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Published on: November 4, 2010
[Clinical characteristics of plastic bronchitis and risk factors for recurrence in children]
Xiao-Yin Tian1, Guang-Li Zhang1, Chong-Jie Wang1
1Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
Insights
Plastic bronchitis (PB) in children often presents with severe respiratory symptoms. Key risk factors for recurrent PB include multi-lobe lung involvement, prolonged ventilation needs, and multi-organ dysfunction.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Critical Care
Context:
- Plastic bronchitis (PB) is a rare but serious condition in children.
- Understanding its clinical features and recurrence factors is crucial for effective management.
- This study analyzes data from a large cohort of pediatric PB patients.
Purpose:
- To elucidate the clinical characteristics of pediatric plastic bronchitis.
- To identify independent risk factors associated with recurrent PB episodes.
- To inform clinical suspicion and management strategies for PB.
Summary:
- A retrospective analysis of 107 children with PB revealed common symptoms like cough, fever, shortness of breath, and respiratory failure.
- Recurrent PB (≥2 episodes) was observed in 33.6% of cases.
- Independent risk factors for recurrence included multi-lobe lung involvement (bronchoscopy), prolonged invasive ventilation, and extra-pulmonary multi-organ dysfunction.
Impact:
- Highlights key indicators for suspecting PB in children with severe pneumonia.
- Provides evidence-based risk factors for predicting PB recurrence.
- Aims to improve diagnostic accuracy and therapeutic interventions for pediatric PB.
Objectives:
To study the clinical characteristics of plastic bronchitis (PB) in children and investigate the the risk factors for recurrence of PB.
Methods:
This was a retrospective analysis of medical data of children with PB who were hospitalized in Children's Hospital of Chongqing Medical University from January 2012 to July 2022. The children were divided into a single occurrence of PB group and a recurrent PB group and the risk factors for recurrence of PB were analyzed.
Results:
A total of 107 children with PB were included, including 61 males (57.0%) and 46 females (43.0%), with a median age of 5.0 years, and 78 cases (72.9%) were over 3 years old. All the children had cough, 96 children (89.7%) had fever, with high fever in 90 children. Seventy-three children (68.2%) had shortness of breath, and 64 children (59.8%) had respiratory failure. Sixty-six children (61.7%) had atelectasis and 52 children (48.6%) had pleural effusion. Forty-seven children (43.9%) had Mycoplasma pneumoniae infection, 28 children (26.2%) had adenovirus infection, and 17 children (15.9%) had influenza virus infection. Seventy-one children (66.4%) had a single occurrence of PB, and 36 cases (33.6%) had recurrent occurrence of PB (≥2 times). Multivariate logistic regression analysis showed that involvement of ≥2 lung lobes (OR=3.376) under bronchoscopy, continued need for invasive ventilation after initial removal of plastic casts (OR=3.275), and concomitant multi-organ dysfunction outside the lungs (OR=2.906) were independent risk factors for recurrent occurrence of PB (P<0.05).
Conclusions:
Children with pneumonia accompanied by persistent high fever, shortness of breath, respiratory failure, atelectasis or pleural effusion should be highly suspected with PB. Involvement of ≥2 lung lobes under bronchoscopy, continued need for invasive ventilation after initial removal of plastic casts, and concomitant multi-organ dysfunction outside the lungs may be risk factors for recurrent occurrence of PB.
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