支气管肺发育不良(BPD)作为早产儿最常见的晚期发病率提出了重大挑战。这项研究旨在评估接受柔性支气管镜检查(FB)的BPD婴儿的气道异常,以了解上气道阻塞和相关并发症的发生率。对2013年至2023年在三级中心接受FB的BPD患者进行了回顾性病例对照研究。BPD患者根据年龄与参照组进行匹配(1:3),性别,和种族,他们也经历了FB。人口统计数据,合并症,FB的指示,调查结果,收集FB期间和之后的并发症。该研究包括50例BPD患者(平均年龄1.26±0.9岁,58%的男性),150个控件。不出所料,BPD患者的胎龄较低,降低出生体重,住院时间更长,接受更多药物治疗。与参照组相比,BPD组的异常支气管镜检查结果明显更常见,鼻甲肥大的发生率增加(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)。并发症包括去饱和(或:3.89[1.32-11.7],P=0.013)和PICU入院(OR:16.6[2.58-322],P=0.011)在BPD中的频率高于参考组。
结论:研究显示,在接受FB的BPD婴儿中,导致上呼吸道阻塞和并发症的结构异常的患病率很高。这些发现强调了在这种脆弱人群中仔细考虑和准备支气管镜检查程序的重要性。
背景:•支气管肺发育不良(BPD)是早产儿中最普遍的晚期发病率。•诊断为BPD的早产儿经常接受诊断程序,包括柔性和刚性支气管镜检查,识别呼吸道内的结构病变。
背景:•与对照组相比,在BPD组中观察到导致上呼吸道阻塞的结构异常的患病率明显更高。•BPD组柔性支气管镜检查期间并发症的发生率高于对照组。
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.
CONCLUSIONS: 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.
BACKGROUND: • 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.
BACKGROUND: • 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.