Casting a look at pediatric plastic bronchitis

Abstract Objectives To review clinical presentations and management strategies for children with plastic bronchitis. Methods Retrospective chart review. Results Seven patients required rigid bronchoscopy to remove bronchial casts over a 17-year study period. Mean age at presentation was 60 months. M...

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Bibliographic Details
Published in:International journal of pediatric otorhinolaryngology 2015-10, Vol.79 (10), p.1658-1661
Main Authors: Jasinovic, Tin, Kozak, Frederick K, Moxham, J. Paul, Chilvers, Mark, Wensley, David, Seear, Michael, Campbell, Andrew, Ludemann, Jeffrey P
Format: Article
Language:English
Subjects:
Bronchial casts
Bronchitis - therapy
Bronchoscopy - adverse effects
Bronchoscopy - methods
Bronchoscopy - statistics & numerical data
Child
Child, Preschool
ECMO
Female
Follow-Up Studies
Humans
Infant
Male
Otolaryngology
Pediatrics
Plastic bronchitis
Retrospective Studies
Rigid bronchoscopy
Splints - adverse effects
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Summary:Abstract Objectives To review clinical presentations and management strategies for children with plastic bronchitis. Methods Retrospective chart review. Results Seven patients required rigid bronchoscopy to remove bronchial casts over a 17-year study period. Mean age at presentation was 60 months. Mean follow-up was 53 months. Co-morbidities included: congenital heart disease ( n = 3), chronic pulmonary disorders ( n = 2) and sickle cell disease ( n = 1). 4 patients required multiple bronchoscopies for recurrent casts. Adjunctive topical therapies were administered in all 7 patients, without complication. Rigid bronchoscopy for cast removal was performed in 2 patients who were on extra-corporal membrane oxygenation (ECMO), using special precautions to safeguard the ECMO catheters. Conclusions Bronchial casts in children may present acutely or sub-acutely. Recurrent casts are unusual; however, in combination with severe cardiac disease may lead to mortality. Adjunctive topical therapies are still under investigation. Special safeguards for ECMO catheters are imperative. This case series complements and adds to the International Plastic Bronchitis Registry.
ISSN:0165-5876
1872-8464
DOI:10.1016/j.ijporl.2015.07.011