Pietsch J B, Nagaraj H S, Groff D B, Yacoub U A, Roberts J L
J Pediatr Surg. 1985 Aug;20(4):391-3. doi: 10.1016/s0022-3468(85)80225-6.
Necrotizing tracheobronchitis (NTB) is a recently recognized cause of tracheal obstruction in the mechanically ventilated neonate. This process involves inflammation and necrosis of the mucosa of the distal trachea and mainstem bronchi. The sloughing of this material into the tracheal lumen results in plugging and acute respiratory distress. We documented this diagnosis in 19 infants. Four were diagnosed at autopsy. Fifteen had emergency bronchoscopy performed in the neonatal intensive care unit with removal of the obstructing debris. Ten of these 15 neonates survived (66.7%). The diagnosis of necrotizing tracheobronchitis should be suspected in those neonates requiring positive pressure ventilation in whom a sudden unexplained increase in ventilatory requirements develops. This is often associated with hypercarbia and a history of high-peak inspiratory pressures with or without hypoxia. Emergency bronchoscopy in these neonates is necessary both for diagnosis and treatment of the necrotizing tracheobronchitis.
坏死性气管支气管炎（NTB）是机械通气新生儿气管阻塞的一种新近被认识的病因。这个过程涉及远端气管和主支气管黏膜的炎症和坏死。这些坏死物质脱落后进入气管腔导致堵塞并引发急性呼吸窘迫。我们记录了19例婴儿的这一诊断。4例在尸检时被诊断。15例在新生儿重症监护病房接受了紧急支气管镜检查并清除了阻塞性碎屑。这15例新生儿中有10例存活（66.7%）。对于那些需要正压通气且出现通气需求突然不明原因增加的新生儿，应怀疑坏死性气管支气管炎的诊断。这通常与高碳酸血症以及有或无低氧血症的高峰吸气压力病史有关。对这些新生儿进行紧急支气管镜检查对于坏死性气管支气管炎的诊断和治疗均很有必要。
