Authors´ conclusions: oral dextrose gel reduces the need for intravenous fluids in at-risk neonates with asymptomatic hypoglycemia in the first 48 hours of life.
Reviewers´ commentary: oral dextrose gel appears to be a safe and effective treatment to reduce the risk of admission due to hypoglycemia in newborns at risk. It is an option that also seems cost-effective and well accepted by families, so it can be considered as the first therapeutic step in the management guidelines for neonatal hypoglycemia.
Authors´ conclusions: among children with uncontrolled moderate-to-severe asthma, those who received add-on dupilumab had fewer asthma exacerbations and better lung function and asthma control than those who received placebo
Reviewers´ commentary: in children with moderate-severe asthma and a type 2 eosinophilic inflammatory profile, add-on dupilumab is an effective treatment, subject to cost and administration conditions.
Sánchez Mateo A, Albi Rodríguez MS. Evid Pediatr. 2022;18:35
Authors´ conclusions: nonoperative management of nonperforated pediatric appendicitis in children has increased in the U.S.A. in recent years. Although most patients are treated successfully, they have a higher rate of emergency department revisits and hospitalizations than children who have appendectomy on their first visit and, in whom non-surgical management fails, there is an increased risk of perforation.
Reviewers´ commentary: nonoperative management of nonperforated pediatric appendicitis has increased in U.S.A. children's hospitals between 2011 and 2020. Although most children are successfully treated, this study suggests bigger rates of subsequent check-ups and hospitalizations, as well as an increased risk of perforation at the time of failure with that type of management. Further rigorous, large-scale studies of nonoperative management in children are needed to determine its optimal use.
Gimeno Díaz de Atauri Á, Ruiz-Canela Cáceres J. Evid Pediatr. 2022;18:36
Authors´ conclusions: in full-term newborns, antibiotics during the first week of life are related to the appearance of functional abdominal pain at the age of 4-6 years, and the presence of food allergy is related to the presence of irritable bowel syndrome and abdominal migraine at 4-6 years.
Reviewers´ commentary: the use of antibiotic therapy in full-term newborns in the first days of life could increase the risk of suffering from gastrointestinal disorders in childhood. This association is weak and of little magnitude. Further studies would be necessary for confirmation.
Ortega Páez E, Martín Masot R. Evid Pediatr. 2022;18:37
Authors´ conclusions: among infants undergoing endotracheal intubation at two Australian tertiary neonatal intensive care units, nasal high-flow therapy during the procedure improved the likelihood of successful intubation on the first attempt without physiological instability in the infant.
Reviewers´ commentary: the results of this study show that the use of nasal high-flow oxygen therapy during neonatal oral intubation is effective and safe, especially among operators with little experience. This technique can be easily implemented in clinical practice and can be generalized to units with access to this equipment.
Carvajal Encina F, Aizpurua Galdeano P. Evid Pediatr. 2022;18:38
Authors´ conclusions: enteral administration of recombinant human insulin could favor the acquisition of full enteral feeding in preterm infants. Additional studies are necessary to determine the optimal dose and its efficacy in the most immature groups of neonates.
Reviewers´ commentary: enteral administration of 2 different recombinant human insulin dosages was safe and compared with placebo, significantly reduced time to full enteral feeding in preterm infants with a gestational age of 26 to 32 weeks.
Molina Arias M, Aparicio Rodrigo M. Evid Pediatr. 2022;18:39
Authors’ conclusions: between March and October 2020, living with young children was associated with an attenuated risk of any COVID-19 and COVID-19 requiring hospitalisation among adults living in healthcare worker households.
Reviewers’ commentary: although the risk of COVID-19 requiring hospitalisation in adults exposed to young children did not reach statistical significance, increased household exposure to young children has not been associated with an increased risk of COVID-19, even during periods when schools were open and there was active transmission of SARS-CoV-2 in the community.
Critically appraised articles
