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Updated: Jul 19, 2026

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
06:15

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus

Published on: March 6, 2019

[Airway malacia: not uncommon in children with atypical respiratory symptoms]

R Boogaard1, S Huijsmans, M W H Pijnenburg

  • 1Erasmus MC-Sophia Kinderziekenhuis, afd Kindergeneeskunde, sub-afd Kinderlongziekten, Rotterdam. r.boogaard@erasmusmc.nl

Nederlands Tijdschrift Voor Geneeskunde
|October 25, 2006
PubMed

Insights

Primary airway malacia affects approximately 1 in 2100 newborns and is often difficult to diagnose using clinical symptoms alone. Bronchoscopy is recommended for suspected cases with unexplained symptoms.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Medical Diagnostics

Context:

  • Airway malacia, a condition characterized by floppy airways, presents diagnostic challenges in pediatric patients.
  • Accurate diagnosis is crucial for appropriate management and to differentiate from other respiratory conditions like asthma.

Purpose:

  • To determine the birth prevalence of primary airway malacia.
  • To evaluate the accuracy of clinical diagnosis versus bronchoscopy findings.
  • To describe the presenting symptoms associated with airway malacia.

Summary:

  • This retrospective study analyzed 512 bronchoscopies, identifying primary airway malacia in 136 children.
  • The estimated birth prevalence is 1 in 2100. Clinical diagnosis was correct in 74% of cases, but malacia was unsuspected pre-bronchoscopy in 52%.
  • Common atypical symptoms included cough, recurrent infections, dyspnea, wheezing, and reduced exertional tolerance, with peak expiratory flow being more affected.

Impact:

  • Highlights the underdiagnosis of airway malacia due to non-specific symptoms.
  • Suggests bronchoscopy as a key diagnostic tool for unexplained exertional intolerance, recurrent infections, or refractory asthma-like symptoms in children.
  • Emphasizes the need for increased awareness among clinicians regarding the varied presentation of airway malacia.
Abstract

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