Computed tomography versus bronchography in the diagnosis and management of tracheobronchomalacia in ventilator dependent infants

Mok, Quen

doi:10.1136/adc.2004.062604

Cited by 53 publications

(41 citation statements)

References 11 publications

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“…Although multidetector computed tomography with multiplanar 3-dimensional reconstruction and magnetic resonance imaging are good at determining the nature of vascular compression of the airway, they cannot yet distinguish reliably between dynamic and static narrowing [10,11]. Fiber-optic bronchoscopy and bronchography are useful for this purpose and routinely used in our malacia assessment program [1,12,13]. Images can be obtained with different levels of CPAP, with the patient breathing spontaneously.…”

Section: Discussionmentioning

confidence: 99%

Aortopexy for persistent tracheal obstruction after double aortic arch repair

Fraga

Calkoen

Gabra

et al. 2009

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Aortopexy for persistent tracheal obstruction after double aortic arch repair

Fraga

Calkoen

Gabra

et al. 2009

Journal of Pediatric Surgery

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“…In children undergoing bronchoscopy for respiratory distress or chronic wet cough, lower airway malacia is present in approximately 30% of patients (10). This increases to approximately 50% in premature infants (11), and in almost all infants who require chronic mechanical ventilation (12). The specific cause for airway malacia remains undefined, and few preventive or therapeutic options are available for the clinician.…”

Section: Clinical Relevancementioning

confidence: 99%

Effect of Prenatal versus Postnatal Vitamin D Deficiency on Pulmonary Structure and Function in Mice

Saadoon¹,

Ambalavanan²,

Zinn

et al. 2017

Am J Respir Cell Mol Biol

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Epidemiologic studies have linked gestational vitamin D deficiency to respiratory diseases, although mechanisms have not been defined. We hypothesized that antenatal vitamin D deficiency would impair airway development and alveolarization in a mouse model. We studied the effect of antenatal vitamin D deficiency by inducing it in pregnant mice and then compared lung development and function in their offspring to littermate controls. Postnatal vitamin D deficiency and sufficiency models from each group were also studied. We developed a novel tracheal ultrasound imaging technique to measure tracheal diameter in vivo. Histological analysis estimated tracheal cartilage total area and thickness. We found that vitamin D-deficient pups had reduced tracheal diameter with decreased tracheal cartilage minimal width. Vitamin D deficiency increased airway resistance and reduced lung compliance, and led to alveolar simplification. Postnatal vitamin D supplementation improved lung function and radial alveolar count, a parameter of alveolar development, but did not correct tracheal narrowing. We conclude that antenatal vitamin D deficiency impairs airway and alveolar development and limits lung function. Reduced tracheal diameter, cartilage irregularity, and alveolar simplification in vitamin D-deficient mice may contribute to increased airways resistance and diminished lung compliance. Vitamin D supplementation after birth improved lung function and, potentially, alveolar simplification, but did not improve defective tracheal structure. This mouse model offers insight into the mechanisms of vitamin D deficiency-associated lung disease and provides an in vivo model for investigating preclinical preventive and therapeutic strategies. Clinical RelevanceThis murine investigation details structural and physiologic aberrances resulting from prenatal and postnatal vitamin D deficiency. In addition to modeling consequences on lung development, our findings emphasize differential benefit of prenatal versus postnatal vitamin D supplementation. These data provide mechanistic insight into clinical consequences of vitamin D deficiency-induced lung disease and the utility of a mouse model to test preventive and therapeutic interventions.

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“…Initial evaluation includes a history and physical examination followed by bronchoscopy or imaging as needed. Endoscopy is frequently cited as the reference standard for evaluation of airway abnormalities, but it is invasive and limited in infants and small children [2]. Pulmonary function tests are limited in the care of small children and do not give anatomic information.…”

mentioning

confidence: 99%