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Respiratory morbidity in children with esophageal atresia


Journal of Pediatrics & Neonatal Care
Viviane MC Meyer,1 Tânia W Folescu,2 Renata WF Cohen,2,3 Deborah AP Silveira,4 Renato FD Amoed,2 Laurinda YS Higa,2 Bárbara A Ferreira,2 Izabela R Sad,2 Patrícia FBM Costa2,4

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Abstract

Objectives: Analyze clinical and epidemiological data of patients with repaired esophageal atresia who presented with respiratory complications, and their clinical progress on follow up.
Methods: Retrospective data was gathered from charts of patients with EA who had corrective surgery in a tertiary hospital, were referred to the pediatric pulmonology clinic due to respiratory complications and had at least two appointments in the clinic, the latest between 2009 and 2016.
Results: 37patients were included, 72,9% of whom had esophageal atresia with distal tracheoesophageal fistula. Recurrent wheezing was the most common respiratory complication, present in 75,7% children in the 1st appointment, followed by recurrent pneumonia (54%) and chronic cough (45,9%). Short Action Beta Agonists was the most common prescribed medication. Spirometry results were abnormal in 66,7% of patients, with 60% presenting with obstructive disorder. Tracheomalacia was the most frequent pathological finding in bronchoscopy exams. Incidence of all respiratory complications decreased during follow up, which can be an effect of both lung growth or appropriate treatment.
Conclusions: Pathophysiology of respiratory complications of EA is still unclear. Several risk factors have been proposed, such as GERD and tracheomalacia, but do not account for allpatients.

Keywords

esophageal atresia, tracheoesophageal fistula, lung diseases, children, esophageal, fistula, anastomotic, leakage, ligation, atresia, tracheoesophageal, fistula, gastroesophageal, reflux, disease

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