Should Neonatologists Rule Out Tracheobronchomalacia in Every Premature Baby With Bronchopulmonary Dysplasia?

Khalife, Marie-Claude Fadous; Feghali, H.; Saliba, Zakhia; Ojaimi, Mode Al; Issa, Issa; Menassa, Juliana; Noun, Peter; Sacy, Robert; Hajj, Pierre; Matta, Reva; Fneich, Ahmad; Matta, Perla; Hallit, Souheil

doi:10.14740/jmc3259

Cited by 1 publication

(2 citation statements)

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“…There are currently no specific criteria to guide which high risk infants should be assessed for TBM. Clinical suspicion for TBM may be due to the inability to wean from invasive mechanical ventilation, the need for high PEEP, agitation episodes “BPD spells” of bradycardia or desaturations, or prolonged need for ventilatory support 28,32 . In this study, infants with BPD underwent dCT at a median PMA of 44 weeks with 67% of these infants requiring endotracheal mechanical ventilation.…”

Section: Discussionmentioning

confidence: 90%

“…Clinical suspicion for TBM may be due to the inability to wean from invasive mechanical ventilation, the need for high PEEP, agitation episodes "BPD spells" of bradycardia or desaturations, or prolonged need for ventilatory support. 28,32 In this study, infants with BPD underwent dCT at a median PMA of 44 weeks with 67% of these infants requiring endotracheal mechanical ventilation. The most common indication for dCT in our study was failure to wean positive pressure ventilation.…”

Section: Discussionmentioning

confidence: 99%

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Dynamic computed tomography for evaluation of tracheobronchomalacia in premature infants with bronchopulmonary dysplasia

Pugh,

Ali,

Agarwal

et al. 2023

Pediatric Pulmonology

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IntroductionDynamic computed tomography (dCT) gives real‐time physiological information and objective descriptions of airway narrowing in tracheobronchomalacia (TBM). There is a paucity of literature in the evaluation of TBM by dCT in premature infants with bronchopulmonary dysplasia (BPD). The aim of this study is to describe the findings of dCT and resultant changes in management in premature infants with TBM.MethodsA retrospective study of 70 infants was performed. Infants included were <32 weeks gestation without major anomalies. TBM was defined as ≥50% expiratory reduction in cross‐sectional area with severity defined as mild (50%–75%), moderate (≥75%–90%), or severe (≥90%).ResultsDynamic CT diagnosed malacia in 53% of infants. Tracheomalacia was identified in 49% of infants with severity as 76% mild, 18% moderate, and 6% severe. Bronchomalacia was identified in 43% of infants with varying severity (53% mild, 40% moderate, 7% severe). Resultant management changes included PEEP titration (44%), initiation of bethanechol (23%), planned tracheostomy (20%), extubation trial (13%), and inhaled ipratropium bromide (7%).ConclusionDynamic CT is a useful noninvasive diagnostic tool for airway evaluation of premature infants. Presence and severity of TBM can provide actionable information to guide more precise clinical decision making.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Dynamic computed tomography for evaluation of tracheobronchomalacia in premature infants with bronchopulmonary dysplasia

Pugh,

Ali,

Agarwal

et al. 2023

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

Should Neonatologists Rule Out Tracheobronchomalacia in Every Premature Baby With Bronchopulmonary Dysplasia?

Abstract: The incidence of primary tracheobronchomalacia (TBM) in pediatric patients is 1/2100 and its prevalence in very premature infants with bronchopulmonary dysplasia is 10-46%. We report the case of a 26-week-old baby with recurrent infections and stunting. He was diagnosed for TBM.

Cited by 1 publication

References 6 publications

Dynamic computed tomography for evaluation of tracheobronchomalacia in premature infants with bronchopulmonary dysplasia

Dynamic computed tomography for evaluation of tracheobronchomalacia in premature infants with bronchopulmonary dysplasia

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