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Successful biodegradable stent insertion in an infant with severe bronchomalacia and cystic fibrosis
Caroline A Harris1, Malcolm Brodlie2, Christopher O'Brien1
1Paediatric Respiratory Medicine, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Insights
This study details the first use of a biodegradable airway stent in an infant with cystic fibrosis (CF) and severe bronchomalacia. The stent successfully managed respiratory failure, offering a novel treatment for this rare condition.
Area of Science:
- Pediatric Pulmonology
- Biomaterials Engineering
- Respiratory Medicine
Background:
- Cystic Fibrosis (CF) can lead to complex airway complications.
- Bronchomalacia, or airway floppiness, presents significant respiratory challenges in infants.
- Severe bronchomalacia can cause life-threatening respiratory failure requiring advanced interventions.
Observation:
- A female infant with antenatally diagnosed CF presented with severe left main stem bronchomalacia.
- The condition resulted in left upper lobe hyperinflation and right upper lobe collapse.
- The infant developed respiratory distress and failure, necessitating high-pressure invasive ventilation.
Findings:
- The first biodegradable bronchial stent insertion in the left main bronchus led to successful extubation.
- A second stent was required due to persistent bronchomalacia after initial stent degradation.
- The patient was discharged off respiratory support and remains well at age three, with no further surgical intervention.
Implications:
- Biodegradable airway stents offer a promising, minimally invasive treatment for pediatric bronchomalacia.
- This case highlights a potential therapeutic strategy for CF patients with severe airway collapse.
- Further research into biodegradable stent design and application in pediatric respiratory conditions is warranted.
Abstract:
We report the first case of biodegradable airway stent insertion for a patient with bronchomalacia and cystic fibrosis (CF). This female infant with antenatally diagnosed cystic fibrosis developed respiratory distress by three weeks of age. On lower airway examination she was found to have severe left main stem bronchomalacia causing left upper lobe hyperinflation and subsequent right upper lobe collapse. By eight weeks of age she developed life-threatening respiratory failure requiring high pressure invasive ventilation. A biodegradable bronchial stent was inserted to the left main bronchus at thirteen weeks of age with successful extubation from invasive respiratory support four days later. A second biodegradable stent was inserted nine weeks later, due to persistent bronchomalacia following stent degradation and redevelopment of oxygen requirement. She was discharged home off all respiratory support eight weeks later and has remained well, requiring no further surgical intervention for bronchomalacia to date, now age three years.
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