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La atrofia muscular espinal (AME) 5q es una de las enfermedades neuromusculares de mayor incidencia en la infancia. Sin embargo, la prevalencia de AME tipo 1, su forma más severa de presentación, es menor debido a muertes prematuras evitables antes de los dos años por insuficiencia ventilatoria subtratada. La irrupción de nuevos tratamientos modificadores de la enfermedad pueden cambiar dramáticamente este pronóstico y es una oportunidad para actualizar el manejo respiratorio, a través de cuidados estandarizados básicos, preferentemente no invasivos, abordando la debilidad de los músculos respiratorios, la insuficiencia tusígena y ventilatoria, con un enfoque preventivo. La siguiente revisión literaria entrega estrategias para evitar la intubación y la traqueostomía usando soporte ventilatorio no invasivo (SVN), reclutamiento de volumen pulmonar (RVP) y facilitación de la tos. Se analizan en detalle los protocolos de extubación en niños con AME tipo 1.

Spinal muscular atrophy (SMA) 5q is one of the neuromuscular diseases with the highest incidence in childhood. Nevertheless, the prevalence of its most severe form SMA1 is lower due to premature preventable deaths before two years of age related to ventilatory insufficiency undertreated. The emergence of new disease-modifying treatments can dramatically change this prognosis and is an opportunity to update respiratory management, through basic standardized care, mostly non-invasive, addressing respiratory muscles pump weakness, cough and ventilatory insufficiency with a preventive approach. This literature review provides consensus recommendations for strategies to avoid intubation and tracheostomy using noninvasive ventilatory support (NVS), lung volume recruitment (LVR), and cough facilitation. Extubation protocols in children with SMA type 1 are analyzed in detail.

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INTRODUCTION: Reactance inversion (RI) has been associated with impaired peripheral airway function in persistent asthma. However, there is little to no data about the difference between asthmatic children with and without RI. This study aimed to detect clinical and lung function differences in moderate-severe asthmatic children with and without RI. METHODS: This study was conducted between 2021 and 2022 in asthmatic school-age children. Impulse oscillometry (IOS) and spirometry were performed according to ATS/ERS standards. RESULTS: A total of 62 patients, with a mean age of 8.4 years, 54.8% were males and were divided into three groups: group 1 (32.3%) with no RI, group 2 (27.4%) with RI but disappearing after bronchodilator test and group 3 (40.3%) with persistent RI after bronchodilator test. Children in groups 2 and 3 had significantly lower birth weights than in group 1. Group 2 had lower gestational age compared to group 1. FEV1 and FEF25-75 of forced vital capacity were significantly lower in groups 2 and 3. In group 3, R5, AX, R5-20, and R5-R20/R5 ratios were significantly higher. Bronchodilator responses (BDR) in X5c, AX, and R5-R20 were significantly different between groups and lower in group 3. CONCLUSION: RI is frequently found in children with moderate-severe persistent asthma, particularly in those with a history of prematurity or low birth weight. In some patients, RI disappears after the bronchodilator test; however, it, persists in those with the worst pulmonary function. RI could be a small airway dysfunction marker.

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The abstract of a scientific research paper must be well written and reviewed. Sometimes is the only section of a paper that is read, therefore must have the problem, research question, objective, hypothesis, method, results and conclusions, with the limitation of the study. Editors through the abstract deduce what a paper is about and its scientific relevance. The title condenses the paper's content in a few words, must capture the reader's attention and includes patients and methods. Both, the research summary and title of the paper are used for references databases. The paper gives some tips to write a good research abstract and title.

El resumen de un artículo científico debe ser prolíjamente redactado y revisado ya que muchas veces es lo único que se lee. Debe ser específico y representativo del texto, describiendo el problema, el objetivo, la hipótesis, cómo se hizo la investigación y que resultados se obtuvieron con sus conclusiones, mostrando las limitaciones del estudio. El título debe llamar la atención del lector y describir los pacientes y el método en forma breve. Es en base al resumen que editores evaluan la validez y relevancia del artículo científico. El título y resumen es lo que se incorpora en las bases de datos bibliográficas. En este artículo se describen los pasos para la redacción de un resumen de un buen artículo científico.

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Introducción La infección respiratoria aguda en nuestro medio generalmente es de característica viral, siendo el virus respiratorio sincicial (VRS) el principal responsable de hospitalización en niños menores de dos años. Es más susceptible en los prematuros, con cardiopatía asociada y con síndrome de Down. (DS). El objetivo principal de este estudio es dar a conocer la incidencia de infección y hospitalización de niños con síndrome de Down por VRS. Para lo cual se realiza la revisión de la base de datos con el número de niños que se atienden en el Hospital Roberto del Río, durante los años 2014-2015, así como la revisión de sus historias clínicas de SD atendidos en el Hospital Roberto del Rio durante este periodo. Resultados: SE analizan 60 niños con SD atendidos en el hospital Roberto del Río que se hospitalizan con infección respiratoria aguda, en su mayoría son de sexo femenino, con VRS negativo, con un rango de hospitalización mínimo entre 7 a 10 días, y máximo de 20 días, y se asocian con más frecuencia a cardiopatía congénita. Se observó un prematuro SD solamente en el estudio. Conclusiones: El 40% de niños atendidos en el Hospital Roberto del Rio se hospitalizan con infección respiratoria aguda y un 41% de los hospitalizados están asociados al VRS. Los niños con SD y con condiciones clínicas asociadas como cardiopatía congénita tienen una alta incidencia de infección y hospitalización.

Summary Introduction: Acute respiratory infection in our environment is usually viral in nature, with respiratory syncytial virus (RSV) being the main cause of hospitalization in children under two years of age, with preterm infants with associated heart disease and Down syndrome being more susceptible. The main objective of this study is to describe the incidence of infection and hospitalization of children with Down syndrome (DS) due to RSV. Method: For this purpose, the database is revised with the number of children with DS treated at the Roberto del Río Children´s Hospital, during the years 2014-2015, as well as the review of their clinical histories. We analyzed 60 cases of children with DS. Results: Hospitalized SD children with acute respiratory infection, were mostly female, with negative RSV, hospitalization range between 7 to 10 days, and a maximum of 20 days, most associated with congenital heart disease. A premature DS baby was observed only in the study. Conclusions: Forty percent of the DS children treated at the Roberto del Rio Children´s Hospital hospitalized with acute respiratory infection and 41% of hospitalized patients were related to RSV, children with DS and associated clinical conditions such as congenital heart disease have a higher incidence of infection and hospitalization.

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