International Journal of Clinical Case Reports 2024, Vol.14, No.3, 157-166 http://medscipublisher.com/index.php/ijccr 163 face a higher risk of severe outcomes. Children with BPD have higher odds of hospitalization, ICU admission, oxygen supplementation, mechanical ventilation, and in-hospital mortality compared to those without BPD (Chaw et al., 2019a). Similarly, children with CHD face higher risks of severe RSV-ALRI, including increased rates of hospitalization, ICU admission, and mechanical ventilation (Chaw et al., 2019b). These findings underscore the need for targeted interventions and management strategies for high-risk pediatric populations. Figure 2 Association between nutritional and clinical risk factors and the occurrence of ALRIs (Adopted fromVinaykumar and Maruti, 2020) Figure 2 shows the relationship between different nutritional and clinical risk factors and the occurrence of ALRIs. The data indicate that malnutrition and anemia significantly increase the incidence of ALRIs. Particularly in cases of severe and very severe pneumonia, the proportion of malnourished children is higher. This suggests that nutritional status is a significant risk factor for ALRIs, and improving children's nutrition can effectively reduce the incidence and severity of ALRIs. 7.2 Best practices in treatment and management The management of ALRIs in children involves both pharmacological and non-pharmacological strategies. Non-invasive ventilation (NIV) modalities such as continuous positive airway pressure (CPAP) and high-flow nasal cannula (HFNC) have shown promise in reducing the risk of intubation and treatment failure compared to standard oxygen therapy (Wang et al., 2021). However, the evidence is still inconclusive regarding their impact on mortality, indicating the need for further research. Antibiotic use in children with uncomplicated lower respiratory tract infections (LRTIs) is another area of concern. A randomized controlled trial (ARTIC PC) found that amoxicillin did not significantly reduce the duration of symptoms in children with uncomplicated LRTIs, suggesting that antibiotics should not be routinely prescribed unless pneumonia is suspected (Little et al., 2021). This aligns with the broader public health goal of reducing antibiotic resistance. 7.3 Areas requiring further research and development Several areas require further research to improve the treatment and management of ALRIs in children. First, there is a need for standardized definitions and guidelines for conditions like BPD to facilitate more consistent and effective management (Chaw et al., 2018). Additionally, more specific studies on RSV infection in children with BPD and CHD, including vaccine development and RSV-specific treatments, are urgently needed (Chaw et al., 2019a; 2019b).
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