Tracheobronchomegaly in preterm infants on mechanical ventilation.

Tracheobronchomegaly (TBM) was diagnosed on chest radiographs as an apparent dilatation of the trachea and main bronchi in four premature infants on prolonged mechanical ventilation for respiratory distress syndrome. In a retrospective study, the parameters of assisted ventilation, the Apgar score, the presence of conatal or later infection, and hypotension were reviewed and analyzed as factors possibly contributing to the pathogenesis of TBM in these infants. The results lead to the conclusion that TBM in premature infants on prolonged ventilatory support is an acquired condition though a congenital defect cannot be excluded as a probable predisposing factor. In the etiopathogenesis of TBM, a repeated barotrauma of prolonged ventilation is a crucial factor while the severity of lung disease and the degree of prematurity, hypotension, infection, and generally poor clinical condition, all appear to be relevant in the development of TBM in a premature infant with respiratory distress syndrome.