Bronchiectasis in chronic pulmonary aspiration: Risk factors and clinical implications
Introduction Bronchiectasis is a well‐known sequela of chronic pulmonary aspiration (CPA) that can result in significant respiratory morbidity and death. However, its true prevalence is unknown because diagnosis requires high resolution computed tomography which is not routinely utilized in this pop...
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| Veröffentlicht in: | Pediatric pulmonology 2012-05, Vol.47 (5), p.447-452 |
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| creator | Piccione, Joseph C. McPhail, Gary L. Fenchel, Matthew C. Brody, Alan S. Boesch, Richard P. |
| description | Introduction
Bronchiectasis is a well‐known sequela of chronic pulmonary aspiration (CPA) that can result in significant respiratory morbidity and death. However, its true prevalence is unknown because diagnosis requires high resolution computed tomography which is not routinely utilized in this population. This study describes the prevalence, time course for development, and risk factors for bronchiectasis in children with CPA.
Materials and Methods
Using a cross‐sectional design, medical records were reviewed for all patients with swallow study or airway endoscopy‐confirmed aspiration in our airway center over a 21 month period. All patients underwent rigid and flexible bronchoscopy, and high resolution chest computed tomography. Prevalence, distribution, and risk factors for bronchiectasis were identified.
Results
One hundred subjects age 6 months to 19 years were identified. Overall, 66% had bronchiectasis, including 51% of those less than 2 years old. The youngest was 8 months old. Severe neurological impairment (OR 9.45, P |
| doi_str_mv | 10.1002/ppul.21587 |
| format | Article |
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Bronchiectasis is a well‐known sequela of chronic pulmonary aspiration (CPA) that can result in significant respiratory morbidity and death. However, its true prevalence is unknown because diagnosis requires high resolution computed tomography which is not routinely utilized in this population. This study describes the prevalence, time course for development, and risk factors for bronchiectasis in children with CPA.
Materials and Methods
Using a cross‐sectional design, medical records were reviewed for all patients with swallow study or airway endoscopy‐confirmed aspiration in our airway center over a 21 month period. All patients underwent rigid and flexible bronchoscopy, and high resolution chest computed tomography. Prevalence, distribution, and risk factors for bronchiectasis were identified.
Results
One hundred subjects age 6 months to 19 years were identified. Overall, 66% had bronchiectasis, including 51% of those less than 2 years old. The youngest was 8 months old. Severe neurological impairment (OR 9.45, P < 0.004) and history of gastroesophageal reflux (OR 3.36, P = 0.036) were identified as risk factors. Clinical history, exam, and other co‐morbidities did not predict bronchiectasis. Sixteen subjects with bronchiectasis had repeat chest computed tomography with 44% demonstrating improvement or resolution.
Discussion
Bronchiectasis is highly prevalent in children with CPA and its presence in young children demonstrates that it can develop rapidly. Early identification of bronchiectasis, along with interventions aimed at preventing further airway damage, may minimize morbidity and mortality in patients with CPA. Pediatr Pulmonol. 2012; 47:447–452. © 2011 Wiley Periodicals, Inc.</description><identifier>ISSN: 8755-6863</identifier><identifier>EISSN: 1099-0496</identifier><identifier>DOI: 10.1002/ppul.21587</identifier><identifier>PMID: 22028069</identifier><identifier>CODEN: PEPUES</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adolescent ; aspiration pneumonia ; Biological and medical sciences ; Bronchiectasis - diagnosis ; Bronchiectasis - epidemiology ; Bronchoscopy - methods ; Child ; Child, Preschool ; children ; Chronic Disease ; Cross-Sectional Studies ; deglutition disorders ; Deglutition Disorders - diagnosis ; Deglutition Disorders - epidemiology ; Esophagus ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; General aspects ; Humans ; Infant ; Male ; Medical sciences ; Other diseases. Semiology ; Pneumology ; Prevalence ; Respiratory Aspiration - diagnosis ; Respiratory Aspiration - epidemiology ; Respiratory system : syndromes and miscellaneous diseases ; Risk Factors ; Tomography, X-Ray Computed ; Young Adult</subject><ispartof>Pediatric pulmonology, 2012-05, Vol.47 (5), p.447-452</ispartof><rights>Copyright © 2011 Wiley Periodicals, Inc.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3977-ad163257b3a5ed6a1451dabeb66e261e9dc8b7a975327df5614d144025104bd53</citedby><cites>FETCH-LOGICAL-c3977-ad163257b3a5ed6a1451dabeb66e261e9dc8b7a975327df5614d144025104bd53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fppul.21587$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fppul.21587$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25795533$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22028069$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Piccione, Joseph C.</creatorcontrib><creatorcontrib>McPhail, Gary L.</creatorcontrib><creatorcontrib>Fenchel, Matthew C.</creatorcontrib><creatorcontrib>Brody, Alan S.</creatorcontrib><creatorcontrib>Boesch, Richard P.</creatorcontrib><title>Bronchiectasis in chronic pulmonary aspiration: Risk factors and clinical implications</title><title>Pediatric pulmonology</title><addtitle>Pediatr. Pulmonol</addtitle><description>Introduction
Bronchiectasis is a well‐known sequela of chronic pulmonary aspiration (CPA) that can result in significant respiratory morbidity and death. However, its true prevalence is unknown because diagnosis requires high resolution computed tomography which is not routinely utilized in this population. This study describes the prevalence, time course for development, and risk factors for bronchiectasis in children with CPA.
