[Diagnostic and therapeutic methods for perioperative children with congenital heart disease with airway stenosis in pediatric intensive care unit].
OBJECTIVE
To explore the diagnostic and therapeutic methods for perioperative children with congenital heart disease (CHD) with airway stenosis in pediatric intensive care unit (PICU).


METHODS
Fiberoptic bronchoscopy was used for the diagnosis of 100 CHD cases in PICU who were clinically considered to have possible airway malformation because of complicated difficult-to-control lung infection, atelectasis and failure with the ventilator after surgery from January 2010 to October 2011. Cases who were confirmed to have severe airway stenosis by bronchoscopy and weaning from the ventilator after surgery were treated with balloon expandable stents into the desired position in the bronchoscopy.


RESULTS
There were 73 cases (73%) of CHD patients with airway abnormalities, including 31 cases of severe stenosis (31%), moderate stenosis in 29 cases (29%), mild stenosis in 13 cases (13%). Nine of the 10 children in whom the mechanical ventilation was hard to be stopped after surgery because of severe airway stenosis were weaned from mechanical ventilation successfully by fiberoptic bronchoscopy, while one case died from primary disease with severe sepsis after the placement of bronchial stents.


CONCLUSIONS
CHD children with difficult-to-control lung infection, atelectasis and failure with ventilator after surgery are often complicated with airway abnormalities. The therapeutic bronchoscopy with airway stent can be used for cases with weaning from the ventilator because of severe airway stenosis.
Pediatric Intensive Care Unit, Bayi Children's Hospital Affiliated to General Hospital of Beijing Military Command, Beijing 100700, China.
Xuan
X
Xu
Xi-cheng
XC
Liu
Dan-dan
DD
Li
Bin
B
Zhu
Li-jun
LJ
Xiao
Email: zhjfengzc@sohu.com.
Zhi-chun
ZC
Feng
Yi-min
YM
Zhu
D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D001999:Bronchoscopy / Q000379:methods*; D003251:Constriction, Pathologic; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008171:Lung Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D008297:Male; D059035:Perioperative Period; D012121:Respiration, Artificial; D015607:Stents; D014132:Trachea / Q000002:abnormalities; D014135:Tracheal Stenosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome