Abstract
Background: Abnormal airway development mayoccur in preterm infants with BPD and give rise tosymptomatic bronchomalacia in infants with severedisease. This condition may be under recognisedin this population, however, because diagnosis hasto date required highly invasive procedures to beundertaken (bronchoscopy or bronchograms). Thecase we present is a 6-month old infant (born at 24weeks gestation) who developed severe BPD andpulmonary hypertension. Tracheobroncholmaciawas suspected on clinical grounds becauseof repeated episodes of sudden and profoundhypercapnia (pCO2 up to 150 mmHg) precipitatedby periods of activity and coughing, despite supportwith mechanical ventilation. Because of worseningrespiratory function Dynamic Volumetric CTbronchography was performed to assess airwaypatency non-invasively.
Method: Parental consent was obtained to performa CT bronchogram using a 320 slice CT scanner(Aquilon ONE, Toshiba). A 2-second scan wasperformed while the infant was making spontaneousrespirations through an ETT. Mechanical ventilationwas temporarily interrupted and CPAP reduced to 0for the duration of the procedure.
Results The scan was well tolerated by theinfant. Using a spiral, non-gated scan protocol,3D reconstruction of the pulmonary anatomy wasobtained with dynamic images of the airway duringa full respiratory cycle. The images provided adefinitive diagnosis of extensive bronchomalacia.
Conclusions: We have demonstrated thattracheobronchomalacia can be diagnosed noninvasivelyin a sick infant, using a 320-slice CTscanner. This imaging modality offers excitingopportunities to enhance diagnostic evaluation insevere lung disease.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Tan, K., Padmanaban, S., Ditchfield, M. et al. 1337 Non-Invasive Diagnosis of Tracheobronchomalacia in An Infant with Bpd Using 320-Slice Ct Bronchography. Pediatr Res 68 (Suppl 1), 662 (2010). https://doi.org/10.1203/00006450-201011001-01337
Issue Date:
DOI: https://doi.org/10.1203/00006450-201011001-01337