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Interventions for primary (intrinsic) tracheomalacia in children
Vikas Goyal1, I Brent Masters, Anne B Chang
1Queensland Children’s Medical Research Institute, The University of Queensland, Brisbane, Australia.drvikasgoyal@gmail.com.
The Cochrane Database of Systematic Reviews
|October 19, 2012
Summary
This review found no evidence supporting therapies for intrinsic tracheomalacia in children. Further research is needed for effective treatments for this airway disorder.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Trials
Background:
- Tracheomalacia is a common airway disorder in children, presenting with diverse respiratory symptoms.
- Current management includes medical, ventilatory, and surgical interventions, but evidence for efficacy is limited.
Purpose of the Study:
- To evaluate the effectiveness of medical and surgical treatments for intrinsic tracheomalacia in pediatric patients.
Main Methods:
- A systematic review of randomized controlled trials (RCTs) was conducted.
- Searches included major databases (CENTRAL, MEDLINE, EMBASE) up to March 2012.
- Data extraction and analysis were performed by two independent reviewers.
Main Results:
- One RCT involving 40 children with airway malacia and respiratory infection was included.
- Nebulized recombinant human deoxyribonuclease (rhDNase) showed no significant difference in cough reduction compared to placebo.
- Outcomes favored placebo, with significant improvement in nighttime cough scores (P=0.02).
Conclusions:
- There is a lack of evidence supporting current therapies for intrinsic tracheomalacia.
- The efficacy of nebulized rhDNase in children with airway malacia and infection remains inconclusive.
- Further RCTs are needed for interventions like antibiotics and chest physiotherapy, focusing on tracheal and physiological outcomes.
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