Necrotizing tracheobronchitis. An ischemic lesion.
Neonates with necrotizing tracheobronchitis present a diverse clinical spectrum from asymptomatic disease to severe airway obstruction. A retrospective clinicopathologic study of 206 neonatal autopsy reports spanning a three-year period yielded 122 cases of necrotizing tracheobronchitis with an incidence of 59%. All study patients received treatment prior to the development of high-frequency ventilator jet, oscillator, or interruption. The site and submucosal depth of airway involvement was variable. The most commonly affected anatomic site was the middle or thoracic trachea (56%). The common cause identified was severe ischemia to the airway mucosa and submucosa, occurring with profound birth asphyxia and/or shock. The presence of ischemia supports the concept that decreased tracheoperfusion may be an important factor in the development of tracheobronchial abnormalities.
Hanson
J B
JB
Department of Perinatology, Children's Hospital, Denver, CO 80218.
Waldstein
G
G
Hernandez
J A
JA
Fan
L L
LL
D001034:Apgar Score; D001980:Bronchi / Q000098:blood supply / Q000473:pathology; D001991:Bronchitis / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D007511:Ischemia / Q000209:etiology* / Q000473:pathology; D009336:Necrosis; D012121:Respiration, Artificial / Q000009:adverse effects*; D014132:Trachea / Q000098:blood supply / Q000473:pathology; D014136:Tracheitis / Q000209:etiology* / Q000473:pathology