Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Pediatric Pulmonary Unit, Soroka University Medical Center, Beer Sheva, Israel.
Eur J Pediatr. 2024 Nov;183(11):4837-4845. doi: 10.1007/s00431-024-05750-w. Epub 2024 Sep 9.
Bronchopulmonary dysplasia (BPD) poses a significant challenge as the most common late morbidity of preterm infants. This study aimed to evaluate airway abnormalities in infants with BPD who underwent flexible bronchoscopy (FB) to gain insights into the prevalence of upper airway obstruction and associated complications. A retrospective case-control study was conducted on BPD patients who underwent FB at a tertiary center between 2013 and 2023. BPD patients were matched (1:3) with a reference group based on age, gender, and ethnicity, who also had undergone FB. Demographic data, comorbidities, indications for FB, findings, and complications during and after FB were collected. The study included 50 BPD patients (mean age 1.26 ± 0.9 years, 58% males), and 150 controls. As expected, BPD patients had a lower gestational age, lower birth weight, and longer hospitalizations and were treated with more medications. Abnormal bronchoscopy findings were significantly more common in the BPD group compared to the reference group, with an increased rate of turbinate hypertrophy (OR [95% CI]: 3.44 [1.27-9.37], P = 0.014), adenoid hypertrophy (OR: 2.7 [1.38-5.29], P = 0.004), lingual tonsils (OR: 5.44 [1.29-27.4], P = 0.0024), subglottic stenosis (OR: 6.95 [2.08-27.1], P = 0.002), and tracheomalacia (OR: 2.98 [1.06-8.19], P = 0.034). Complications including desaturation (OR: 3.89 [1.32-11.7], P = 0.013) and PICU admission (OR: 16.6 [2.58-322], P = 0.011) were more frequent in the BPD than in the reference group.
The study revealed a high prevalence of structural anomalies leading to upper airway obstruction and complications in infants with BPD undergoing FB. These findings emphasize the importance of careful consideration and preparation for bronchoscopic procedures in this vulnerable population.
• Bronchopulmonary dysplasia (BPD) represents the most prevalent late morbidity among preterm infants. • Preterm infants diagnosed with BPD frequently undergo diagnostic procedures, including flexible and rigid bronchoscopies, to identify structural pathologies within the respiratory tract.
• A significantly higher prevalence of structural anomalies leading to upper airway obstruction was observed in the BPD group compared to controls. • The incidence of complications during flexible bronchoscopy was higher in the BPD group than in controls.
评估支气管肺发育不良（BPD）婴儿行纤维支气管镜（FB）检查的气道异常，以了解上气道梗阻的发生率及相关并发症。
这是一项在 2013 年至 2023 年期间于某三级中心行 FB 检查的 BPD 患者的回顾性病例对照研究。BPD 患者与参考组（根据年龄、性别和种族）按 1:3 匹配，参考组也进行了 FB 检查。收集患者的人口统计学数据、合并症、FB 检查指征、检查结果和 FB 期间及之后的并发症。
研究纳入了 50 例 BPD 患者（平均年龄 1.26±0.9 岁，58%为男性）和 150 例对照。BPD 患者的胎龄更低、出生体重更低、住院时间更长，且接受了更多的药物治疗。与参考组相比，BPD 组的异常支气管镜表现明显更常见，鼻甲肥大（OR [95%CI]：3.44 [1.27-9.37]，P=0.014）、腺样体肥大（OR：2.7 [1.38-5.29]，P=0.004）、舌扁桃体（OR：5.44 [1.29-27.4]，P=0.0024）、声门下狭窄（OR：6.95 [2.08-27.1]，P=0.002）和气管软化（OR：2.98 [1.06-8.19]，P=0.034）的发生率更高。BPD 组的并发症包括低氧血症（OR：3.89 [1.32-11.7]，P=0.013）和 PIC 入院（OR：16.6 [2.58-322]，P=0.011）的发生率高于参考组。
该研究揭示了 BPD 婴儿行 FB 检查时上气道梗阻和并发症的结构异常发生率较高。这些发现强调了在这一脆弱人群中，仔细考虑和准备支气管镜检查的重要性。
