ERS Statement on Tracheomalacia and Bronchomalacia in Children.

File Description SizeFormat 
ERS statement on TBM - FINAL.docxFile embargoed until 18 July 2020443.16 kBMicrosoft Word    Request a copy
Title: ERS Statement on Tracheomalacia and Bronchomalacia in Children.
Authors: Wallis, C
Alexopoulou, E
Antón-Pacheco, JL
Bhatt, JM
Bush, A
Chang, AB
Charatsi, A-M
Coleman, C
Depiazzi, J
Douros, K
Eber, E
Everard, M
Kantar, A
Masters, IB
Midulla, F
Nenna, R
Roebuck, D
Snijders, D
Priftis, K
Item Type: Journal Article
Abstract: Tracheomalacia (TM) and tracheobronchomalacia (TBM) may be primary abnormalities of the large airways or associated with a wide variety of congenital and acquired conditions. The evidence on diagnosis, classification and management is scant. There is no universally accepted classification of severity. Clinical presentation includes early-onset stridor or fixed wheeze, recurrent infections, brassy cough and even near-death attacks, depending on the site and severity of the lesion. Diagnosis is usually made by flexible bronchoscopy in a free-breathing child but may also be shown by other dynamic imaging techniques such as low contrast volume bronchography, computed tomography or magnetic resonance imaging. Lung function testing can provide supportive evidence but is not diagnostic. Management may be medical or surgical, depending on the nature and severity of the lesions but the evidence base for any therapy is limited. While medical options that include bronchodilators, anti-muscarinic agents, mucolytics and antibiotics, (as well as treatment of co-morbidities and associated conditions) are used, there is currently little evidence for benefit. Chest physiotherapy is commonly prescribed, but the evidence base is poor. When symptoms are severe, surgical options include aortopexy or posterior tracheopexy, tracheal resection of short affected segments, internal stents and external airway splinting. If respiratory support is needed, CPAP is the most commonly used modality either via a facial mask or tracheostomy. Parents of children with TBM report diagnostic delays and anxieties about how to manage their child's condition, and want more information. There is a need for more research to establish an evidence base for malacia. This statement provides a review of the current literature to inform future study.
Issue Date: 18-Jul-2019
Date of Acceptance: 1-Jul-2019
URI: http://hdl.handle.net/10044/1/72024
DOI: https://doi.org/10.1183/13993003.00382-2019
ISSN: 0903-1936
Publisher: European Respiratory Society
Journal / Book Title: European Respiratory Journal
Volume: 54
Issue: 1
Copyright Statement: ©ERS 2019. This is an author-submitted, peer-reviewed version of a manuscript that has been accepted for publication in the European Respiratory Journal, prior to copy-editing, formatting and typesetting. This version of the manuscript may not be duplicated or reproduced without prior permission from the copyright owner, the European Respiratory Society. The publisher is not responsible or liable for any errors or omissions in this version of the manuscript or in any version derived from it by any other parties. The final, copy-edited, published article, which is the version of record, is available without a subscription 18 months after the date of issue publication.
Sponsor/Funder: Asthma UK
Funder's Grant Number: R43065
Keywords: Respiratory System
11 Medical and Health Sciences
Publication Status: Published online
Conference Place: England
Embargo Date: 2020-07-18
Online Publication Date: 2019-07-18
Appears in Collections:National Heart and Lung Institute



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Creative Commons