Related Experiment Video
Updated: Jan 12, 2026
Heterotopic and Orthotopic Tracheal Transplantation in Mice used as Models to Study the Development of Obliterative Airway Disease
Published on: January 20, 2010
Tracheal Structural Changes in Tracheostomy-Dependent Children With Bronchopulmonary Dysplasia
Alexander Szymczak1, Ben Hirsch1, Ashley Young2
1Northwestern University Feinberg School of Medicine Chicago Illinois USA.
Insights
Infants with Bronchopulmonary dysplasia (BPD) requiring tracheostomy face more airway complications but achieve decannulation more often. This suggests tracheostomy is a safe and effective intervention for BPD patients.
Area of Science:
- Pediatric Otolaryngology
- Neonatology
- Respiratory Medicine
Background:
- Severe Bronchopulmonary dysplasia (BPD) increases the risk of upper airway complications due to prolonged intubation and ventilation.
- Tracheostomy-dependent infants with BPD require evaluation for structural airway changes compared to non-BPD infants.
Purpose of the Study:
- To compare the incidence of airway complications and outcomes in tracheostomy-dependent infants with and without BPD.
- To assess the safety and efficacy of tracheostomy in infants with BPD.
Main Methods:
- Retrospective cohort study of 82 infants (<6 months) undergoing tracheostomy between 2012-2022.
- Comparison of demographic, clinical characteristics, and airway outcomes between BPD (n=42) and non-BPD (n=40) groups.
- Median follow-up duration of 28.8 months.
Main Results:
- BPD infants were younger at birth (26.5 vs. 37.0 weeks) and older at tracheostomy (4.44 vs. 3.36 months).
- BPD infants had higher rates of mechanical ventilation, longer intubation duration, subglottic stenosis (30/42 vs. 16/40), glottic edema (32/42 vs. 19/40), and laryngotracheal reconstruction (16/42 vs. 5/40).
- Despite increased pathology, BPD infants were more likely to be decannulated (21/42 vs. 8/40).
Conclusions:
- Tracheostomy-dependent infants with BPD exhibit increased airway pathology, including subglottic stenosis and glottic edema.
- These infants also show a higher likelihood of requiring laryngotracheal reconstruction but a greater chance of decannulation.
- Tracheostomy is a safe and effective intervention for BPD patients, with outcomes comparable to other pediatric cohorts.
Background:
Patients with severe Bronchopulmonary dysplasia (BPD) are prone to upper airway complications due to their need for prolonged intubation, early tracheostomy placement, and chronic high-pressure ventilation. This study examines structural changes over time in tracheostomy-dependent BPD patients compared to those without BPD.
Methods:
A retrospective cohort study of children who underwent tracheostomy at an age less than 6 months at a tertiary-care children's hospital between January 2012 and December 2022.
Results:
A total of 82 patients underwent tracheostomy at an age of less than 6 months, of which 42 (51.2%) had BPD. Patients with BPD were older at the time of tracheostomy (4.44 vs. 3.36 months, p = 0.012) and had a younger gestational age (26.5 vs. 37.0 weeks, p < 0.001). Additionally, patients with BPD had higher rates of mechanical ventilation (42/42 vs. 24/40, p = 0.0018) and a greater number of days intubated prior to tracheostomy (92 vs. 21, p < 0.001). The median follow-up period for all patients was 28.8 months [IQR = 36.8]. BPD infants were more likely to develop subglottic stenosis (30/42 vs. 16/40, p = 0.0082), glottic edema (32/42 vs. 19/40, p = 0.0074), require laryngotracheal reconstruction (16/42 vs. 5/40, p = 0.0095) and get decannulated (21/42 vs. 8/40, p = 0.0045) compared to infants without BPD.
Conclusions:
Tracheostomy-dependent infants with BPD had higher rates of glottic edema, subglottic stenosis, and laryngotracheal reconstruction but were more likely to be decannulated. These findings suggest that, despite increased airway pathology, tracheostomy is a safe and effective intervention in this population, with outcomes comparable to other pediatric cohorts.
Level Of Evidence:
4.
Related Concept Videos
01:23The Bronchial Tree
The trachea, commonly known as the windpipe, is a tube that connects the larynx (voice box) to the bronchi. At a point called the carina, it bifurcates into two primary bronchi. The right primary bronchus is wider, shorter, and more vertical than the left primary...
01:22Trachea
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of...
01:31Anatomy of Respiratory System II: Lower Respiratory Tract
The Larynx
It is located between the pharynx and the trachea, acts as a passageway for air, and hosts several critical structures, such as the epiglottis, vocal cords, and glottis. The epiglottis acts as a gateway, guiding food to the...
01:20Chronic Obstructive Pulmonary Disease-II: Pathophysiology
Chronic Inflammation
01:23Oxygen Delivering System III: Tracheostomy and T-piece
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...