title: Bronchodilator responsiveness in a ventilator-dependent infant with severe tracheobronchomalacia.
abstract: A neonatal case of severe, ventilator-dependent tracheobronchomalacia (TBM) is described. The extent of the malacic segment was determined by endoscopy and tracheobronchography. Additionally, relevant and ever increasing reversible peripheral airway obstruction was documented by measuring the mechanical properties of the respiratory system before and after salbutamol. With the combination of endoscopically guided aortopexy and salbutamol infusion, the infant was eventually weaned from mechanical ventilation at the age of 86 days. We speculate that in ventilator-dependent infants with severe TBM the determination of bronchodilator responsiveness may have clinical consequences.
authors.affiliation: Pediatric Intensive Care, Children's Hospital, University of Berne, Inselspital, Switzerland. wagner@insel.ch
authors.forename: B P
authors.initials: BP
authors.lastname: Wagner
authors.forename: P
authors.initials: P
authors.lastname: Birrer
authors.forename: M
authors.initials: M
authors.lastname: Tönz
authors.forename: H
authors.initials: H
authors.lastname: Tschäppeler
authors.forename: J
authors.initials: J
authors.lastname: Pfenninger
mesh_terms: D000420:Albuterol / Q000494:pharmacology / Q000627:therapeutic use*; D001982:Bronchial Diseases / Q000150:complications / Q000628:therapy*; D001993:Bronchodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001995:Bronchography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011175:Positive-Pressure Respiration; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology / Q000628:therapy*; D015656:Respiratory Mechanics / Q000187:drug effects*; D014133:Tracheal Diseases / Q000150:complications / Q000628:therapy*
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol