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Casting a look at pediatric plastic bronchitis

Tin Jasinovic1, Frederick K Kozak1, J Paul Moxham1

  • 1Division of Pediatric Otolaryngology, British Columbia's Children's Hospital, Vancouver, BC, Canada.

International Journal of Pediatric Otorhinolaryngology
|August 8, 2015
PubMed

Insights

Plastic bronchitis in children presents with bronchial casts, often requiring rigid bronchoscopy for removal. Recurrent cases and co-morbidities like heart disease may increase mortality risk.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Critical Care

Background:

  • Plastic bronchitis involves the formation of bronchial casts, posing a significant respiratory challenge in pediatric patients.
  • Understanding the clinical spectrum and effective management is crucial for improving outcomes.

Purpose of the Study:

  • To review the clinical presentations of pediatric plastic bronchitis.
  • To evaluate the management strategies employed for this condition.
  • To add to the existing knowledge base, including data from the International Plastic Bronchitis Registry.

Main Methods:

  • A retrospective chart review was conducted.
  • Data from seven pediatric patients requiring rigid bronchoscopy for bronchial cast removal over 17 years were analyzed.

Main Results:

  • Seven pediatric patients underwent rigid bronchoscopy for bronchial cast removal.
  • The mean age at presentation was 60 months, with a mean follow-up of 53 months.
  • Co-morbidities included congenital heart disease, chronic pulmonary disorders, and sickle cell disease. Four patients experienced recurrent casts, and two required bronchoscopy while on extracorporeal membrane oxygenation (ECMO) with special precautions.

Conclusions:

  • Bronchial casts in children can manifest acutely or sub-acutely.
  • Recurrent casts are uncommon but can be fatal in conjunction with severe cardiac disease.
  • Adjunctive topical therapies require further investigation, and safeguarding ECMO catheters is essential during procedures.
Abstract

Keywords:
Bronchial castsECMOPlastic bronchitisRigid bronchoscopy

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