Cystic fibrosis (CF) clinical care guidelines exist for the care of infants up to age 2 years and for individuals ≥6 years of age. An important gap exists for preschool children between the ages of 2 and 5 years. This period marks a time of growth and development that is critical to achieve optimal nutritional status and maintain lung health. Given that disease often progresses in a clinically silent manner, objective and sensitive tools that detect and track early disease are important in this age group. Several challenges exist that may impede the delivery of care for these children, including adherence to therapies. A multidisciplinary committee was convened by the CF Foundation to develop comprehensive evidence-based and consensus recommendations for the care of preschool children, ages 2 to 5 years, with CF. This document includes recommendations in the following areas: routine surveillance for pulmonary disease, therapeutics, and nutritional and gastrointestinal care.
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April 2016
Special Article|
April 01 2016
Clinical Practice Guidelines From the Cystic Fibrosis Foundation for Preschoolers With Cystic Fibrosis
Thomas Lahiri, MD;
aPediatric Pulmonology, University of Vermont Children’s Hospital and Department of Pediatrics, University of Vermont College of Medicine, Burlington, Vermont;
Address correspondence to Thomas Lahiri, MD, Director, Pediatric Pulmonology, University of Vermont Children’s Hospital, Smith 571, 111 Colchester Ave, Burlington, VT 05401. E-mail: Thomas.Lahiri@uvmhealth.org
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Sarah E. Hempstead, MS;
Sarah E. Hempstead, MS
bThe Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire;
cGeisel School of Medicine at Dartmouth, Lebanon, New Hampshire;
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Cynthia Brady, DNP;
Cynthia Brady, DNP
dChildren’s Respiratory and Critical Care Specialists and Children’s Hospitals and Clinics of Minnesota, Minneapolis, Minnesota;
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Carolyn L. Cannon, MD;
Carolyn L. Cannon, MD
eTexas A&M Health Science Center, College Station, Texas;
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Kelli Clark, BS;
Kelli Clark, BS
fDepartment of Pediatrics, University of North Carolina, Charlotte, North Carolina;
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Michelle E. Condren, PharmD;
Michelle E. Condren, PharmD
gUniversity of Oklahoma College of Pharmacy and School of Community Medicine, Tulsa, Oklahoma;
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Margaret F. Guill, MD;
Margaret F. Guill, MD
cGeisel School of Medicine at Dartmouth, Lebanon, New Hampshire;
hAllergy and Pediatric Pulmonology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire;
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R. Paul Guillerman, MD;
R. Paul Guillerman, MD
iDepartment of Radiology, Baylor College of Medicine and Department of Pediatric Radiology, Texas Children’s Hospital, Houston, Texas;
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Christina G. Leone, MSW;
Christina G. Leone, MSW
jCystic Fibrosis Center, Children’s Hospital Colorado, Aurora, Colorado;
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Karen Maguiness, MS;
Karen Maguiness, MS
kSection of Pediatric Pulmonology, Allergy and Sleep Medicine, Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana ;
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Lisa Monchil, RRT-NPS;
Lisa Monchil, RRT-NPS
lArmond V. Mascia, MD Cystic Fibrosis Center, Maria Fareri Children’s Hospital at Westchester Medical Center, Valhalla, New York;
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Scott W. Powers, PhD;
Scott W. Powers, PhD
mDepartment of Pediatrics and Cincinnati Children’s Research Foundation, University of Cincinnati College of Medicine and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital, Cincinnati, Ohio;
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Margaret Rosenfeld, MD;
Margaret Rosenfeld, MD
nDivision of Pulmonary Medicine, Seattle Children’s Hospital and Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington;
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Sarah Jane Schwarzenberg, MD;
Sarah Jane Schwarzenberg, MD
oPediatric Gastroenterology, Hepatology and Nutrition, University of Minnesota Masonic Children’s Hospital, Minneapolis, Minnesota;
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Connie L. Tompkins, PhD;
Connie L. Tompkins, PhD
pDepartment of Rehabilitation and Movement Sciences, University of Vermont College of Nursing and Health Sciences, Burlington, Vermont; and
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Edith T. Zemanick, MD;
Edith T. Zemanick, MD
qDepartment of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
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Stephanie D. Davis, MD
Stephanie D. Davis, MD
kSection of Pediatric Pulmonology, Allergy and Sleep Medicine, Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana ;
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Address correspondence to Thomas Lahiri, MD, Director, Pediatric Pulmonology, University of Vermont Children’s Hospital, Smith 571, 111 Colchester Ave, Burlington, VT 05401. E-mail: Thomas.Lahiri@uvmhealth.org
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
Pediatrics (2016) 137 (4): e20151784.
Article history
Accepted:
December 29 2015
Citation
Thomas Lahiri, Sarah E. Hempstead, Cynthia Brady, Carolyn L. Cannon, Kelli Clark, Michelle E. Condren, Margaret F. Guill, R. Paul Guillerman, Christina G. Leone, Karen Maguiness, Lisa Monchil, Scott W. Powers, Margaret Rosenfeld, Sarah Jane Schwarzenberg, Connie L. Tompkins, Edith T. Zemanick, Stephanie D. Davis; Clinical Practice Guidelines From the Cystic Fibrosis Foundation for Preschoolers With Cystic Fibrosis. Pediatrics April 2016; 137 (4): e20151784. 10.1542/peds.2015-1784
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