Pediatric intrathoracic large airway obstruction: diagnostic and therapeutic considerations
| Autor: | Amato Jj, Zahtz G, Bierman Fz, Peter Silver, Laura Nimkoff, Mayer Sagy |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Heart Defects
Congenital Male medicine.medical_specialty Double aortic arch Congenital lobar emphysema Tracheoesophageal fistula Diagnosis Differential medicine Humans Tetralogy of Fallot Tracheal Diseases business.industry Infant Newborn Vascular ring Infant Bronchial Diseases General Medicine respiratory system Airway obstruction medicine.disease Surgery Airway Obstruction Trachea Tracheomalacia Child Preschool Pediatrics Perinatology and Child Health Emergency Medicine Female Bronchomalacia business Respiratory Insufficiency Algorithms |
| Zdroj: | Pediatric emergency care. 10(6) |
| ISSN: | 0749-5161 |
| Popis: | We describe seven patients who had intrathoracic airway obstruction resulting in severe respiratory distress. The patients were a four month old with bronchial cartilage hypoplasia presenting as congenital lobar emphysema; a one month old with segmental bronchomalacia; a one month old with tracheal bronchus; a two day old and a seven month old with aneurysmal distension of the pulmonary arteries secondary to tetralogy of Fallot, with absent pulmonary valve and atrioventricular canal with pulmonary poststenotic dilatation, respectively; a three year old with double aortic arch forming a vascular ring; and a three month old with tracheomalacia from tracheoesophageal fistula. The patients had various associated congenital defects, and all of them required one or more surgical procedures to repair the defects and relieve the airway obstruction. Five patients received endotracheal intubation with mechanical ventilation on their first admission, and three of them died postoperatively. The diagnostic workup to delineate the anatomic factors causing the obstruction, as well as to determine the therapeutic medical and surgical strategies to relieve it, are described. We conclude that the course of illness in most pediatric patients with intrathoracic airway obstruction is complex, is associated with high morbidity and mortality, and entails extensive multidisciplinary diagnostic and therapeutic efforts. |
| Databáze: | OpenAIRE |
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