Cystic fibrosis and the thoracic surgeon

Rolla, M.; D’Andrilli, Antonio; Rendina, Erino Angelo; Diso, Daniele; Venuta, Federico

doi:10.1016/j.ejcts.2010.07.024

Cited by 18 publications

(11 citation statements)

References 89 publications

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“…[1][2][3][4] Pulmonary resection in patients with cystic fibrosis (CF) has been infrequently reported. 7,8 In Argentina, the main causes of PNE are sequelae of adenoviral infections. These patients have severe and extensive lesions with bronchiolitis obliterans (BO) and disseminated bronchiectasis, resulting in irreversible changes in the lung parenchyma.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for morbidities and mortality in children following pneumonectomy

et al. 2016

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Background and objective: Pneumonectomy (PNE) is a procedure infrequently performed in children. A high morbidity/mortality rate associated with PNE has been described. Few series have been published in the last 15 years. Risk factors associated with morbidity/mortality after PNE were evaluated. Indications, course, survival and complications of PNE in children were also analized. Methods: In a case series of 51 children who underwent PNE, death within 30 days of surgery, pneumonia, empyema, sepsis, adult respiratory distress syndrome, bronchopleural fistula, bleeding, pneumothorax and post-PNE syndrome were considered major morbidities. Scoliosis, wound infection and atelectasis were considered minor morbidities. Results: Median age at PNE was 7.4 years; 45% were males. Indications of pneumonectomy were postinfectious bronchiectasis (61%), tumours (17%), pulmonary malformations (17%), aspiration syndrome (14%), cystic fibrosis (6%), immunodeficiency (4%) and trauma (2%). Mortality rate was 4% at 1 month. Major and minor morbidities were present in 23% and 27% of patients, respectively. Risk factors for development of morbidities after PNE were age ≤ 3 years (OR: 16.7; 95% CI: 2.4-117) and the need for mechanical ventilation for at least 4 days (OR: 8; 95% CI: 1.5-43.6). Conclusion: Children are at high risk of death, major and minor morbidities following PNE. Caution is recommended for this group of patients.

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Section: Introductionmentioning

confidence: 99%

Risk factors for morbidities and mortality in children following pneumonectomy

et al. 2016

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“…However, with improvements in surgical techniques and meticulous intraoperative management, patients with prior chest surgery often undergo lung transplantation without any appreciable differences in intraoperative time, need for mechanical ventilation, ICU length of stay, or transfusion requirements. 65…”

Section: Pneumothoraces and Previous Thoracic Surgerymentioning

confidence: 99%

Organ Transplantation for Cystic Fibrosis

Morrell

Kiel

Pilewski

2019

Semin Respir Crit Care Med

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Cystic fibrosis (CF) remains the most common indication for lung transplantation in children and the third most common in adults and has the highest median survival posttransplant for all pretransplant diagnoses. Criteria for transplant in patients with CF vary widely among transplant centers and early referral to multiple centers may be needed to maximize opportunities for lung transplantation. Comorbidities unique to CF such as resistant and atypical pathogens like Burkholderia and Mycobacterium abscessus, and cirrhosis require special consideration for lung transplantation but should not be considered as absolute contraindications. For those patients who are listed for lung transplantation, mechanical support with extracorporeal membrane oxygenation and mechanical ventilation can be efficacious as bridges to lung transplantation in experienced centers with adequate resources. Liver and pancreas transplantations are also acceptable options for end-organ disease related to CF and can provide improvements in both quantity and quality of life.

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“…This appears to be similarly true in localized skin, bone, and lymphatic infections. More widespread infections including disseminated lung disease in children may benefit from surgical debulking of localized lung diseases, such as lobectomy or segmentectomy, in combination with prolonged intravenous and oral antimicrobial therapy [69]. …”

Section: Treatmentmentioning

confidence: 99%

Mycobacterium abscessus Complex Infections in Children: A Review

Sabin

Ferrieri

Kline

2017

Curr Infect Dis Rep

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Purpose of Review Infections in children with Mycobacterium abscessus complex represent a particular challenge for clinicians. Increasing incidence of these infections worldwide has necessitated focused attention to improve both diagnostic as well as treatment modalities. Published medical literature was reviewed, with emphasis on material published in the past 5 years. Recent Findings Increasing availability of new diagnostic tools, such as matrix-assisted laser desorption ionization-time of flight mass spectrometry and custom PCRs, has provided unique insights into the subspecies within the complex and improved diagnostic certainty. Microbiological review of all recent isolates at the University of Minnesota Medical Center was also conducted, with description of the antimicrobial sensitivity patterns encountered in our center, and compared with those published from other centers in the recent literature. A discussion of conventional antimicrobial treatment regimens, alongside detailed description of the relevant antimicrobials, is derived from recent publications. Summary Antimicrobial therapy, combined with surgical intervention in some cases, remains the mainstay of pediatric care. Ongoing questions remain regarding the transmission mechanics, immunologic vulnerabilities exploited by these organisms in the host, and the optimal antimicrobial regimens necessary to enable a reliable cure. Updated treatment guidelines based on focused clinical studies in children and accounting especially for the immunocompromised children at greatest risk are very much needed.

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Cystic fibrosis and the thoracic surgeon

Cited by 18 publications

References 89 publications

Risk factors for morbidities and mortality in children following pneumonectomy

Risk factors for morbidities and mortality in children following pneumonectomy

Organ Transplantation for Cystic Fibrosis

Mycobacterium abscessus Complex Infections in Children: A Review

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