Interventional Pulmonology in the Pediatric Population

Abstract

Endoscopic airway interventions within pediatric populations vary considerably. Some of this variance may be related to institutional experience, however, may also be limited by operator experience and available equipment. Previous reports of pediatric bronchoscopic interventional procedures have been identified within the surgical literature; however, newer reports have identified other specialties participating in the care of these patients. Here, we will provide a review of the current relevant medical literature, including an evidence-based review of advanced diagnostic and therapeutic bronchoscopic treatments within the pediatric population.

Keywords

interventional pulmonology - pediatrics - central airway obstruction - endobronchial ultrasound - therapeutic bronchoscopy

• References

• 1 Bolliger CT, Mathur PN, Beamis JF , et al; European Respiratory Society/American Thoracic Society. ERS/ATS statement on interventional pulmonology. Eur Respir J 2002; 19 (2) 356-373
• 2 Yarmus L, Pandian V, Gilbert C , et al. Safety and efficiency of interventional pulmonologists performing percutaneous tracheostomy. Respiration 2012; 84 (2) 123-127
• 3 Yarmus L, Gilbert C, Lechtzin N, Imad M, Ernst A, Feller-Kopman D. Safety and feasibility of interventional pulmonologists performing bedside percutaneous endoscopic gastrostomy tube placement. Chest 2013; 144 (2) 436-440
• 4 Wahidi MM, Ernst A. Role of the interventional pulmonologist in the intensive care unit. J Intensive Care Med 2005; 20 (3) 141-146
• 5 Siemsen M, Andersen NE, Nielsen KG. EBUS in a 6-year-old boy with enlarged hilar lymph nodes. J Bronchology Interv Pulmonol 2011; 18 (2) 205
• 6 Wurzel DF, Steinfort DP, Massie J, Ryan MM, Irving LB, Ranganathan SC. Paralysis and a perihilar protuberance: an unusual presentation of sarcoidosis in a child. Pediatr Pulmonol 2009; 44 (4) 410-414
• 7 Steinfort DP, Wurzel D, Irving LB, Ranganathan SC. Endobronchial ultrasound in pediatric pulmonology. Pediatr Pulmonol 2009; 44 (4) 303-308
• 8 Gilbert CR, Feller-Kopman D, Akulian J, Hayes M, Yarmus L. Interventional pulmonology procedures in the pediatric population. Pediatr Pulmonol 2014; 49 (6) 597-604
• 9 Gilbert CR, Chen A, Akulian JA , et al. The use of convex probe endobronchial ultrasound-guided transbronchial needle aspiration in a pediatric population: a multicenter study. Pediatr Pulmonol 2014; 49 (8) 807-815
• 10 McLaren CA, Elliott MJ, Roebuck DJ. Tracheobronchial intervention in children. Eur J Radiol 2005; 53 (1) 22-34
• 11 Lamb CR, Feller-Kopman D, Ernst A , et al. An approach to interventional pulmonary fellowship training. Chest 2010; 137 (1) 195-199
• 12 Yarmus L, Feller-Kopman D, Imad M, Kim S, Lee HJ. Procedural volume and structure of interventional pulmonary fellowships: a survey of fellows and fellowship program directors. Chest 2013; 144 (3) 935-939
• 13 Ernst A, Silvestri GA, Johnstone D ; American College of Chest Physicians. Interventional pulmonary procedures: Guidelines from the American College of Chest Physicians. Chest 2003; 123 (5) 1693-1717
• 14 About Medical Specialties Matching Program (MSMP). Available at: http://www.nrmp.org/fellowships/medical-specialties-matching-program/ . Accessed October 28, 2014
• 15 Masters IB, Cooper P. Paediatric flexible bronchoscopy. J Paediatr Child Health 2002; 38 (6) 555-559
• 16 Yastor M, Elliot RA. Preoperative Assessment of the Newborn. New York, NY: McGraw Hill Medical; 2008: 300-309
• 17 Wetzel RC. Evaluation of Children. New York, NY: McGraw Hill; 2008: 310-340
• 18 Lockhart CH, Elliot JL. Potential hazards of pediatric rigid bronchoscopy. J Pediatr Surg 1984; 19 (3) 239-242
• 19 Everett LL. Anesthesia for Children. New York, NY: McGraw Hill; 2008: 1520-1540
