Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040586 (tracheobronchitis)
 449 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the 6-year period from 1984 to 1989, 196 bronchoscopies were performed on 132 neonates. The indications were grouped into four categories: (1) difficulties in artificial ventilation or failure to wean the baby from the ventilator (52); (2) other respiratory difficulties (52); (3) audible stridor (16); and (4) routine preoperative or postoperative examination of esophageal atresia patients (12). The most common finding was laryngomalacia or tracheomalacia (31). Other findings were: obstructing tracheal or bronchial granulation or stricture (23), obstructing mucous plug (22), grave tracheobronchitis (11), tracheoesophageal H-fistula (5), laryngeal perforation (3), congenital laryngeal stenosis (2), and complete laryngotracheoesophageal cleft (1). Four patients had miscellaneous pathology. The findings were normal in 30 patients. A therapeutic procedure was included in 99 of the 196 bronchoscopies. Seven serious complications occurred during the operative bronchoscopies, two of them requiring immediate pulmonary surgery. All complications were successfully managed. In contrast, no complications occurred in the 97 purely diagnostic bronchoscopies. In experienced hands, bronchoscopy of the newborn is a safe and useful examination. Complications occur when therapeutic procedures are included. Therefore, operative bronchoscopy should only be performed in conditions in which immediate thoracotomy and pulmonary surgery can be performed.
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PMID:Bronchoscopy during the first month of life. 162 16

We performed a brief bronchoscopy in 42 newborn infants with esophageal atresia and tracheoesophageal fistula (TEF). The procedure was carried out in the operating room, usually just prior to thoracotomy for repair of the anomaly. Most infants had a gastrostomy tube placed initially. Observations included: (1) level of fistula, (2) presence of unusual variants, eg, double fistula, trifurcation fistula, (3) presence and severity of tracheobronchitis, and (4) position of the aortic arch. The endoscopic findings influenced the operative technique or management of 24 of the 42 infants (57%), including 13 infants (31%) with crucial findings which dictated a change in operative technique or management. Examples of the latter were an unsuspected cervical fistula associated with esophageal atresia, repaired by a cervical approach; other unusual variants of TEF (proximal fistula, trifurcation or quadrifurcation TEF), requiring specific dissection at thoracotomy; congenital stenosis of the right mainstem bronchus, requiring postoperative dilatation; or severe tracheobronchitis, which contraindicated thoracotomy. Observations at bronchoscopy accurately predicted the position of the aortic arch in ten recent infants, although the side of dominant pulsation was indeterminate in three other infants. Only one minor complication was attributable to the bronchoscopy. The procedure appeared to be safe and beneficial, and should be considered for all infants with esophageal atresia and TEF.
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PMID:Crucial bronchoscopic findings in esophageal atresia and tracheoesophageal fistula. 337 53

Necrotizing tracheobronchitis (NTB) is characterized by acute episodes of airway obstruction, hypercarbia, and lack of chest movement in mechanically ventilated neonates. Emergency bronchoscopic removal of necrotic tissue is essential for survival. Although postmortem lesions extend into smaller bronchi, survivors have not demonstrated residual tracheobronchial abnormalities. Two infants were treated successfully for NTB but succumbed to diffuse tracheobronchial strictures with progressive pulmonary hyperinflation. A third neonate with esophageal atresia and left pulmonary agenesis developed NTB. Despite initial postbronchoscopic improvement, the infant died at age 6 weeks with diffuse obstructing NTB. All three infants required endotracheal intubation and mechanical ventilation. High-frequency jet ventilation was not used. Tracheal cultures for fungi, bacteria and viruses were negative. Successful treatment of NTB may be followed acutely by recurrence of NTB and chronically by diffuse tracheobronchial strictures and emphysema.
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PMID:Diffuse necrotizing tracheobronchitis: an acute and chronic disease. 337 55