Department of Surgery, Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Department of Surgery, Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA 19104, USA.
Adv Drug Deliv Rev. 2021 Jul;174:168-189. doi: 10.1016/j.addr.2021.04.004. Epub 2021 May 1.
Pediatric upper airway disorders are frequently life-threatening and require precise assessment and intervention. Targeting these pathologies remains a challenge for clinicians due to the high complexity of pediatric upper airway anatomy and numerous potential etiologies; the most common treatments include systemic delivery of high dose steroids and antibiotics or complex and invasive surgeries. Furthermore, the majority of innovative airway management technologies are only designed and tested for adults, limiting their widespread implementation in the pediatric population. Here, we provide a comprehensive review of the most recent challenges of managing common pediatric upper airway disorders, describe the limitations of current clinical treatments, and elaborate on how to circumvent those limitations via local controlled drug delivery. Furthermore, we propose future advancements in the field of drug-eluting technologies to improve pediatric upper airway management outcomes.
小儿上呼吸道疾病常危及生命，需要精确的评估和干预。由于小儿上呼吸道解剖结构高度复杂，潜在病因众多，针对这些疾病仍然是临床医生面临的挑战；最常见的治疗方法包括全身给予大剂量类固醇和抗生素，或进行复杂和有创的手术。此外，大多数创新的气道管理技术仅为成人设计和测试，限制了它们在儿科人群中的广泛应用。在这里，我们全面回顾了管理常见小儿上呼吸道疾病的最新挑战，描述了当前临床治疗的局限性，并详细说明了如何通过局部控制药物输送来规避这些局限性。此外，我们还提出了药物洗脱技术领域的未来进展，以改善小儿上呼吸道管理的效果。
