Journal article
Tracheomalacia is associated with lower FEV1 and Pseudomonas acquisition in children with CF
Pediatric pulmonology, Vol.49(10), pp.960-970
10/2014
DOI: 10.1002/ppul.22922
PMCID: PMC4711356
PMID: 24166775
Abstract
Summary
Background
Tracheomalacia (TM) occurs in approximately 1 in 2,100 children. Because the trachea develops abnormally in animal models of cystic fibrosis (CF), we hypothesized this may also occur in children with CF, increasing their risk of TM.
Purpose
To examine the prevalence and clinical consequences of TM in children with CF.
Methods
We studied children with CF born between 1995 and 2012. TM was defined as dynamic collapse of the trachea, and the severity was recorded as described in the chart. The effect of TM on patient outcomes, including FEV1, CT changes, and acquisition of CF pathogens, was assessed using a longitudinal patient dataset.
Results
Eighty‐nine percent of children with CF had at least one bronchoscopy (n = 97/109). Fifteen percent of these children had TM described in any bronchoscopy report (n = 15/97). Of the patients with TM, eight had meconium ileus (P = 0.003) and all were pancreatic insufficient. Pseudomonas aeruginosa infection occurred 1.3 years earlier among children with TM (P = 0.01). Starting FEV1 values by age 8 were diminished by over 18% of predicted for patients with TM. Life‐threatening episodes of airway obstruction occurred in 3 of 15 patients with CF and TM, including one leading to death. Gender, prematurity, and hepatic disease were not associated with TM. No difference was observed in the frequency of bronchiectasis.
Conclusions
TM is significantly more common in infants and children with CF than in the general population and is associated with airway obstruction and earlier Pseudomonas acquisition. Pediatr Pulmonol. 2014; 49:960–970. © 2013 Wiley Periodicals, Inc.
Details
- Title: Subtitle
- Tracheomalacia is associated with lower FEV1 and Pseudomonas acquisition in children with CF
- Creators
- Anthony J Fischer - University of IowaSachinkumar B Singh - University of IowaRyan J Adam - University of IowaDavid A Stoltz - University of IowaChristopher F Baranano - University of IowaSimon Kao - University of IowaMiles M Weinberger - University of IowaPaul B McCray - University of IowaTimothy D Starner - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Pediatric pulmonology, Vol.49(10), pp.960-970
- DOI
- 10.1002/ppul.22922
- PMID
- 24166775
- PMCID
- PMC4711356
- NLM abbreviation
- Pediatr Pulmonol
- ISSN
- 8755-6863
- eISSN
- 1099-0496
- Number of pages
- 11
- Grant note
- Division of Pediatric Allergy, Immunology, and Pulmonary Medicine at the University of Iowa Children's Hospital
- Language
- English
- Date published
- 10/2014
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Molecular Physiology and Biophysics; Pulmonary, Critical Care, and Occupational Medicine; Microbiology and Immunology; Pulmonary Medicine; Stead Family Department of Pediatrics; Internal Medicine
- Record Identifier
- 9984025450302771
Metrics
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