title: Bronchoscopy findings in children and young adults with tracheostomy due to congenital anomalies and neurological impairment.
abstract: The aim of this study was to examine bronchoscopy findings for children and young adults with long-term tracheostomies due to congenital anomalies and neurological impairment and identify characteristics associated with abnormal bronchoscopic findings. We conducted a retrospective study of 128 bronchoscopy cases (81 children) at a pediatric rehabilitation center. Thirty-eight cases (30%) had normal findings and 14 children (17% of all children) were decannulated following bronchoscopy. Ninety cases (70% of cases) had abnormal findings (e.g. granulomas, airway inflammation, fixed obstruction). An acute indication for bronchoscopy was the strongest predictor of an abnormal finding, while age (younger) and diagnosis (multiple congenital anomalies (MCA)) also were associated with abnormalities. For a subsample of children undergoing bronchoscopy for routine surveillance (n= 90), underlying diagnosis (MCA) was the strongest predictor of an abnormal finding, while younger age contributed slightly. These findings add to the limited literature describing bronchoscopic findings in children and youth with tracheostomies due to congenital anomalies or neurological impairment. These findings may be useful for rehabilitation clinicians in determining care needs for children with long-term tracheostomy.
authors.affiliation: Department of Pulmonology, Franciscan Hospital for Children, Boston, MA, USA Division of Respiratory Diseases, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA.
authors.forename: Virginia S
authors.initials: VS
authors.lastname: Kharasch
authors.forename: Helene M
authors.initials: HM
authors.lastname: Dumas
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Haley
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Sawicki
authors.forename: Larry H
authors.initials: LH
authors.lastname: Ludlow
authors.forename: Erika A
authors.initials: EA
authors.lastname: Wright
authors.forename: Dwight T
authors.initials: DT
authors.lastname: Jones
authors.forename: Jane E
authors.initials: JE
authors.lastname: O'Brien