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[Tracheobronchial complications of assisted ventilation in children]
1Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital d'enfants Armand-Trousseau, Paris.
Insights
Assisted ventilation in children can lead to acquired tracheobronchial lesions. Tracheobronchoscopy is crucial for diagnosing these abnormalities, with tracheostomy posing a higher risk.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Medical Device Complications
Context:
- Mechanical ventilation is essential for critically ill children.
- Assisted ventilation, particularly via endotracheal tubes or tracheostomy, can cause airway damage.
- Tracheobronchial complications may manifest during or after ventilation support.
Purpose:
- To review the common acquired tracheobronchial lesions in children undergoing assisted ventilation.
- To highlight tracheobronchoscopy as the primary diagnostic tool for these abnormalities.
- To compare the incidence and types of lesions associated with different ventilation methods.
Summary:
- Assisted ventilation in pediatric patients can result in acquired lesions of the trachea and bronchi.
- Common adverse effects include tracheobronchial granulomas, stenosis, and tracheomalacia.
- Tracheostomy use is associated with a higher frequency of tracheobronchial lesions and stomal complications compared to endotracheal intubation.
Impact:
- Informing clinicians about potential airway complications of assisted ventilation in children.
- Emphasizing the importance of prompt diagnosis and management of tracheobronchial abnormalities.
- Guiding decisions regarding ventilation strategies and monitoring to minimize airway injury.
Abstract:
Assisted ventilation in children may cause acquired lesions of the trachea and bronchi. Symptoms may appear even during or after assisted ventilation. Tracheobronchoscopy is the best method for diagnosis of tracheobronchial abnormalities. Tracheobronchial granulomas and stenosis, and tracheobronchomalacia are the most common adverse effects of assisted ventilation via either endotracheal tube or tracheostomy. The frequency of tracheobronchial lesions is higher in case of assisted ventilation via tracheostomy, with a high incidence of stomal complications.