteroids with monitoring to assess for clinical improvement in symptoms is suggested for those who do have chronic cough or recurrent wheezing. Routine use of diuretics is not suggested; discontinuation in a judicious manner is suggested for infants with PPRD who are discharged from the neonatal intensive care unit on chronic diuretic therapy. In total, the authors developed recommendations for or against three common medical therapies and four diagnostic evaluations.

"These recommendations are intended to aid clinicians in the outpatient management of infants, children, and adolescents with PPRD, regardless of the degree of prematurity, the severity of disease, the disease phenotype, or the age of the patient at the time of presentation," the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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