• 20 Yasufuku K, Chiyo M, Sekine Y , et al. Real-time endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal and hilar lymph nodes. Chest 2004; 126 (1) 122-128
• 21 Nakajima T, Yasufuku K, Fujiwara T , et al. Endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of intrapulmonary lesions. J Thorac Oncol 2008; 3 (9) 985-988
• 22 Gilbert C, Yarmus L, Feller-Kopman D. Use of endobronchial ultrasound and endoscopic ultrasound to stage the mediastinum in early-stage lung cancer. J Natl Compr Canc Netw 2012; 10 (10) 1277-1282
• 23 Yasufuku K, Nakajima T, Fujiwara T , et al. Role of endobronchial ultrasound-guided transbronchial needle aspiration in the management of lung cancer. Gen Thorac Cardiovasc Surg 2008; 56 (6) 268-276
• 24 Yasufuku K, Pierre A, Darling G , et al. A prospective controlled trial of endobronchial ultrasound-guided transbronchial needle aspiration compared with mediastinoscopy for mediastinal lymph node staging of lung cancer. J Thorac Cardiovasc Surg 2011; 142 (6) 1393-1400 , e1
• 25 Olympus. Endoscopic ultrasound probes. http://medical.olympusamerica.com/products . Available at: Accessed October 28, 2014
• 26 Boufersaoui A, Smati L, Benhalla KN , et al. Foreign body aspiration in children: experience from 2624 patients. Int J Pediatr Otorhinolaryngol 2013; 77 (10) 1683-1688
• 27 Foltran F, Ballali S, Passali FM , et al. Foreign bodies in the airways: a meta-analysis of published papers. Int J Pediatr Otorhinolaryngol 2012; 76 (Suppl. 01) S12-S19
• 28 Swanson KL, Prakash UB, Midthun DE , et al. Flexible bronchoscopic management of airway foreign bodies in children. Chest 2002; 121 (5) 1695-1700
• 29 Pillai JB, Smith J, Hasan A, Spencer D. Review of pediatric airway malacia and its management, with emphasis on stenting. Eur J Cardiothorac Surg 2005; 27 (1) 35-44
• 30 Jacobs JP, Quintessenza JA, Botero LM , et al. The role of airway stents in the management of pediatric tracheal, carinal, and bronchial disease. Eur J Cardiothorac Surg 2000; 18 (5) 505-512
• 31 Fouty BW, Pomeranz M, Thigpen TP, Martin RJ. Dilatation of bronchial stenoses due to sarcoidosis using a flexible fiberoptic bronchoscope. Chest 1994; 106 (3) 677-680
• 32 Malik AM, Ahmed Z, Durgham N, Stockmann PT, Belenky WM, Zestos M. Airway and ventilation management during repair of a large acquired tracheoesophageal fistula: the novel use of a readily available tool. J Clin Anesth 2012; 24 (2) 133-136
• 33 Maksoud-Filho JG, Gonçalves MEP, Cardoso SR, Tannuri U. Early diagnostic and endoscopic dilatation for the treatment of acquired upper airway stenosis after intubation in children. J Pediatr Surg 2008; 43 (7) 1254-1258
• 34 Whigham AS, Howell R, Choi S, Peña M, Zalzal G, Preciado D. Outcomes of balloon dilation in pediatric subglottic stenosis. Ann Otol Rhinol Laryngol 2012; 121 (7) 442-448
• 35 Soong WJ, Jeng MJ, Lee YS, Tsao PC, Yang CF, Soong YH. Pediatric obstructive fibrinous tracheal pseudomembrane—characteristics and management with flexible bronchoscopy. Int J Pediatr Otorhinolaryngol 2011; 75 (8) 1005-1009
• 36 Mandell DL, Yellon RF. Endoscopic KTP laser excision of severe tracheotomy-associated suprastomal collapse. Int J Pediatr Otorhinolaryngol 2004; 68 (11) 1423-1428
• 37 Sharp HR, Hartley BEJ. KTP laser treatment of suprastomal obstruction prior to decannulation in paediatric tracheostomy. Int J Pediatr Otorhinolaryngol 2002; 66 (2) 125-130
• 38 Yellon RF. Totally obstructing tracheotomy-associated suprastomal granulation tissue. Int J Pediatr Otorhinolaryngol 2000; 53 (1) 49-55
• 39 Madgy D, Ahsan SF, Kest D, Stein I. The application of the potassium-titanyl-phosphate (KTP) laser in the management of subglottic hemangioma. Arch Otolaryngol Head Neck Surg 2001; 127 (1) 47-50
