The use of bronchial occlusion test in a preterm infant with severe bronchopulmonary dysplasia complicated by severe lobar emphysema

LIU Hui-Juan; GUAN Rui-Lian; QIN Xin; WANG Huai-Zhen; ZHANG Gao-Long; LI Jian-Bin; MA Li; LI Le; LU Lian-Wei; SUN Yi; ZHANG Hua-Yan

doi:10.7499/j.issn.1008-8830.2403014

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Chinese Journal of Contemporary Pediatrics ›› 2024, Vol. 26 ›› Issue (6) : 659-664. DOI: 10.7499/j.issn.1008-8830.2403014

COLUMN ON DIAGNOSIS & TREATMENT IN MDT MODE

The use of bronchial occlusion test in a preterm infant with severe bronchopulmonary dysplasia complicated by severe lobar emphysema

LIU Hui-Juan, GUAN Rui-Lian, QIN Xin, WANG Huai-Zhen, ZHANG Gao-Long, LI Jian-Bin, MA Li, LI Le, LU Lian-Wei, SUN Yi, ZHANG Hua-Yan

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Abstract

In infants with severe bronchopulmonary dysplasia (sBPD), severe pulmonary lobar emphysema may occur as a complication, contributing to significant impairment in ventilation. Clinical management of these infants is extremely challenging and some may require lobectomy to improve ventilation. However, prior to the lobectomy, it is very difficult to assess whether the remaining lung parenchyma would be able to sustain adequate ventilation postoperatively. In addition, preoperative planning and perioperative management are also quite challenging in these patients. This paper reports the utility of selective bronchial occlusion in assessing the safety and efficacy of lobectomy in a case of sBPD complicated by severe right upper lobar emphysema. Since infants with sBPD already have poor lung development and significant lung injury, lobectomy should be viewed as a non-traditional therapy and be carried out with extreme caution. Selective bronchial occlusion test can be an effective tool in assessing the risks and benefits of lobectomy in cases with sBPD and lobar emphysema. However, given the technical difficulty, successful application of this technique requires close collaboration of an experienced interdisciplinary team.

Key words

Bronchial occlusion / Bronchopulmonary dysplasia / Pulmonary emphysema / Lobectomy / Infant

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LIU Hui-Juan, GUAN Rui-Lian, QIN Xin, WANG Huai-Zhen, ZHANG Gao-Long, LI Jian-Bin, MA Li, LI Le, LU Lian-Wei, SUN Yi, ZHANG Hua-Yan. The use of bronchial occlusion test in a preterm infant with severe bronchopulmonary dysplasia complicated by severe lobar emphysema[J]. Chinese Journal of Contemporary Pediatrics. 2024, 26(6): 659-664 https://doi.org/10.7499/j.issn.1008-8830.2403014

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