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Pediatric Surgery International
Published in: Pediatric Surgery International 1/2018

01-01-2018 | Original Article

Bronchoscopic assessments and clinical outcomes in pediatric patients with tracheomalacia and bronchomalacia

Authors: Yuichi Okata, Tomomi Hasegawa, Yuko Bitoh, Kosaku Maeda

Published in: Pediatric Surgery International | Issue 1/2018

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Abstract

Background

Tracheomalacia and bronchomalacia (TM/BM) are one of the serious causes of airway obstruction in infants and children. This study reviewed our bronchoscopic assessments and clinical outcomes in pediatric patients with TM/BM, and investigated risk factors of surgical intervention for TM/BM.

Methods

Fifty-seven consecutive patients who were diagnosed as TM/BM by bronchoscopy between 2009 and 2013 were reviewed retrospectively. They were divided into two groups according to the presence (group E, n = 26) or absence (group N, n = 31) of acute life-threatening events and extubation failure (ALTE/EF). The severity of TM/BM was evaluated by Oblateness Index which was obtained from bronchoscopic images.

Results

Oblateness Index was significantly higher in Group E than in Group N. Patients in Group E underwent surgical intervention for TM/BM more frequently, and had significantly longer intubation period and hospital stay. Clinical symptoms of ALTE/EF, Oblateness Index ≥ 0.70, and multiple malacic lesions were significant risk factors indicating surgical events in patients with TM/BM.

Conclusions

Patients with TM/BM who had ALTE/EF had more severe malacic lesions indicating surgical intervention, and worse clinical outcomes. Oblateness Index is a simple and semi-quantitative index for bronchoscopic assessment of TM/BM, and can be one of the prognostic tools to predict clinical severity of pediatric TM/BM.
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Metadata
Title
Bronchoscopic assessments and clinical outcomes in pediatric patients with tracheomalacia and bronchomalacia
Authors
Yuichi Okata
Tomomi Hasegawa
Yuko Bitoh
Kosaku Maeda
Publication date
01-01-2018
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 1/2018
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-017-4209-x

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