Bronchial balloon occlusion in children with complex pulmonary air leaks

Hathorn, C; Armitage, Nicole; Wensley, David; Seear, Michael

doi:10.1136/archdischild-2012-302529

Cited by 11 publications

(8 citation statements)

References 17 publications

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“…The technique has been described in only a few case reports, and for bronchopleural fistula consists of placing a guidewire along the endotracheal tube and a balloon angiography catheter with a small volume of contrast agent [94,116]. Under fluoroscopic guidance the fistula can be detected by inflating the balloon in different sites until the chest tube stops producing bubbles.…”

Section: Balloon Dilation and Occlusionmentioning

confidence: 99%

“…The balloon should be deflated at intervals for short periods of time to reduce pressure on the bronchial walls, and care must be taken to avoid balloon overdistension. Potential adverse effects include accumulated secretions with a risk of infection, necrosis, stenosis or bronchial wall erosion with potential migration of the balloon [116]. Balloon occlusion has been detailed in only one paediatric case with life-threatening haemoptysis [94].…”

Section: Balloon Dilation and Occlusionmentioning

confidence: 99%

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ERS statement: interventional bronchoscopy in children

et al. 2017

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Paediatric airway endoscopy is accepted as a diagnostic and therapeutic procedure, with an expanding number of indications and applications in children. The aim of this European Respiratory Society task force was to produce a statement on interventional bronchoscopy in children, describing the evidence available at present and current clinical practice, and identifying areas deserving further investigation. The multidisciplinary task force panel performed a systematic review of the literature, focusing on whole lung lavage, transbronchial and endobronchial biopsy, transbronchial needle aspiration with endobronchial ultrasound, foreign body extraction, balloon dilation and occlusion, laser-assisted procedures, usage of airway stents, microdebriders, cryotherapy, endoscopic intubation, application of drugs and other liquids, and caregiver perspectives. There is a scarcity of published evidence in this field, and in many cases the task force had to resort to the collective clinical experience of the committee to develop this statement. The highlighted gaps in knowledge underline the need for further research and serve as a call to paediatric bronchoscopists to work together in multicentre collaborations, for the benefit of children with airway disorders.

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Section: Balloon Dilation and Occlusionmentioning

confidence: 99%

Section: Balloon Dilation and Occlusionmentioning

confidence: 99%

ERS statement: interventional bronchoscopy in children

et al. 2017

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“…Several techniques have been used to occlude the bronchi, but none have been widely studied. Bronchial occlusion can have complications, such as necrosis, erosion of the bronchial wall or bronchial stenosis, airway perforation, and distal infection [11]. Lewis et al [12] reported one of the first cases of selective bronchial occlusion in a 26-week preterm infant with hyaline membrane disease with a persistent air leak that was successfully treated using a Swan-Ganz catheter.…”

Section: Discussionmentioning

confidence: 99%

A Case of Persistent Air Leak Managed by Selective Left Main Bronchus Intubation in an Infant with Pulmonary Tuberculosis

et al. 2020

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Unusual clinical course Background: Persistent air leak, or persistent pneumothorax, is defined as a pneumothorax that persists beyond the first week, or air leak through a chest drain for more than 48 hours. The most common findings in pediatric pulmonary tuberculosis are parenchymal disease and mediastinal lymphadenopathy, but airway obstruction can cause emphysema and pneumothorax. A case is presented of persistent air leak in a 3-month-old infant with pulmonary tuberculosis that was managed by selective left main bronchus intubation. Case Report: A 3-month-old boy presented with respiratory distress and fever. Imaging findings suggested pulmonary tuberculosis, and first-line anti-tuberculous treatment was initiated with isoniazid, rifampicin, pyrazinamide, and ethambutol (HRZE). He was discharged home after eight days, but was admitted four days later with respiratory distress. Chest X-rays showed a tension pneumothorax that required drainage and chest computed tomography (CT) showed right lung emphysema. Bronchoscopy found extrinsic obstruction of both main bronchi. Chest drains continued to leak air leak after 48 h. Right middle and lower lobectomy and drainage of multiple lymph nodes resulted in significant improvement. He developed pneumonia and acute respiratory distress syndrome, which prevented mechanical ventilation. The left main bronchus was selectively intubated to allow the air leak to heal and to ventilate the lung. He was extubated 10 days later and recovered completely. Conclusions: This case highlights that when medical management of persistent air leak associated with tuberculosis is not effective, surgery, active ventilation, and selective main bronchus intubation should be considered.

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“…HATHORN et al [165] reported six patients with complex air leaks treated with endobronchial balloon occlusion. The intervention was successful in two cases of broncho-pleural fistulae and in one of two cases of intra-pulmonary leak.…”

Section: Paediatric Bronchologymentioning

confidence: 99%