Bozkanat Kubra Melike, Schramm Dirk
Department of Pediatrics, Division of Pulmonary, Asthma and Sleep, Stanford University School of Medicine, Palo Alto, California, USA.
Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Germany.
Curr Opin Pediatr. 2025 Jun 1;37(3):272-277. doi: 10.1097/MOP.0000000000001470. Epub 2025 Apr 10.
Pediatric interventional pulmonology (PIP) is an evolving subspecialty aiming at respiratory diseases in children through procedural interventions. This review discusses recent developments and challenges in global adoption of these advancements.
Innovations such as ultra-thin cryoprobes and bronchoscopes allow for diagnostic and interventional procedures in pediatric airways. Cryotherapy demonstrates advantages in obtaining biopsies, treating airway stenosis, and extracting foreign bodies. Endobronchial ultrasound has improved the accuracy of diagnosing lymphadenopathy and pulmonary lesions, but its large size and high cost limit its use in resource-poor areas. Other newer techniques, such as tracheoesophageal fistula repair and endobronchial valves for air leaks, are promising but lack strong evidence for widespread adoption. Geographical and economic disparities impede progress, with high-income countries pioneering innovation, and low- and middle-income areas facing access and training challenges.
While PIP does have the potential to be transformational, global disparities in its adoption are significant. International collaborations, standardized training, and resources are paramount. This can be achieved through virtual training platforms and global conferences that will help narrow the gaps, ensuring equitable PIP growth to benefit pediatric respiratory care globally.
儿科介入肺病学(PIP)是一个不断发展的亚专业,旨在通过程序性干预治疗儿童呼吸系统疾病。本综述讨论了全球采用这些进展的最新发展情况和挑战。
超薄冷冻探头和支气管镜等创新技术使儿科气道的诊断和介入程序成为可能。冷冻疗法在获取活检组织、治疗气道狭窄和取出异物方面显示出优势。支气管内超声提高了诊断淋巴结病和肺部病变的准确性,但其尺寸大、成本高,限制了其在资源匮乏地区的使用。其他较新的技术,如气管食管瘘修复和用于漏气的支气管内瓣膜,前景广阔,但缺乏广泛应用的有力证据。地理和经济差异阻碍了进展,高收入国家引领创新,而低收入和中等收入地区面临获取和培训方面的挑战。
虽然儿科介入肺病学有潜力带来变革,但其在全球采用方面的差异很大。国际合作、标准化培训和资源至关重要。这可以通过虚拟培训平台和全球会议来实现,这些将有助于缩小差距,确保儿科介入肺病学公平发展,造福全球儿童呼吸护理。