Bronchoscopic interventions for plastic bronchitis in children without structural heart disease

Kallam, Erin F.; Kasi, Ajay S; Patki, Rucha; Silva, George Lucas; Simon, Dawn M.; Caltharp, Shelley A.; Guglani, Lokesh

doi:10.1007/s00431-021-04161-5

Cited by 14 publications

(20 citation statements)

References 20 publications

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“…Sang ju-Yin Decoction is a commonly used formula for children with cough and wind-heat disease. In vitro cell experiments show that it can stop nuclear-written version of spoken word factors and reduce the expression of insulting/swelling factors, which may be one of its antiswelling machines/methods [ 6 ]. HBD2 is one of the most studied germ-killing peptides.…”

Section: Introductionmentioning

confidence: 99%

Effects of Modified Sang ju-Yin Decoction Combined with IFNαlb Nebulization on IL-1β and HBD2 in Children with Asthmatic Bronchitis

Zhang

Wang

Liu

et al. 2022

Computational and Mathematical Methods in Medicine

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Background. Breathing disease swelling of the lung tubes caused by viral infection is more and more likely to develop into related to the lung tubes breathing disease, especially repeating breathing loudly. Objective. To investigate the effect of modified Sang ju-Yin Decoction combined with Interferon (IFN)αlb nebulization on children with asthmatic bronchitis and the effects of IL-1β and β-defensin 2 (HBD2). Materials and Methods. The clinical data of 80 children with asthmatic bronchitis who were diagnosed and treated in our hospital from May 2019 to May 2021 were selected as the research objects and divided into the control group and the observation group with 40 cases in each group according to different treatment methods. Among them, the control group was nebulized with IFNαlb, and the observation group was given addition and subtraction of Sang ju-Yin Decoction based on the control group. The clinical symptoms, pulmonary function indexes, adverse reactions, and effects on serum inflammatory indexes were observed and compared between the two groups. Results. There was no significant difference in the scores of symptoms and signs between the two groups before treatment ( P > 0.05 ), while the scores of shortness of breath, cough, stridor, lung rales, and signs after treatment of observation group were better than those of the control group ( P < 0.05 ). There was no significant difference in serum inflammatory indexes and pulmonary function indexes between the two groups before treatment ( P > 0.05 ), while the differences in IL-6, IL-10, TNF-α, IL-1β, and HBD2 after treatment were significant between the two groups ( P < 0.05 ). After treatment, the RR, TV, and PEF indexes of the two groups of children were significantly improved ( P < 0.05 ). After treatment, the adverse reaction rate of liver function damage, dry throat discomfort, rash, nausea, and vomiting in the observation group was 7.5%, which was significantly lower than 27.5% in the control group ( P < 0.05 ). Conclusion. Modified Sang ju-Yin Decoction combined with IFNαlb nebulization can improve symptoms and promote the recovery of patients in the treatment of acute bronchitis.

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Section: Introductionmentioning

confidence: 99%

Effects of Modified Sang ju-Yin Decoction Combined with IFNαlb Nebulization on IL-1β and HBD2 in Children with Asthmatic Bronchitis

Zhang

Wang

Liu

et al. 2022

Computational and Mathematical Methods in Medicine

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“…Numerous systemic illnesses have been reported to be associated with PB, including Fontan cardiac surgery [8] , asthma [9] , nephrotic syndrome [10] , idiopathic chronic eosinophilic pneumonia [11] and so on.…”

