A common occurrence in the neonatal intensive care unit (NICU) is metabolic acidosis. Sodium bicarbonate (SB) has been widely used, but there is insufficient evidence on how SB affects neonates in NICUs with metabolic acidosis. The worsening of intracellular acidosis, the impairment of myocardial function, fluctuations in cerebral blood flow, and intracranial hemorrhage are some of the unfavorable effects of SB treatment in neonates that have been documented in the literature. This study aimed to explore neonatologists’ practices for using intravenous SB (ISB) in NICUs. A multi-country survey was carried out in 2022 using an online questionnaire sent to neonatologists in various countries in order to gather information about the use of ISB in NICUs. A previously validated questionnaire was adapted and used in this study. The response rate was 67%. The findings show that 91.2% of neonatologists were using SB to correct metabolic acidosis in the NICU; 71.4% did not have written guidelines for using sodium bicarbonate. The majority of them (78.9%) reported that dosage is included in their guidelines for the use of ISB. The findings of this study emphasize the critical importance of providing guidelines in using ISB for managing metabolic acidosis in NICU to standardize procedures and reduce the use of potentially unsuitable and unsafe treatments, as it has been shown that 71.4% of neonatologists worldwide use sodium bicarbonate without guidelines.

Background: Blood transfusion is a highly critical life-saving factor in neonates, especially in extremely low birth weight infants. There is a significant lack of consensus on optimal blood transfusion methods for neonates. Aim: To investigate and analyze blood transfusion practice in neonates among neonatologists and neonatal nurses in a multi-country pattern. Methods: From September 2023 to June 2024, a cross-sectional questionnaire-based study was conducted to collect data on global blood transfusion practices in neonates. A questionnaire, developed through an extensive literature review, was distributed to neonatologists and neonatal nurses primarily via e-mail, with additional distribution via social media platforms. Results: This study included a total of 180 neonatologists and neonatal nurses from 27 different countries. Almost 37.7% were working in a level 3 NICU. Approximately 37.7% of the participants stated that they transfuse blood within three hours, and approximately 45.5% stated they usually use 15 mL/kg of blood. After receiving a transfusion, 99.4% of the participants mentioned that they continue to check the vital signs. More than half (72.2%) of NICU practitioners use filters when giving blood. Regarding written instructions and guidelines in the unit for blood transfusion, the majority (84.4%) stated having them in their units, of which, 86.8% mentioned that blood transfusion threshold stated in the guidelines either using hemoglobin or hematocrit. Conclusions: This study found variability in blood transfusion practices around the world. While most have developed neonatal blood transfusion guidelines, certain countries still lack national protocols. Establishing comprehensive guidelines is essential to standardizing procedures, thereby minimizing the risk of inappropriate or unsafe blood transfusions in this neonatology practice.

Background: With rising life expectancy in cystic fibrosis (CF), effective transition from pediatric to adult care is essential. Structured transition models are thought to improve continuity of care, clinical stability, and psychosocial outcomes. This review of reviews synthesizes systematic review evidence on the effectiveness of these models across healthcare systems. Methods: Reviews and systematic reviews with or without meta-analysis published between 2005 and 2025 were identified through comprehensive searches. Methodological quality was assessed using AMSTAR 2, and primary study overlap was quantified using the Corrected Covered Area (CCA). A narrative synthesis was conducted for all included reviews, stratified by intervention type and geography. Results: Structured programs consistently outperformed informal approaches. Joint pediatric–adult clinics were associated with preserved lung function and fewer hospitalizations. The use of readiness tools, such as the Transition Readiness Assessment Questionnaire, showed improvement in self-management skills. Transition coordinators enhanced adherence and improved patient satisfaction with care. Evidence was limited regarding the long-term impact on mortality or transplant status. Conclusion: Structured transition models, particularly those incorporating joint clinics and coordinator-led care, are effective in improving self-management, adherence, and continuity of care for adolescents and young adults with CF. Future systematic reviews should focus on synthesizing evidence for long-term clinical outcomes. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42025214760 , PROSPERO CRD42025214760.

Background: Artificial intelligence is well poised to be a multi-dimensional resource for children and their health in the future. Recent advancement in machine learning and algorithms have helped tackle diseases like asthma, pneumonia, and lung nodules.Objectives: Present study aims to provide a detailed overview of AI application in Pediatric Pulmonology.Methods: Many articles, published in review journals have been included to write the current review. The literature search was done by using electronic databases such as PubMed, Google Scholar, ResearchGate, Frontiers. Pictorial descriptions of AI efficiency have been included for better understanding. Studies have been reviewed to highlight the pandemic scenario and its effect on children.Results: Various studies have shown promising results of AI application in Pediatric Pulmonology through efficient imaging and digital technology-based devices. The utility of AI technique has been included under the following subheadings 1) Artificial Intelligence in Pediatric Auscultation, 2) Artificial Intelligence in Pediatric Imaging, 3) Artificial Intelligence based Pediatric PFTs, 4) Machine learning in prediction of childhood asthma persistence, 5) AI in Pneumonia diagnosis in children, 6) AI in Pediatric Pulmo-oncology, 6) Covid-19 scenario, 7) Current and Future Perspective of AI, 8) Challenges and Pitfalls of AI in Pediatric Pulmonology.Conclusion: AI technology has come a long way in the field of Pediatrics especially during the post-covid scenario through novel digital devices and automation. Lack of technology awareness, funding and AI in study curriculum are a few challenges faced by the health care professionals currently. These limitations must be addressed for more clinical utility in daily practice.

A comprehensive review and meta-analysis were conducted with the purpose of determining the extent to which asthma is prevalent among children in Saudi Arabia. This was done with the intention of addressing the dearth of data at the national level regarding this significant health concern. The study included data from PubMed, Embase, Cochrane Library, and Google Scholar for the period 2015–2024, focusing on studies that reported the prevalence of asthma among children in the country. The primary outcome was the pooled prevalence of physician-diagnosed asthma among children. Eight studies, comprising a total of 9454 children, were included in the analysis. The estimated pooled prevalence of asthma was 28.9%, with a higher prevalence observed among boys compared to girls. A random-effects model was used to account for heterogeneity among studies, which was notably high (I² = 99%). Factors contributing to the high prevalence included increasing urbanization, air pollution, and specific environmental exposures, particularly in regions like Jazan. Limitations of the analysis included reliance on self-reported data without spirometric confirmation and potential publication bias. Despite these challenges, the findings emphasize the urgent need for public health interventions to reduce asthma prevalence and improve outcomes. Future research should incorporate standardized diagnostic methods and objective measurements to provide more accurate estimates and to develop effective management strategies.

Objective: This study aims to evaluate the association between socioeconomic conditions and the lung function of children below 18 years old. Design: Systematic review. Methods: PRISMA guidelines were followed to browse relevant studies from 2013 to 2023. Data from the included studies were extracted after the Newcastle–Ottawa risk of bias tool was applied. Main Outcome: Forced expiratory volume in the first second (FEV₁) liters. Results: 20 papers with 89,619 participants were included. Logistic regression model for FEV₁ based on multiple SES indices, suggested a positive association between lower respiratory function and a lower SES, with an interquartile odds ratio (OR) of 1.67 (95% CI 1.03– 1.34). Conclusion: Children from a lower socioeconomic status (SES) do exhibit lower lung function and addressing the causes of this can contribute to developing preventive public health strategies. Limitations: Lack of appropriate reference values and varied indicators of socioeconomic status in the studies contributed to significant statistical differences. Prospero Registration Number: CRD 42020197658.