This article compares two important pathophysiological states, Kawasaki disease, and multisystem inflammatory syndrome, in children associated with COVID-19 (MIS-C). Both occur predominantly in children, have a temporal association with an infectious agent, and are associated with immune-system alteration and systemic inflammation under certain circumstances. The two share common pathophysiology, including enhancement of interleukin-1 neutrophils, activation of the inflammasome, pyroptosis, or NETosis. Moreover, the clinical presentation of the diseases overlaps. However, they are indeed two separate diseases, proven by the differences in the epidemiological and etiological aspects and the pathophysiological processes involved in the development and frequency of some clinical signs. This article highlights potentially exciting areas that have not yet been studied in detail, which could help better understand the development of these diseases.
- MeSH
- COVID-19 * MeSH
- dítě MeSH
- Kawasakiho syndrom * diagnóza MeSH
- lidé MeSH
- syndrom systémové zánětlivé reakce MeSH
- zánět MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
OBJECTIVE: To evaluate the heart rate (HR) and oxygen saturation (SpO2) at 15-second intervals within 60 seconds after incremental increases of fractional inspired oxygen (FiO2) during resuscitation of infants younger than 29 weeks requiring two different forms of ventilatory support. STUDY DESIGN: Retrospective observational study. METHODS: Forty-three infants were stabilized, 14 by continuous positive airway pressure exclusively (CPAP group), and 29 by positive pressure ventilation (PPV group). Both groups received ventilatory support in a special bed with two cameras enabling the evaluation of all interventions including HR, SpO2, FiO2, positive inflation pressure, and positive end-expiratory pressure values. FiO2 was commenced at 0.30 and titrated in 0.1-0.2 increments every 30-60 seconds. The relationships between the incremental increases of FiO2 and related SpO2 and HR changes were evaluated. RESULTS: Although there was an inverse correlation between initial FiO2 and SpO2 in both groups, a significant positive correlation between the incremental increase of FiO2 and SpO2 changes after 30 seconds was found only in the CPAP group. Only higher initial levels of FiO2 had a positive effect on the improvement in SpO2 in the PPV group. CONCLUSION: The efficacy of FiO2 titration in 0.1-0.2 increments may be attenuated and delayed in extremely preterm infants required PPV during the first 6 minutes of life.
- MeSH
- kyslík analýza MeSH
- lidé MeSH
- novorozenci extrémně nezralí * MeSH
- novorozenec MeSH
- resuscitace metody MeSH
- retrospektivní studie MeSH
- trvalý přetlak v dýchacích cestách MeSH
- ventilace umělá s výdechovým přetlakem MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
