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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