Related Experiment Video
Updated: May 20, 2025
Author Spotlight: Expanding Interventional Pulmonology Research with Robotic-Assisted Bronchoscopy
Published on: July 19, 2024
Multidisciplinary aerodigestive team meetings for the management of complex airway patients
Aryan Kalra1, Rachel Blokland2, Wendy Nicholls3
1School of Medicine, The University of Western Australia, Perth, WA, Australia.
Insights
This study reviewed 304 pediatric patients in a multidisciplinary aerodigestive team (ADT) meeting, identifying common conditions like tracheomalacia and laryngomalacia. The findings guide the development of aerodigestive programs for complex pediatric cases.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Gastroenterology
- Pediatric Pulmonology
Background:
- Multidisciplinary aerodigestive team (ADT) meetings are crucial for managing complex pediatric airway and gastrointestinal conditions.
- Understanding the clinical profiles and management outcomes of patients discussed in ADT meetings is essential for optimizing care.
Purpose of the Study:
- To examine the clinical profiles and management strategies for patients evaluated in a tertiary pediatric hospital's ADT meetings.
- To provide insights for the development of aerodigestive programs globally.
Main Methods:
- Retrospective chart review of patients discussed at Perth Children's Hospital ADT meetings from December 2018 to July 2022.
- Analysis of patient demographics, clinical characteristics, diagnoses, investigations, procedures, and follow-up outcomes.
Main Results:
- 580 consults for 304 pediatric patients were analyzed, with common diagnoses including tracheomalacia, laryngomalacia, and laryngotracheal stenosis.
- Patients with secondary diagnoses, tracheostomy dependence, or upper airway/esophageal disorders were more likely to require multiple ADT consultations.
- Numerous diagnostic and interventional procedures were performed, including microlaryngoscopy, bronchoscopy, adenoidectomy, and balloon dilation for stenosis.
Conclusions:
- The aerodigestive program effectively utilizes a multidisciplinary approach for managing medically complex pediatric patients.
- This study offers a substantial dataset from an Otolaryngology-led program, valuable for establishing and refining aerodigestive services worldwide.
Objective:
To examine the clinical profiles and management of patients discussed at our tertiary paediatric hospital's multidisciplinary aerodigestive team (ADT) meetings.
Method:
Retrospective chart review of all patients discussed at the Perth Children's Hospital ADT meetings between December 2018 and July 2022. Patient demographics, clinical characteristics and meeting outcomes, including procedures, investigations and follow-up were reviewed.
Results:
A total of 580 ADT meeting consults were recorded for 304 patients, with 116 patients requiring multiple consultations. The median age at time of consult was 2.74 years and 51.0 % of patients were male. The commonest aerodigestive tract disorders included tracheomalacia (20.7 %), laryngomalacia (20.7 %), laryngotracheal stenosis (13.2 %), gastro-oesophageal reflux (9.4 %) and tracheo-oesophageal fistula (9.4 %). A secondary diagnosis was seen in 45.5 % of patients, most commonly Trisomy 21 (10.2 %), Robin Sequence (4.9 %) and Cerebral Palsy (3.0 %). Children with secondary diagnoses (P < 0.01), tracheostomy dependence (P < 0.01), upper airway disorders (P < 0.01) and oesophageal disorders (P < 0.01) were more likely to require multiple ADT consults. Further investigations were ordered after 25.9 % of consults, most commonly polysomnography (14.9 %) and video fluoroscopic swallowing studies (6.1 %). A total of 742 procedures were performed to diagnose and/or treat aerodigestive disease. The commonest diagnostic procedures were microlaryngoscopy and bronchoscopy (46.9 %), upper gastrointestinal endoscopy (7.8 %) and sleep nasendoscopy (6.7 %). The commonest interventional surgical procedures were adenoidectomy (12.4 %), balloon dilation of laryngotracheal stenosis (9.4 %), steroid injection to laryngeal scar or granulation tissue (8.4 %) and supraglottoplasty (6.7 %).
Conclusion:
The aerodigestive program utilises a multidisciplinary approach to manage a medically complex cohort of patients. This study presents a large sample of patients from an Otolaryngology-led aerodigestive program in Australia and is intended to guide development of aerodigestive programs across the world in various clinical contexts.
Related Concept Videos
01:30Asthma-IV: Nursing Management
First, in...
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
Assessment
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...
01:29Chronic Obstructive Pulmonary Disease-V: Management
Smoking Cessation
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....