Patients 1 year or older with a history of recurrent pneumonia or intubation are more likely to have an aspiration-related airway lesion. There is a high incidence of aspiration-related airway lesions identified on DLB and not seen on flexible laryngoscopy, with 66.3% (110 of 166) of those lesions eventually requiring surgical intervention. In all, 66.3% of patients (110 of 166) eventually underwent surgical repair of an identified aspiration-related airway lesion.Ĭonclusions and Relevance In children with chronic aspiration who warrant further evaluation, flexible laryngoscopy alone is not sufficient. Patients with an aspiration-related airway lesion were less likely to have neurologic disease than were patients without an airway lesion (0.50 P < .001). Older age (adjusted risk ratio, 1.37 P = .01), recurrent pneumonia (1.40 P = .004), and history of intubation (1.35 P = .01) were significantly associated with the presence of an aspiration-related airway lesion in the multivariable model. Patients with an aspiration-related airway lesion were older (mean age, 2.7 vs 2.2 years P = .02) and more likely to have another aerodigestive disorder than were patients without an airway lesion (21.7% vs 11.6% P = .004). Direct laryngoscopy and bronchoscopy identified 173 additional diagnoses and had a greater diagnostic yield for airway lesions (45.1% ) than flexible laryngoscopy examination alone ( P < .001). Flexible laryngoscopy examination alone identified 93 patients with an airway lesion. Sixty-two percent (328 of 532) of the participants were male. Their mean (SD) age was 2.2 (3.6) years (age range, 0.1-25.0 years), with more than half younger than 1 year. Results Five hundred thirty-two patients met the inclusion criteria. Main Outcomes and Measures Data were collected and analyzed, including age, sex, history of intubation, flexible laryngoscopy results, DLB findings, recurrent pneumonia, and associated diagnoses. Intervention Direct laryngoscopy and bronchoscopy using general anesthesia. A medical record review was performed on all patients with a documented diagnosis of pulmonary aspiration who underwent DLB using general anesthesia during a 5-year period (January 2010 to December 2014). Objectives To determine the yield of direct laryngoscopy and bronchoscopy (DLB) using general anesthesia in pediatric patients who aspirate and to identify clinical predictors of aspiration-related airway lesions.ĭesign, Setting, and Participants Retrospective review at a tertiary referral children’s hospital. Importance There is no consensus on the evaluation of pediatric patients with aspiration.
0 kommentar(er)
