Therapeutic interventions and pulmonary function in pediatric patients with post-infectious bronchiolitis obliterans

Table 5 Key studies on post-infectious bronchiolitis obliterans: Sample sizes, main results, and critical limitations

Ref.	Sample size (n)	Design	Main findings	Key limitations/biases
Jerkic et al[1]	(Multiple studies)	Retrospective, multicenter workshop summary	Provided diagnostic framework based on expert consensus; highlighted frequent severe obstructive patterns on PFTs and HRCT	Mainly expert opinion, heterogeneous cases, lack of standardized treatment comparisons
Cazzato et al[2]	10	Case series	Confirmed persistent airway obstruction; FEV1 and FEF25%-75% significantly reduced in most patients	Small cohort, no control group, variable follow-up, single-region recruitment
Colom et al[3]	46	Cross sectional (12-year follow-up)	Some children showed mild improvements in FEV1 and FVC over 12 years; severity depends on initial damage	Limited generalizability, possible survival bias, lack of treatment standardization
Jung et al[4]	47	Cross sectional	Identified predictors of poor prognosis (e.g., mosaic perfusion, air trapping on CT)	Short term follow-up, single-center, no external validation
Kim et al[5]	23	Cross-sectional with quantitative CT	Suggested quantitative CT correlates well with lung function	Variability in CT technique, no standard thresholds
Li et al[31]	42	Prospective observational	Azithromycin + corticosteroids improved symptoms in 86% of children	Non-randomized, no control group, subjective symptom assessment
Zheng et al[25]	34	Retrospective ICS comparison	Continuous inhaled corticosteroids improved FEV1 more than intermittent use in children > 5 years	Lack of randomization, possible adherence bias, short follow-up
Zhang et al[26]	30	Case series nebulization therapy	Long term budesonide + bronchodilator nebulization in toddlers improved small airway tidal flows and CT findings	Small cohort, no control group; subjective imaging interpretation; variable treatment duration
Teixeira et al[28]	30	Randomized control trial	Tiotropium showed acute bronchodilator response in some PIBO patients	Single center, short follow-up
Yilmaz et al[27]	11	Retrospective, single center	IVIG treatment showed clinical stability in severe PIBO	Small sample, no comparative arm, retrospective bias
Colom and Teper[30]	125	Retrospective observational study	Proposed criteria to diagnose PIBO early	Single center, retrospective design, limited generalizability, Needs validation in prospective cohorts
Rosewich et al[12]	20 (+ 22 controls)	Cross-sectional	Highlighted persistent neutrophilic airway inflammation	No intervention tested, only descriptive, single time-point, age variability

PFTs: Pulmonary function tests; HRCT: High-resolution computed tomography; FVC: Forced vital capacity; CT: Computed tomography; ICS: Inhaled corticosteroids; PIBO: Post-infectious bronchiolitis obliterans; IVIG: Intravenous immunoglobulin.