Management of bronchomalacia in infants post-cardiac surgery using synchronized nasal DuoPAP: A novel technology

Background: Tracheo-bronchomalacia (TBM) is the weakness in the structural integrity of the cartilaginous ring and arch. It may occur in isolation with prematurity or secondarily in association with various congenital anomalies. Bronchomalacia is more commonly associated with congenital heart diseas...

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Main Authors: Alok Kumar, M Praveen, Nikhil Tiwari, H Ravi Ramamoorthy, Ankur Joshi, Badal Parikh
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Annals of Cardiac Anaesthesia
Subjects:
Online Access:http://www.annals.in/article.asp?issn=0971-9784;year=2022;volume=25;issue=4;spage=531;epage=535;aulast=Kumar
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author Alok Kumar
M Praveen
Nikhil Tiwari
H Ravi Ramamoorthy
Ankur Joshi
Badal Parikh
author_facet Alok Kumar
M Praveen
Nikhil Tiwari
H Ravi Ramamoorthy
Ankur Joshi
Badal Parikh
author_sort Alok Kumar
collection DOAJ
description Background: Tracheo-bronchomalacia (TBM) is the weakness in the structural integrity of the cartilaginous ring and arch. It may occur in isolation with prematurity or secondarily in association with various congenital anomalies. Bronchomalacia is more commonly associated with congenital heart diseases. The conventional treatment options include positive pressure ventilation with or without tracheostomy, surgical correction of external compression and airway stenting. Aim: To use “synchronized” nasal Dual positive airway pressure (DuoPAP), a non-invasive mode of ventilation as an alternative treatment option for bronchomalacia to avoid complications associated with conventional treatment modalities. Study Design: Prospective observational study conducted in Army Hospital Research and Referral from Jul 2019 to Dec 2020. Material and Methods: We diagnosed seven cases of TBM post-cardiac surgery at our institute, incidence of 4.2%. Four infants were diagnosed with left sided bronchomalacia, 2 were diagnosed with right sided bronchomalacia and one with tracheomalacia. Those infants were managed by “synchronized” nasal DuoPAP, a first in ventilation technology by Fabian Therapy Evolution ventilator (Acutronic, Switzerland). Results: All seven infants showed significant improvement with synchronized nasal DuoPAP both clinically as well as radiologically. None of the infant required tracheostomy and discharged to home successfully. Conclusion: The synchronized nasal DuoPAP is a low cost and effective treatment option for infants with TBM. It could be attributed to synchronization of the breaths leading to better tolerance and compliance in paediatric age group.
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spelling doaj.art-6eaed073c0cc47d6b3e4620321f9ce912022-12-22T03:41:41ZengWolters Kluwer Medknow PublicationsAnnals of Cardiac Anaesthesia0971-97842022-01-0125453153510.4103/aca.aca_112_21Management of bronchomalacia in infants post-cardiac surgery using synchronized nasal DuoPAP: A novel technologyAlok KumarM PraveenNikhil TiwariH Ravi RamamoorthyAnkur JoshiBadal ParikhBackground: Tracheo-bronchomalacia (TBM) is the weakness in the structural integrity of the cartilaginous ring and arch. It may occur in isolation with prematurity or secondarily in association with various congenital anomalies. Bronchomalacia is more commonly associated with congenital heart diseases. The conventional treatment options include positive pressure ventilation with or without tracheostomy, surgical correction of external compression and airway stenting. Aim: To use “synchronized” nasal Dual positive airway pressure (DuoPAP), a non-invasive mode of ventilation as an alternative treatment option for bronchomalacia to avoid complications associated with conventional treatment modalities. Study Design: Prospective observational study conducted in Army Hospital Research and Referral from Jul 2019 to Dec 2020. Material and Methods: We diagnosed seven cases of TBM post-cardiac surgery at our institute, incidence of 4.2%. Four infants were diagnosed with left sided bronchomalacia, 2 were diagnosed with right sided bronchomalacia and one with tracheomalacia. Those infants were managed by “synchronized” nasal DuoPAP, a first in ventilation technology by Fabian Therapy Evolution ventilator (Acutronic, Switzerland). Results: All seven infants showed significant improvement with synchronized nasal DuoPAP both clinically as well as radiologically. None of the infant required tracheostomy and discharged to home successfully. Conclusion: The synchronized nasal DuoPAP is a low cost and effective treatment option for infants with TBM. It could be attributed to synchronization of the breaths leading to better tolerance and compliance in paediatric age group.http://www.annals.in/article.asp?issn=0971-9784;year=2022;volume=25;issue=4;spage=531;epage=535;aulast=Kumarbronchomalacianon-invasive ventilationsynchronized duopaptracheomalacia
spellingShingle Alok Kumar
M Praveen
Nikhil Tiwari
H Ravi Ramamoorthy
Ankur Joshi
Badal Parikh
Management of bronchomalacia in infants post-cardiac surgery using synchronized nasal DuoPAP: A novel technology
Annals of Cardiac Anaesthesia
bronchomalacia
non-invasive ventilation
synchronized duopap
tracheomalacia
title Management of bronchomalacia in infants post-cardiac surgery using synchronized nasal DuoPAP: A novel technology
title_full Management of bronchomalacia in infants post-cardiac surgery using synchronized nasal DuoPAP: A novel technology
title_fullStr Management of bronchomalacia in infants post-cardiac surgery using synchronized nasal DuoPAP: A novel technology
title_full_unstemmed Management of bronchomalacia in infants post-cardiac surgery using synchronized nasal DuoPAP: A novel technology
title_short Management of bronchomalacia in infants post-cardiac surgery using synchronized nasal DuoPAP: A novel technology
title_sort management of bronchomalacia in infants post cardiac surgery using synchronized nasal duopap a novel technology
topic bronchomalacia
non-invasive ventilation
synchronized duopap
tracheomalacia
url http://www.annals.in/article.asp?issn=0971-9784;year=2022;volume=25;issue=4;spage=531;epage=535;aulast=Kumar
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AT nikhiltiwari managementofbronchomalaciaininfantspostcardiacsurgeryusingsynchronizednasalduopapanoveltechnology
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