Materials and Methods
Using a cross‐sectional design, medical records were reviewed for all patients with swallow study or airway endoscopy‐confirmed aspiration in our airway center over a 21 month period. All patients underwent rigid and flexible bronchoscopy, and high resolution chest computed tomography. Prevalence, distribution, and risk factors for bronchiectasis were identified.
Results
One hundred subjects age 6 months to 19 years were identified. Overall, 66% had bronchiectasis, including 51% of those less than 2 years old. The youngest was 8 months old. Severe neurological impairment (OR 9.45, P < 0.004) and history of gastroesophageal reflux (OR 3.36, P = 0.036) were identified as risk factors. Clinical history, exam, and other co‐morbidities did not predict bronchiectasis. Sixteen subjects with bronchiectasis had repeat chest computed tomography with 44% demonstrating improvement or resolution.
Discussion
Bronchiectasis is highly prevalent in children with CPA and its presence in young children demonstrates that it can develop rapidly. Early identification of bronchiectasis, along with interventions aimed at preventing further airway damage, may minimize morbidity and mortality in patients with CPA. Pediatr Pulmonol. 2012; 47:447–452. © 2011 Wiley Periodicals, Inc.</description><subject>Adolescent</subject><subject>aspiration pneumonia</subject><subject>Biological and medical sciences</subject><subject>Bronchiectasis - diagnosis</subject><subject>Bronchiectasis - epidemiology</subject><subject>Bronchoscopy - methods</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>children</subject><subject>Chronic Disease</subject><subject>Cross-Sectional Studies</subject><subject>deglutition disorders</subject><subject>Deglutition Disorders - diagnosis</subject><subject>Deglutition Disorders - epidemiology</subject><subject>Esophagus</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>General aspects</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Other diseases. Semiology</subject><subject>Pneumology</subject><subject>Prevalence</subject><subject>Respiratory Aspiration - diagnosis</subject><subject>Respiratory Aspiration - epidemiology</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Risk Factors</subject><subject>Tomography, X-Ray Computed</subject><subject>Young Adult</subject><issn>8755-6863</issn><issn>1099-0496</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90E1PVDEUBuDGaGRAN_4A042JIbnQ7966E6JAMsGJirhrzm17Q-V-2d6J8u_tMAPuWLVpn3NOzovQG0qOKCHseJrW3RGjstbP0IISYyoijHqOFrWWslK14ntoP-dfhJQ_Q1-iPcYIq4kyC_TjJI2Du4nBzZBjxnHA7qY8RYdL134cIN1hyFNMMMdx-IC_xnyLW3DzmDKGwWPXxaKhw7GfunLZsPwKvWihy-H17jxAV58_fT89r5Zfzi5OPy4rx43WFXiqOJO64SCDV0CFpB6a0CgVmKLBeFc3GoyWnGnfSkWFp0IQJikRjZf8AL3f9p3S-Hsd8mz7mF3oOhjCuM625EMEUYLUhR5uqUtjzim0dkqxL-sVtHHMbnK09zkW_HbXd930wT_Sh-AKeLcDkMvybYLBxfzfSW2k5Lw4unV_YhfunhhpV6ur5cPwalsT8xz-PtZAurVKcy3t9eWZPbn8Kb6dX6-s5P8AthqakQ</recordid><startdate>201205</startdate><enddate>201205</enddate><creator>Piccione, Joseph C.</creator><creator>McPhail, Gary L.</creator><creator>Fenchel, Matthew C.</creator><creator>Brody, Alan S.</creator><creator>Boesch, Richard P.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Liss</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201205</creationdate><title>Bronchiectasis in chronic pulmonary aspiration: Risk factors and clinical implications</title><author>Piccione, Joseph C. ; McPhail, Gary L. ; Fenchel, Matthew C. ; Brody, Alan S. ; Boesch, Richard P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3977-ad163257b3a5ed6a1451dabeb66e261e9dc8b7a975327df5614d144025104bd53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>aspiration pneumonia</topic><topic>Biological and medical sciences</topic><topic>Bronchiectasis - diagnosis</topic><topic>Bronchiectasis - epidemiology</topic><topic>Bronchoscopy - methods</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>children</topic><topic>Chronic Disease</topic><topic>Cross-Sectional Studies</topic><topic>deglutition disorders</topic><topic>Deglutition Disorders - diagnosis</topic><topic>Deglutition Disorders - epidemiology</topic><topic>Esophagus</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>General aspects</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Other diseases. Semiology</topic><topic>Pneumology</topic><topic>Prevalence</topic><topic>Respiratory Aspiration - diagnosis</topic><topic>Respiratory Aspiration - epidemiology</topic><topic>Respiratory system : syndromes and miscellaneous diseases</topic><topic>Risk Factors</topic><topic>Tomography, X-Ray Computed</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Piccione, Joseph C.