Pediatric Tracheomalacia Follow-up

Updated: Jul 30, 2018
  • Author: Emily Concepcion, DO; Chief Editor: Girish D Sharma, MD, FCCP, FAAP  more...
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Follow-up

Further Outpatient Care

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  • No specific therapy or precautions are needed.

  • Provide outpatient care if bronchodilators are considered because they worsen the condition in some patients.

  • Follow the normal immunization schedule.

  • Reassurance during acute respiratory illnesses may be necessary. Babies may need to be seen frequently during these illnesses. During an upper respiratory infection, the normal cough sounds more crouplike in these children because the walls of the trachea appose during the cough. This also causes irritation in the tracheal walls, which prolongs the cough. The added pressures to overcome nasal obstruction adds to the dynamic collapse during the infection. As long as the baby is able to achieve adequate oral intake and is acting normally, intervention is usually not necessary.

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Further Inpatient Care

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  • Admission is not necessary unless the baby with tracheomalacia is having respiratory distress.

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Inpatient & Outpatient Medications

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  • No long-term medications are required.

  • Consider systemic corticosteroids during a respiratory tract infection if the baby is having difficulty breathing.

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Transfer

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  • If the baby is having severe respiratory distress, transfer him or her to a pediatric intensive care unit.

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Complications

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  • Severe obstruction requiring acute intervention with mechanical ventilation or positive pressure

  • Chronic obstruction necessitating surgical intervention (eg, tracheostomy, stent placement, aortopexy)

  • Aortopexy and stent placement have been compared over a 10-year followup. [9] Both are equally effective in improving symptoms and allowing for normal growth and development. Aortopexy is associated with more perioperative complications, whereas stents are associated with long-term complications and the need for removal.

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Prognosis

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  • The prognosis is excellent. Most patients outgrow this condition by the time they are aged 3 years; many infants outgrow tracheomalacia before they are aged 1 year.

  • If gastroesophageal reflux is present, attention to this speeds healing.

  • Tracheomalacia after tracheoesophageal fistula repair may take longer to heal than primary tracheomalacia.

  • Tracheomalacia after a compressing lesion lasts longer, depending on the length of time of the compression.

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Patient Education

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  • For excellent patient education resources, see eMedicineHealth's patient education article Bronchoscopy.

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