• 40 Aksoy EA, Elsürer C, Serin GM, Unal OF. Evaluation of pediatric subglottic cysts. Int J Pediatr Otorhinolaryngol 2012; 76 (2) 240-243
• 41 Lim J, Hellier W, Harcourt J, Leighton S, Albert D. Subglottic cysts: the Great Ormond Street experience. Int J Pediatr Otorhinolaryngol 2003; 67 (5) 461-465
• 42 Cholewa D, Waldschmidt J. Laser treatment of hemangiomas of the larynx and trachea. Lasers Surg Med 1998; 23 (4) 221-232
• 43 Nicolai T, Fischer-Truestedt C, Reiter K, Grantzow R. Subglottic hemangioma: a comparison of CO2 laser, Neodym-Yag laser, and tracheostomy. Pediatr Pulmonol 2005; 39 (3) 233-237
• 44 Wang H, Zhang N, Tao M , et al. Application of interventional bronchoscopic therapy in eight pediatric patients with malignant airway tumors. Tumori 2012; 98 (5) 581-587
• 45 Hewitson JP, Von Oppell UO. Role of thoracic surgery for childhood tuberculosis. World J Surg 1997; 21 (5) 468-474
• 46 Powered ENT. Instruments. 2013 Available at: http://www.medtronic.com/for-healthcare-professionals/products-therapies/ear-nose-throat/powered-ent-instruments/powered-ent-instruments/index.htm . Accessed February 10, 2014
• 47 Ransom ER, Antunes MB, Smith LP, Jacobs IN. Microdebrider resection of acquired subglottic cysts: case series and review of the literature. Int J Pediatr Otorhinolaryngol 2009; 73 (12) 1833-1836
• 48 Kirse DJ. Use of the microdebrider in pediatric endoscopic airway surgery. Curr Opin Otolaryngol Head Neck Surg 2009; 17 (6) 477-482
• 49 Hackman TG, Ferguson BJ. Powered instrumentation and tissue effects in the nose and paranasal sinuses. Curr Opin Otolaryngol Head Neck Surg 2005; 13 (1) 22-26
• 50 Lunn W, Garland R, Ashiku S, Thurer RL, Feller-Kopman D, Ernst A. Microdebrider bronchoscopy: a new tool for the interventional bronchoscopist. Ann Thorac Surg 2005; 80 (4) 1485-1488
• 51 Casal RF, Iribarren J, Eapen G , et al. Safety and effectiveness of microdebrider bronchoscopy for the management of central airway obstruction. Respirology 2013; 18 (6) 1011-1015
• 52 Graham SM, Nerad JA. Orbital complications in endoscopic sinus surgery using powered instrumentation. Laryngoscope 2003; 113 (5) 874-878
• 53 Filler RM, Forte V, Chait P. Tracheobronchial stenting for the treatment of airway obstruction. J Pediatr Surg 1998; 33 (2) 304-311
• 54 Antón-Pacheco JL, Cabezalí D, Tejedor R , et al. The role of airway stenting in pediatric tracheobronchial obstruction. Eur J Cardiothorac Surg 2008; 33 (6) 1069-1075
• 55 Santoro G, Picardo S, Testa G , et al. Balloon-expandable metallic stents in the management of tracheomalacia in neonates. J Thorac Cardiovasc Surg 1995; 110 (4 Pt 1) 1145-1148
• 56 Eurpoe C. Pre-mounted PALMAZ GENESIS stent. Available at: http://www.cordis.com/sites/default/files/pdf/Endo-and-Biliary-Catalog-for-website.pdf#zoom=100 . Accessed October 28, 2014
• 57 Maeda K, Ono S, Tazuke Y, Baba K. Long-term outcomes of congenital tracheal stenosis treated by metallic airway stenting. J Pediatr Surg 2013; 48 (2) 293-296
• 58 Shin JH, Hong S-J, Song H-Y , et al. Placement of covered retrievable expandable metallic stents for pediatric tracheobronchial obstruction. J Vasc Interv Radiol 2006; 17 (2 Pt 1) 309-317
• 59 Gaissert HA, Grillo HC, Wright CD, Donahue DM, Wain JC, Mathisen DJ. Complication of benign tracheobronchial strictures by self-expanding metal stents. J Thorac Cardiovasc Surg 2003; 126 (3) 744-747
• 60 FDA public health notification: complications from metallic tracheal stents in patients with benign airway disorders. 2005. Available at: http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/PublicHealthNotifications/ucm062115.htm . Accessed October 28, 2014
• 61 Nicolai T, Huber RM, Reiter K, Merkenschlager A, Hautmann H, Mantel K. Metal airway stent implantation in children: follow-up of seven children. Pediatr Pulmonol 2001; 31 (4) 289-296
