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Pulmonary complications in children with Down syndrome: A scoping review
Mariska De Lausnay1, Kris Ides2, Mark Wojciechowski3
1Department of Pediatrics, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium; Laboratory of Experimental Medicine and Pediatrics (LEMP), Antwerp University, Belgium.
Insights
Children with Down syndrome (DS) frequently experience complex lower airway issues, including infections and anomalies. Early diagnosis and a multidisciplinary team approach are crucial for better outcomes in these pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Genetics
- Clinical Medicine
Background:
- Down syndrome (DS) is a common genetic disorder.
- DS is associated with numerous congenital anomalies and health concerns.
- Lower airway problems represent a significant health burden in children with DS.
Purpose of the Study:
- To provide a comprehensive scoping review of lower airway conditions in children with Down syndrome.
- To identify both infectious and non-infectious respiratory issues encountered in this population.
Main Methods:
- Systematic literature search of MEDLINE and PubMed databases.
- Inclusion of original studies on pediatric airway problems in DS, adhering to PRISMA guidelines.
- Critical review and thematic summarization of extracted data on patient characteristics, methods, and outcomes.
Main Results:
- Sixty studies were reviewed, highlighting prevalent airway anomalies, dysphagia, aspiration, and severe respiratory infections.
- Children with DS exhibit a higher incidence of airway anomalies and often experience silent aspiration.
- Respiratory infections, including bronchiolitis, are more severe in DS, leading to increased hospitalization; pulmonary hypertension and wheeze are also more common.
Conclusions:
- Lower airway problems are more frequent and complex in children with Down syndrome.
- Airway anomalies and aspiration require specialized management strategies.
- A multidisciplinary team approach is essential for timely diagnosis, effective management, and improved long-term outcomes for DS children with respiratory issues.
Context:
Down syndrome (DS) is a prevalent chromosomal disorder associated with a wide range of congenital anomalies and other health problems.
Objectives:
To give a scoping overview of encountered lower airway problems (both infectious and non-infectious) in DS children.
Data Sources:
We systematically searched the MEDLINE and PubMed databases for relevant publications.
Study Selection:
Studies were eligible if they were original studies about pediatric airway problems in DS and were evaluated by the PRISMA guidelines.
Data Extraction:
Data concerning patient characteristics, study methods and outcomes were critically reviewed.
Results:
Sixty papers were included. These were reviewed and summarized by topic, i.e. airway anomalies, dysphagia and aspiration, lower respiratory tract infections (and bronchiolitis in particular), pulmonary hypertension and other. Respiratory problems are proven to be a frequent and a major health burden in DS children. Airway anomalies (both single and multiple) are more prevalent and require a specific approach. A large proportion of DS children have (often silent) aspiration, resulting in protracted and difficult-to-treat symptoms. Respiratory tract infections are usually more severe and associated with an increased need for (prolonged) hospitalization. Pulmonary hypertension, wheeze and some other rare conditions are more commonly encountered in DS.
Limitations:
Large number of studies and high levels of study heterogeneity.
Conclusions:
Several lower airway problems are more frequent and more complex in children with DS. These findings emphasize the need for a multidisciplinary approach by an experienced team allowing for a prompt diagnosis, proper management and improved long term outcome.
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