Abstract
BackgroundManagement of the airway and ventilation in neonates with a tracheoesophageal fistula (TEF) remains a significant challenge. The routine method of intubation involves placement of the tracheal tube tip beyond the fistula opening followed by isolation of the fistula from ventilation using the inflated cuff. When the fistula opening is close to the carina or below the level of the carina, the traditional technique is not suitable for adequate ventilation. Moreover, this method fails to prevent gastric insufflation.Case presentationWe herein report a series of 10 newborns with TEFs (1,090–3,080 g) who underwent bronchoscopic insertion of a 5-Fr balloon-tipped bronchial blocker (BTBB) for temporary occlusion of the fistula. In seven newborns, placement of the BTBB was easily and quickly achieved with no incorrect placements. In addition, we successfully utilized the inner hollow cavity of the BTBB for gastric decompression in six neonates with severe gastric distension. However, three failed placements occurred in premature infants (<2,000 g) because the narrow cricoid cavity was too small to accommodate a 2.8-mm fiberoptic bronchoscope and a BTBB. The procedure was well tolerated by all infants, and no significant adverse events occurred.ConclusionsOur findings illustrate that BTBBs can provide durable blockage of the fistula opening and should be considered as a treatment modality for infants with large carinal TEFs. Moreover, BTBB placement is neither arduous nor time-consuming. The hollow center, small round balloon, and 30-degree angled tip of the BTBB make this device feasible for clinical application, especially for neonates with severe gastrointestinal distension.
Highlights
ConclusionsOur findings illustrate that balloon-tipped bronchial blocker (BTBB) can provide durable blockage of the fistula opening and should be considered as a treatment modality for infants with large carinal tracheoesophageal fistula (TEF). Moreover, BTBB placement is neither arduous nor time-consuming. The hollow center, small round balloon, and 30-degree angled tip of the BTBB make this device feasible for clinical application, especially for neonates with severe gastrointestinal distension. Keywords: Tracheoesophageal fistula (TEF), Balloon-tipped bronchial blocker (BTBB), Fogarty catheter, Fiberoptic bronchoscope, Case report
Management of the airway and ventilation in neonates with a tracheoesophageal fistula (TEF) remains a significant challenge
Our findings illustrate that balloon-tipped bronchial blocker (BTBB) can provide durable blockage of the fistula opening and should be considered as a treatment modality for infants with large carinal TEFs
Summary
Our findings illustrate that BTBBs can provide durable blockage of the fistula opening and should be considered as a treatment modality for infants with large carinal TEFs. Moreover, BTBB placement is neither arduous nor time-consuming. The hollow center, small round balloon, and 30-degree angled tip of the BTBB make this device feasible for clinical application, especially for neonates with severe gastrointestinal distension. Keywords: Tracheoesophageal fistula (TEF), Balloon-tipped bronchial blocker (BTBB), Fogarty catheter, Fiberoptic bronchoscope, Case report
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.