Document Detail

An official American Thoracic Society clinical practice guideline: classification, evaluation, and management of childhood interstitial lung disease in infancy.
MedLine Citation:
PMID:  23905526     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There is growing recognition and understanding of the entities that cause interstitial lung disease (ILD) in infants. These entities are distinct from those that cause ILD in older children and adults.
METHODS: A multidisciplinary panel was convened to develop evidence-based guidelines on the classification, diagnosis, and management of ILD in children, focusing on neonates and infants under 2 years of age. Recommendations were formulated using a systematic approach. Outcomes considered important included the accuracy of the diagnostic evaluation, complications of delayed or incorrect diagnosis, psychosocial complications affecting the patient's or family's quality of life, and death.
RESULTS: No controlled clinical trials were identified. Therefore, observational evidence and clinical experience informed judgments. These guidelines: (1) describe the clinical characteristics of neonates and infants (<2 yr of age) with diffuse lung disease (DLD); (2) list the common causes of DLD that should be eliminated during the evaluation of neonates and infants with DLD; (3) recommend methods for further clinical investigation of the remaining infants, who are regarded as having "childhood ILD syndrome"; (4) describe a new pathologic classification scheme of DLD in infants; (5) outline supportive and continuing care; and (6) suggest areas for future research.
CONCLUSIONS: After common causes of DLD are excluded, neonates and infants with childhood ILD syndrome should be evaluated by a knowledgeable subspecialist. The evaluation may include echocardiography, controlled ventilation high-resolution computed tomography, infant pulmonary function testing, bronchoscopy with bronchoalveolar lavage, genetic testing, and/or lung biopsy. Preventive care, family education, and support are essential.
Geoffrey Kurland; Robin R Deterding; James S Hagood; Lisa R Young; Alan S Brody; Robert G Castile; Sharon Dell; Leland L Fan; Aaron Hamvas; Bettina C Hilman; Claire Langston; Lawrence M Nogee; Gregory J Redding;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  188     ISSN:  1535-4970     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-08-02     Completed Date:  2013-10-17     Revised Date:  2014-08-03    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  376-94     Citation Subset:  AIM; IM    
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MeSH Terms
Diagnostic Techniques, Respiratory System / standards*
Disease Management*
Lung Diseases, Interstitial* / classification,  diagnosis,  therapy
Practice Guidelines as Topic*
Societies, Medical*
United States
Grant Support
Alan S Brody / ; Robert G Castile / ; Sharon Dell / ; Robin R Deterding / ; Leland L Fan / ; James S Hagood / ; Aaron Hamvas / ; Bettina C Hilman / ; Geoffrey Kurland / ; Claire Langston / ; Lawrence M Nogee / ; Gregory J Redding / ; Lisa R Young / ; Daniel W Young / ; Alejandro J Colom / ; Alejandro M Teper / ; Adam Jaffe / ; Ernst Cutz / ; Felix Ratjen / ; John D Mark / ; Beverly Newman / ; Carlyne Cool / ; Steven Abman / ; Margaret Anthony / ; Csaba Galambos / ; Gwen Kerby / ; Marzena Krawiec / ; David Lynch / ; Megan Dishop / ; Annick Clement / ; Jonathan Popler / ; Pauline Chou / ; Susanna McColley / ; Adrienne Prestridge / ; Young-Jee Kim / ; Susan C Coventry / ; Ronald L Morton / ; Fred Askin / ; Pamela Zeitlin / ; Alicia Casey / ; Martha Fishman / ; T Bernard Kinane / ; Sze Man Tse / ; Stuart Sweet / ; Herman Thomas / ; Frances White / ; Pierre Barker / ; W Adam Gower / ; Daniel Sheehan / ; William Travis / ; Clement Ren / ; Susan Wert / ; Bruce Trapnell / ; Peter B Baker / ; Frederick Long / ; Samuel Goldfarb / ; Robert P Guillerman / ; George Mallory / ; Timothy Vece / ; Gail Deutsch / ; Eric L Effman / ; Theresa Guilbert / ; Andrew Bush /

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