Section: Discussionmentioning

confidence: 99%

Plastic bronchitis in children：a review of 55 cases over a 10-year period

Chen

Huang

et al. 2023

Preprint

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Objective To summarize the clinical characteristics and treatment experiences of patients with plastic bronchitis (PB).Methods All patients who were diagnosed with PB by bronchoscopic removal of tree-like casts at a single institution from January 2012 to May 2022 were retrospectively reviewed. Demographic and clinical data were retrieved from electronic patient records༎Results A total of 55 patients, with a median age of 5.3 years, were eligible for the study. Nineteen cases had underlying diseases, among which asthma was the most common. Clinical symptoms were characterized by cough and fever, while moist rales (78.2%) and dyspnea (61.8%) were the most common signs. The most common laboratory finding was elevated C-reactive protein (58.2%). Patchy exudation was the most frequent radiographic finding (81.2%), followed by consolidation (60.0%) and pleural effusion (43.6%). Respiratory pathogens were detected in 41 cases, and M. pneumoniae was the most common one (41.8%), followed by adenovirus (20.0%) and influenza B virus (10.9%). The casts were removed by alveolar lavage, combined with ambroxol immersion (63.6%) and forceps (30.9%). Patients received an average of 2.3 bronchoscopies, and the median time for the first procedure was 3 days after admission. Antibiotics were given to all patients, methylprednisolone to 33 (60.0%), and gamma globulin to 25 (45.5%). A total of 53 cases were improved with an overall mortality rate of 3.6%.Conclusions PB in children is characterized by airway obstruction, mostly caused by respiratory infections, and timely removal of the cast by bronchoscopy is the most effective treatment.

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“…The mortality rate turned out to be considerably higher in children with CHD than in the remaining groups [ 23 ], which could be explained by the coexistence of respiratory and circulatory disorders. It has been reported [ 43 ] that asthma is a risk factor for recurrent PB in non-CHD children.…”

Section: Discussionmentioning

confidence: 99%

Plastic Bronchitis—A Serious Rare Complication Affecting Children Only after Fontan Procedure?

Pałyga-Bysiecka

Polewczyk

Kołodziej

et al. 2021

JCM

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Background: Plastic bronchitis (PB) may occur not only in children following palliative Fontan procedure but also in those without underlying heart disease. We aim to assess the clinical course, therapeutic measures, outcome, and follow-up of PB in children with congenital heart disease (CHD) and children without cardiac problems. Methods: This retrospective case series assessed children with PB admitted to hospital between 2015 and 2019. Parents or guardians of patients were contacted by e-mail or telephone between September 2017 and June 2019 to enquiry about recurrence of PB and strategy of treatment. The diagnosis of PB was based on the expectoration (spontaneous or during bronchoscopy) of endobronchial plugs. Results: This study delineated the clinical, histological, and laboratory features of plastic bronchitis in children following Fontan procedure (Group A) and in those without heart defects (Group B, non-CHD children). The main symptoms were cough accompanied by dyspnea, and hypoxemia with a decrease in oxygen saturation, often leading to acute respiratory failure. In children with CHD, the first episode of PB occurred at a relatively young age. Although chronic, i.e., lasting more than 3 weeks, inhaled therapy was implemented in both groups of patients, the recurrences of PB were observed. The mean time to PB recurrence after the first episode in Group A was longer than that in Group B (1.47 vs. 0.265 years, p = 0.2035). There was no re-episode with recurrence of PB in 3 cases out of 10 in total in Group A (30%) and 1 case out of 4 in total in Group B (25%). While the majority of children in Group A usually developed bronchial casts on the right side, the patients in Group B (without CHD) suffered from bronchial casts located only on the left side. Conclusions: Despite many similarities, clinical, histological, and laboratory studies in the children with plastic bronchitis after Fontan’s surgery and in children without heart defects suggest that there are differences in the course of the disease in patients without CHD, such as a more advanced age of the first episode of PB, the location of plastic casts on the left side, and a stronger role of inflammatory factors and mechanisms. Further research is needed to understand the pathophysiology of PB and choose the most appropriate therapy.

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Bronchoscopic interventions for plastic bronchitis in children without structural heart disease

Cited by 14 publications

References 20 publications

Effects of Modified Sang ju-Yin Decoction Combined with IFNαlb Nebulization on IL-1β and HBD2 in Children with Asthmatic Bronchitis

Effects of Modified Sang ju-Yin Decoction Combined with IFNαlb Nebulization on IL-1β and HBD2 in Children with Asthmatic Bronchitis

Plastic bronchitis in children：a review of 55 cases over a 10-year period

Plastic Bronchitis—A Serious Rare Complication Affecting Children Only after Fontan Procedure?

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