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Airway malacia in premature infant twins with bronchopulmonary dysplasia: Two case reports

Wanwan Yang1, Jiuxiang Zhang1, Dongxue Lu1

  • 1Department of Anesthesiology and Perioperative Medicine Xijing Hospital Fourth Military Medical University Xi'an Shaanxi China.

Clinical Case Reports
|January 14, 2022
PubMed

Insights

Premature infants with bronchopulmonary dysplasia may experience airway malacia during anesthesia, complicating positive pressure ventilation. Endotracheal intubation is recommended for low-birth-weight infants, especially those with reactive airways.

Area of Science:

  • Neonatal Anesthesia
  • Ophthalmology
  • Pulmonology

Background:

  • Retinopathy of prematurity (ROP) surgery in premature infants is often complicated by bronchopulmonary dysplasia (BPD).
  • Reactive airway disease is a common clinical manifestation of BPD in these infants.
  • Airway malacia poses a significant risk during positive pressure ventilation in infants.

Observation:

  • Two premature infant twins experienced difficulties with positive pressure ventilation during anesthesia induction.
  • These anesthetic events occurred during procedures for binocular anterior chamber puncture and vitreous cavity injection.
  • Airway malacia was identified as the most probable cause in both cases.

Findings:

  • Infants with BPD and reactive airways are at increased risk for airway malacia.
  • Positive pressure ventilation can be challenging in premature infants with compromised respiratory systems.
  • Anesthesia induction for ophthalmic procedures can precipitate airway collapse in susceptible infants.

Implications:

  • Endotracheal intubation should be considered for low-birth-weight infants undergoing anesthesia.
  • Clinicians must consider the possibility of airway malacia in infants with BPD.
  • Early recognition and management of airway malacia are crucial for safe anesthetic care in premature infants.

Keywords:
airway malaciabronchopulmonary dysplasiaretinopathy of prematurity

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