Endobronchial occlusion with one-way endobronchial valves: A novel technique for persistent air leaks in children

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: In children, persistent air leaks can result from pulmonary infection or barotrauma.Management strategies include surgery, prolonged pleural drainage, ventilator manipulation, and extracorporeal membrane oxygenation (ECMO). We report the use of endobronchial valve placement as an effective minimally invasive intervention for persistent air leaks in children. Methods: Children with refractory prolonged air leaks were evaluated by a multidisciplinary team (pediatric surgery, interventional pulmonology, pediatric intensive care, and thoracic surgery) for endobronchial valve placement. Flexible bronchoscopy was performed, and air leak location was isolated with balloon occlusion. Retrievable one-way endobronchial valves were placed. Results: Four children (16months to 16 years) had prolonged air leaks following necrotizing pneumonia (2), lobectomy (1), and pneumatocele (1). Patients had 1-4 valves placed. Average time to air leak resolution was 12 days (range 0-39). Average duration to chest tube removal was 25 days (range 7-39). All four children had complete resolution of air leaks. All were discharged from the hospital. None required additional surgical interventions. Conclusion: Endobronchial valve placement for prolonged air leaks owing to a variety of etiologies was effective in these children for treating air leaks, and their use may result in resolution of fistulae and avoidance of the morbidity of pulmonary surgery.

Original languageEnglish (US)
Pages (from-to)82-85
Number of pages4
JournalJournal of Pediatric Surgery
Volume50
Issue number1
DOIs
StatePublished - Jan 1 2015

Fingerprint

Air
Barotrauma
Balloon Occlusion
Chest Tubes
Pulmonary Medicine
Lung
Extracorporeal Membrane Oxygenation
Bronchoscopy
Mechanical Ventilators
Critical Care
Thoracic Surgery
Fistula
Drainage
Pediatrics
Morbidity
Infection

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

@article{27f3f8197bd840b68eed35d745d91864,
title = "Endobronchial occlusion with one-way endobronchial valves: A novel technique for persistent air leaks in children",
abstract = "Purpose: In children, persistent air leaks can result from pulmonary infection or barotrauma.Management strategies include surgery, prolonged pleural drainage, ventilator manipulation, and extracorporeal membrane oxygenation (ECMO). We report the use of endobronchial valve placement as an effective minimally invasive intervention for persistent air leaks in children. Methods: Children with refractory prolonged air leaks were evaluated by a multidisciplinary team (pediatric surgery, interventional pulmonology, pediatric intensive care, and thoracic surgery) for endobronchial valve placement. Flexible bronchoscopy was performed, and air leak location was isolated with balloon occlusion. Retrievable one-way endobronchial valves were placed. Results: Four children (16months to 16 years) had prolonged air leaks following necrotizing pneumonia (2), lobectomy (1), and pneumatocele (1). Patients had 1-4 valves placed. Average time to air leak resolution was 12 days (range 0-39). Average duration to chest tube removal was 25 days (range 7-39). All four children had complete resolution of air leaks. All were discharged from the hospital. None required additional surgical interventions. Conclusion: Endobronchial valve placement for prolonged air leaks owing to a variety of etiologies was effective in these children for treating air leaks, and their use may result in resolution of fistulae and avoidance of the morbidity of pulmonary surgery.",
author = "Jennifer Toth and Podany, {Abigail B.} and Reed, {Michael F.} and Dorothy Rocourt and Gilbert, {Christopher R.} and Santos, {Mary Catherine} and Robert Cilley and Peter Dillon",
year = "2015",
month = "1",
day = "1",
doi = "10.1016/j.jpedsurg.2014.10.007",
language = "English (US)",
volume = "50",
pages = "82--85",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",
number = "1",

}

TY - JOUR

T1 - Endobronchial occlusion with one-way endobronchial valves

T2 - A novel technique for persistent air leaks in children

AU - Toth, Jennifer

AU - Podany, Abigail B.

AU - Reed, Michael F.

AU - Rocourt, Dorothy

AU - Gilbert, Christopher R.

AU - Santos, Mary Catherine

AU - Cilley, Robert

AU - Dillon, Peter

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Purpose: In children, persistent air leaks can result from pulmonary infection or barotrauma.Management strategies include surgery, prolonged pleural drainage, ventilator manipulation, and extracorporeal membrane oxygenation (ECMO). We report the use of endobronchial valve placement as an effective minimally invasive intervention for persistent air leaks in children. Methods: Children with refractory prolonged air leaks were evaluated by a multidisciplinary team (pediatric surgery, interventional pulmonology, pediatric intensive care, and thoracic surgery) for endobronchial valve placement. Flexible bronchoscopy was performed, and air leak location was isolated with balloon occlusion. Retrievable one-way endobronchial valves were placed. Results: Four children (16months to 16 years) had prolonged air leaks following necrotizing pneumonia (2), lobectomy (1), and pneumatocele (1). Patients had 1-4 valves placed. Average time to air leak resolution was 12 days (range 0-39). Average duration to chest tube removal was 25 days (range 7-39). All four children had complete resolution of air leaks. All were discharged from the hospital. None required additional surgical interventions. Conclusion: Endobronchial valve placement for prolonged air leaks owing to a variety of etiologies was effective in these children for treating air leaks, and their use may result in resolution of fistulae and avoidance of the morbidity of pulmonary surgery.

AB - Purpose: In children, persistent air leaks can result from pulmonary infection or barotrauma.Management strategies include surgery, prolonged pleural drainage, ventilator manipulation, and extracorporeal membrane oxygenation (ECMO). We report the use of endobronchial valve placement as an effective minimally invasive intervention for persistent air leaks in children. Methods: Children with refractory prolonged air leaks were evaluated by a multidisciplinary team (pediatric surgery, interventional pulmonology, pediatric intensive care, and thoracic surgery) for endobronchial valve placement. Flexible bronchoscopy was performed, and air leak location was isolated with balloon occlusion. Retrievable one-way endobronchial valves were placed. Results: Four children (16months to 16 years) had prolonged air leaks following necrotizing pneumonia (2), lobectomy (1), and pneumatocele (1). Patients had 1-4 valves placed. Average time to air leak resolution was 12 days (range 0-39). Average duration to chest tube removal was 25 days (range 7-39). All four children had complete resolution of air leaks. All were discharged from the hospital. None required additional surgical interventions. Conclusion: Endobronchial valve placement for prolonged air leaks owing to a variety of etiologies was effective in these children for treating air leaks, and their use may result in resolution of fistulae and avoidance of the morbidity of pulmonary surgery.

UR - http://www.scopus.com/inward/record.url?scp=84922470462&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84922470462&partnerID=8YFLogxK

U2 - 10.1016/j.jpedsurg.2014.10.007

DO - 10.1016/j.jpedsurg.2014.10.007

M3 - Article

C2 - 25598099

AN - SCOPUS:84922470462

VL - 50

SP - 82

EP - 85

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

IS - 1

ER -