• 62 Fayon M, Donato L, de Blic J , et al. French experience of silicone tracheobronchial stenting in children. Pediatr Pulmonol 2005; 39 (1) 21-27
• 63 Novotny L, Crha M, Rauser P , et al. Novel biodegradable polydioxanone stents in a rabbit airway model. J Thorac Cardiovasc Surg 2012; 143 (2) 437-444
• 64 Wood DE, Cerfolio RJ, Gonzalez X, Springmeyer SC. Bronchoscopic management of prolonged air leak. Clin Chest Med 2010; 31 (1) 127-133
• 65 Gillespie CT, Sterman DH, Cerfolio RJ , et al. Endobronchial valve treatment for prolonged air leaks of the lung: a case series. Ann Thorac Surg 2011; 91 (1) 270-273
• 66 Travaline JM, McKenna Jr RJ, De Giacomo T , et al; Endobronchial Valve for Persistent Air Leak Group. Treatment of persistent pulmonary air leaks using endobronchial valves. Chest 2009; 136 (2) 355-360
• 67 Lee HJ, Shojaee S, Sterman DH. Endoscopic lung volume reduction. An American perspective. Ann Am Thorac Soc 2013; 10 (6) 667-679
• 68 Gompelmann D, Eberhardt R, Herth FJ. Endoscopic lung volume reduction. A European perspective. Ann Am Thorac Soc 2013; 10 (6) 657-666
• 69 Feller-Kopman D, Bechara R, Garland R, Ernst A, Ashiku S. Use of a removable endobronchial valve for the treatment of bronchopleural fistula. Chest 2006; 130 (1) 273-275
• 70 Gilbert CR, Toth JW, Kaifi JT, Belani CP, Varlotto J, Reed MF. Endobronchial valve placement for spontaneous pneumothorax from stage IIIA non-small cell lung cancer facilitates neoadjuvant therapy. Ann Thorac Surg 2013; 96 (6) 2225-2227
• 71 Mahajan AK, Verhoef P, Patel SB, Carr G, Kyle Hogarth D. Intrabronchial valves: a case series describing a minimally invasive approach to bronchopleural fistulas in medical intensive care unit patients. J Bronchology Interv Pulmonol 2012; 19 (2) 137-141
• 72 Fischer W, Feller-Kopman D, Shah A, Orens J, Illei P, Yarmus L. Endobronchial valve therapy for pneumothorax as a bridge to lung transplantation. J Heart Lung Transplant 2012; 31 (3) 334-336
• 73 Reed MF, Podany A, Rocourt D, Dillon P, Gilbert C, Toth JW. Endobronchial occlusion with one-way endobronchial valves: A novel technique for persistent air leaks in children. In: Proceedings of the Annual Meeting of American Pediatric Surgical Association; May 29–June 1, 2014; Phoenix, AZ
• 74 Silvestri GA, Feller-Kopman D, Chen A, Wahidi M, Yasufuku K, Ernst A. Latest advances in advanced diagnostic and therapeutic pulmonary procedures. Chest 2012; 142 (6) 1636-1644
• 75 Cox PG, Miller J, Mitzner W, Leff AR. Radiofrequency ablation of airway smooth muscle for sustained treatment of asthma: preliminary investigations. Eur Respir J 2004; 24 (4) 659-663
• 76 Castro M, Rubin AS, Laviolette M , et al; AIR2 Trial Study Group. Effectiveness and safety of bronchial thermoplasty in the treatment of severe asthma: a multicenter, randomized, double-blind, sham-controlled clinical trial. Am J Respir Crit Care Med 2010; 181 (2) 116-124
• 77 Wechsler ME, Laviolette M, Rubin AS , et al; Asthma Intervention Research 2 Trial Study Group. Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma. J Allergy Clin Immunol 2013; 132 (6) 1295-1302
• 78 Busse WW ; National Asthma Education and Prevention Program. Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Summary Report 2007. J Allergy Clin Immunol 2007; 120 (5, Suppl): S94-S138
• 79 Bush A, Saglani S. Management of severe asthma in children. Lancet 2010; 376 (9743) 814-825
• 80 Chung KF, Wenzel SE, Brozek JL , et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J 2014; 43 (2) 343-373
• 81 Stackhouse RA, Infosino A. Airway management. In: Stoelting RK, Miller RD, , eds. Basics of Anesthesia. 5th ed. Philadelphia, PA: Churchill Livingstone; 2007: 207-239
• 82 American College of Surgeons. American Trauma Life Support for Doctors. Student Course Manual. 7th ed. Chicago, IL: First Impression; 2004: 262