Neonatal Med.  2024 May;31(2):24-30. 10.5385/nm.2024.31.2.24.

Bronchoscopic Evaluations in Preterm Infants with Moderate to Severe Bronchopulmonary Dysplasia

• Suh MJ
• Choi CW
• Jung YH

• KMID: 2556151
• DOI: http://doi.org/10.5385/nm.2024.31.2.24

Abstract

Purpose
Bronchopulmonary dysplasia (BPD) is a chronic lung disease that primarily affects premature infants receiving mechanical ventilation and oxygen therapy. Severe BPD leads to long-term respiratory complications, including lung tissue damage, vascular abnormalities, and airway diseases. This study aimed to investigate bronchoscopy findings and characteristics in patients with moderate-to-severe BPD, and to investigate BPD-associated airway diseases.
Methods
A retrospective study of preterm infants diagnosed with moderate-to-severe BPD who underwent bronchoscopic evaluation in the neonatal intensive care unit at Seoul National University Bundang Hospital between 2004 and December 2022 was conducted.
Results
Nineteen patients with a mean gestational age of 28.0±1.6 weeks and mean birth weight of 960.5±271.0 g were included in the study. Among these 19 patients, 18 were diagnosed with severe BPD. Tracheobronchomalacia, laryngomalacia, and subglottic stenosis were observed in 63.2%, 52.6%, and 36.8% of patients, respectively. Tracheostomy was performed in nine of the 19 patients (47.4%); five were discharged without requiring tracheostomy following surgical or medical interventions.
Conclusion
Tracheobronchomalacia, laryngomalacia, and subglottic stenosis were common in patients with moderate or severe BPD who underwent bronchoscopic evaluations, of which 50% required tracheostomy. Our study findings provide valuable insights into the pathophysiology of BPD-associated airway diseases and may inform future clinical management strategies for patients with BPD.

Keyword

Infant, premature; Bronchopulmonary dysplasia; Tracheobronchomalacia; Bronchoscopy; Airway extubation

Figure

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  Figure 1. Flow diagram of the study population. Abbreviations: BPD, bronchopulmonary dysplasia; SNUBH, Seoul National University Bundang Hospital.

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  Figure 2. Venn diagram representing the distribution of individuals based on structural abnormalities identified in bronchoscopy results. Values are expressed as numbers.

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