</creatorcontrib><creatorcontrib>McPhail, Gary L.</creatorcontrib><creatorcontrib>Fenchel, Matthew C.</creatorcontrib><creatorcontrib>Brody, Alan S.</creatorcontrib><creatorcontrib>Boesch, Richard P.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric pulmonology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Piccione, Joseph C.</au><au>McPhail, Gary L.</au><au>Fenchel, Matthew C.</au><au>Brody, Alan S.</au><au>Boesch, Richard P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bronchiectasis in chronic pulmonary aspiration: Risk factors and clinical implications</atitle><jtitle>Pediatric pulmonology</jtitle><addtitle>Pediatr. Pulmonol</addtitle><date>2012-05</date><risdate>2012</risdate><volume>47</volume><issue>5</issue><spage>447</spage><epage>452</epage><pages>447-452</pages><issn>8755-6863</issn><eissn>1099-0496</eissn><coden>PEPUES</coden><abstract>Introduction
Bronchiectasis is a well‐known sequela of chronic pulmonary aspiration (CPA) that can result in significant respiratory morbidity and death. However, its true prevalence is unknown because diagnosis requires high resolution computed tomography which is not routinely utilized in this population. This study describes the prevalence, time course for development, and risk factors for bronchiectasis in children with CPA.
Materials and Methods
Using a cross‐sectional design, medical records were reviewed for all patients with swallow study or airway endoscopy‐confirmed aspiration in our airway center over a 21 month period. All patients underwent rigid and flexible bronchoscopy, and high resolution chest computed tomography. Prevalence, distribution, and risk factors for bronchiectasis were identified.
Results
One hundred subjects age 6 months to 19 years were identified. Overall, 66% had bronchiectasis, including 51% of those less than 2 years old. The youngest was 8 months old. Severe neurological impairment (OR 9.45, P < 0.004) and history of gastroesophageal reflux (OR 3.36, P = 0.036) were identified as risk factors. Clinical history, exam, and other co‐morbidities did not predict bronchiectasis. Sixteen subjects with bronchiectasis had repeat chest computed tomography with 44% demonstrating improvement or resolution.
Discussion
Bronchiectasis is highly prevalent in children with CPA and its presence in young children demonstrates that it can develop rapidly. Early identification of bronchiectasis, along with interventions aimed at preventing further airway damage, may minimize morbidity and mortality in patients with CPA. Pediatr Pulmonol. 2012; 47:447–452. © 2011 Wiley Periodicals, Inc.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>22028069</pmid><doi>10.1002/ppul.21587</doi><tpages>6</tpages></addata></record> |
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| subjects | Adolescent aspiration pneumonia Biological and medical sciences Bronchiectasis - diagnosis Bronchiectasis - epidemiology Bronchoscopy - methods Child Child, Preschool children Chronic Disease Cross-Sectional Studies deglutition disorders Deglutition Disorders - diagnosis Deglutition Disorders - epidemiology Esophagus Female Gastroenterology. Liver. Pancreas. Abdomen General aspects Humans Infant Male Medical sciences Other diseases. Semiology Pneumology Prevalence Respiratory Aspiration - diagnosis Respiratory Aspiration - epidemiology Respiratory system : syndromes and miscellaneous diseases Risk Factors Tomography, X-Ray Computed Young Adult |
| title | Bronchiectasis in chronic pulmonary aspiration: Risk factors and clinical implications |
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