Title

Tracheobronchomalacia diagnosed by tracheobronchography in ventilator-dependent infants.

Document Type

Article

Publication Date

12-1-2016

Identifier

DOI: 10.1007/s00247-016-3685-9

Abstract

BACKGROUND: Tracheobronchomalacia prevalence in premature infants on prolonged mechanical ventilation is high.

OBJECTIVE: To examine the prevalence of tracheobronchomalacia diagnosed by tracheobronchography in ventilator-dependent infants, and describe the demographic, clinical and dynamic airway characteristics of those infants with tracheobronchomalacia.

MATERIALS AND METHODS: This retrospective review studies 198 tracheobronchograms performed from 1998 to 2011 in a cohort of 158 ventilator-dependent infantstracheobronchomalacia.

RESULTS: Tracheobronchograms were performed at a median age of 52 weeks post menstrual age. The primary diagnoses in these infants were bronchopulmonary dysplasia (53%), other causes of chronic lung disease of infancy (28%) and upper airway anomaly (13%). Of those with bronchopulmonary dysplasia, 48% had tracheobronchomalacia. Prematurity (P=0.01) and higher baseline - pre-tracheobronchogram positive end-expiratory pressure (P=0.04) were significantly associated with tracheobronchomalacia. Dynamic airway collapse during tracheobronchography showed statistically significant airway opening at optimal positive end-expiratory pressure (P < 0.001). There were no significant complications noted during and immediately following tracheobronchography.

CONCLUSION: The overall prevalence of tracheobronchomalacia in this cohort of ventilator-dependent infants is 40% and in those with bronchopulmonary dysplasia is 48%. Infants born prematurely and requiring high pre-tracheobronchogram positive end-expiratory pressure were likely to have tracheobronchomalacia. Tracheobronchography can be used to safely assess the dynamic function of the airway and can provide the clinician the optimal positive end-expiratory pressure to maintain airway patency.

Journal Title

Pediatric radiology

Volume

46

Issue

13

First Page

1813

Last Page

1821

MeSH Keywords

Bronchography; Bronchopulmonary Dysplasia; Female; Humans; Infant; Infant, Newborn; Male; Prevalence; Respiration, Artificial; Retrospective Studies; Tracheobronchomalacia

Keywords

Airway; Bronchopulmonary dysplasia; Infants; Neonatology; Respiratory; Tracheobronchography; Tracheobronchomalacia

Collection

Neonatology

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