Dynamic computed tomography for evaluation of tracheobronchomalacia in premature infants with bronchopulmonary dysplasia.
Dynamic computed tomography for evaluation of tracheobronchomalacia in premature infants with bronchopulmonary dysplasia.
复制标题
动态计算机断层扫描评估支气管肺发育不良早产儿气管支气管软化。
DOI：
10.1002/ppul.26652
复制
发表时间：
2023
影响因子：
3.1
通讯作者：
Sharma,Megha
中科院分区：
文献类型：
--
作者：
Pugh,CharlesPreston;Ali,Sumera;Agarwal,Amit;Matlock,DavidN;Sharma,Megha
动态CT（dynamic computed tomography，dCT）能够提供真实的实时生理信息，客观描述气管支气管软化症（tracheobronchomalacia，TBM）患者气道狭窄情况。在支气管肺发育不良（BPD）早产儿中通过dCT评价TBM的文献很少。本研究的目的是描述的结果dCT和由此产生的变化，在管理早产儿TBM.MethodsA回顾性研究70名婴儿进行。纳入的婴儿妊娠<32周，无重大异常。TBM定义为横截面积呼气减少≥50%，严重程度定义为轻度（50%-75%）、中度（≥75%-90%）或重度（≥90%）。在49%的婴儿中发现了气管软化症，其严重程度为76%轻度，18%中度和6%重度。43%的婴儿有不同程度的支气管软化（53%轻度，40%中度，7%重度）。由此产生的管理变化包括PEEP滴定（44%），开始氨甲酰胆碱（23%），计划气管切开术（20%），拔管试验（13%），吸入异丙托溴铵（7%.ConclusionDynamic CT是一个有用的非侵入性诊断工具，早产儿气道评价。TBM的存在和严重程度可以提供可操作的信息，以指导更精确的临床决策。
IntroductionDynamic computed tomography (dCT) gives real‐time physiological information and objective descriptions of airway narrowing in tracheobronchomalacia (TBM). There is a paucity of literature in the evaluation of TBM by dCT in premature infants with bronchopulmonary dysplasia (BPD). The aim of this study is to describe the findings of dCT and resultant changes in management in premature infants with TBM.MethodsA retrospective study of 70 infants was performed. Infants included were <32 weeks gestation without major anomalies. TBM was defined as ≥50% expiratory reduction in cross‐sectional area with severity defined as mild (50%–75%), moderate (≥75%–90%), or severe (≥90%).ResultsDynamic CT diagnosed malacia in 53% of infants. Tracheomalacia was identified in 49% of infants with severity as 76% mild, 18% moderate, and 6% severe. Bronchomalacia was identified in 43% of infants with varying severity (53% mild, 40% moderate, 7% severe). Resultant management changes included PEEP titration (44%), initiation of bethanechol (23%), planned tracheostomy (20%), extubation trial (13%), and inhaled ipratropium bromide (7%).ConclusionDynamic CT is a useful noninvasive diagnostic tool for airway evaluation of premature infants. Presence and severity of TBM can provide actionable information to guide more precise clinical decision making.