Conclusion
In patients with BPD, the natural maturation of the airway does not
occur resulting in a small, highly compliant structure that is prone to
collapse and injury. Further, neonates with BPD are often exposed to
prolonged periods to invasive mechanical ventilation and multiple
intubations, which leads to airway damage. Consequently, both dynamic
and fixed central airway pathologies are common in this patient
population and are associated with increase respiratory morbidity.
Future work is needed to develop targeted therapies for dynamic airway
pathology and improve prevention of fixed airway lesions.
Figure 1 : Bronchoscopic, chest computed tomography, and
ultrashort echo-time magnetic resonance images of three neonates with
bronchopulmonary dysplasia and tracheomalacia during inhalation (A, B,
and C and exhalation (D, E, and F)
Figure 2: Chest radiograph, chest computed tomography, and
bronchoscopic images of a neonate with bronchopulmonary dysplasia and
marked tracheobronchomegaly.
Figure 3: An endoscopic image of a neonate with
bronchopulmonary dysplasia and a normal subglottis (A). Endoscopic
images of four neonates with BPD and grade 1 (B), grade 2 (C), grade 3
(C), and grade 4 (D) subglottic stenosis.
Figure 4: Bronchoscopic images of the carina (A) and right main
bronchus (B) in a neonate with bronchopulmonary dysplasia and severe
suction trauma. Bronchoscopic images of the carina (C) and right main
bronchus (D) in the same patient following seven days of treatment with
topical ciprofloxacin/dexamethasone applied via the endotracheal tube.
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