title: [Tracheobronchomalacia in pediatric patients: clinical experience].
abstract: BACKGROUND
  Tracheobronchomalacia is characterized by a deficiency in the cartilaginous support of the trachea and bronchi and hypotony in the myoelastic elements, that lead to different levels of airway obstruction.
  
  
  OBJECTIVE
  To report our experience in the treatment of traqueobronchomalacia.
  
  
  METHODS
  Retrospective review of 24 patients with tracheomalacia of different levels (3 tracheobronchomalacia, 3 laryngotracheomalacia) and 8 patients with bronchomalacia.
  
  
  RESULTS
  The age at diagnosis ranged from 9 days to 9 years. Clinical presentation was recurrent wheezing in 19 patients, stridor in 6 and atelectasis in 4. The associated factors were neurological impairment in 8, congenital heart disease in 10 and prolonged mechanical ventilation in 4. The diagnosis was done by flexible bronchoscopy in all patients, using sedation and allowing spontaneous breathing. At the moment of diagnosis, treatment consisted in oxygen supply in 14 patients, physiotherapy in 21, beta 2 adrenergic agonists in 27, racemic epinephrine in 8, mechanical ventilation in 12, ipratropium bromide in 5 and inhaled steroids in 13. After diagnosis, 24 patients received bronchodilator therapy with ipratropium bromide, 15 received racemic epinephrine and 22 received inhaled steroids. In 21, beta 2 adrenergic agonists were discontinued. Thirteen patients required ventilation support and home oxygen. Twenty two patients showed a satisfactory clinical evolution and 6 patients died.
  
  
  CONCLUSIONS
  The clinical presentation of tracheobronchomalacia is varied and diagnosis is done by flexible bronchoscopy. Treatment will depend on the severity of the disease, but beta 2 adrenergic agonists should be excluded.
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Clínico Pontiflicia Universidad Católica de Chile. acastill@med.puc.cl
authors.forename: Andrés
authors.initials: A
authors.lastname: Castillo
authors.forename: Jeany
authors.initials: J
authors.lastname: Smith
authors.forename: Valeria
authors.initials: V
authors.lastname: Figueroa
authors.forename: Pablo
authors.initials: P
authors.lastname: Bertrand
authors.forename: Ignacio
authors.initials: I
authors.lastname: Sánchez
mesh_terms: D001982:Bronchial Diseases / Q000175:diagnosis* / Q000628:therapy; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012121:Respiration, Artificial; D012189:Retrospective Studies; D014133:Tracheal Diseases / Q000175:diagnosis* / Q000628:therapy