Assessment of pre-extubation pulmonary function in preterm infants with subsequent tracheomalacia.

BACKGROUND

Tracheomalacia, a common condition in neonates and children, is often associated with prematurity and prolonged mechanical ventilation. We aimed to investigate the characteristics of pulmonary function tests (PFTs) performed before extubation in preterm infants with subsequent diagnosis of tracheomalacia.

METHODS

We retrospectively analyzed 44 preterm infants who underwent pre-extubation PFTs and subsequent flexible fiberoptic bronchoscopy (FFB) between April 2011 and May 2023. Nineteen infants were diagnosed with tracheomalacia by FFB (tracheomalacia group) and compared with 25 infants without the diagnosis (nontracheomalacia group). Tracheomalacia was defined as tracheal collapse during expiration with an increased ratio of the posterior membranous wall to tracheal cartilage observed during FFB. We compared patient characteristics and pulmonary function parameters, including static respiratory compliance (Crs) and crying vital capacity (CVC), between the two groups.

RESULTS

The tracheomalacia group had significantly lower gestational age and birth weight. Pre-extubation Crs was significantly higher in the tracheomalacia group (1.23 vs. 0.97 mL/cmH2O/kg, p < 0.05), while CVC and maximal inspiratory pressure did not differ significantly.

CONCLUSION

Preterm infants who were subsequently diagnosed with tracheomalacia exhibited higher Crs before extubation. Pre-extubation Crs may be a potential predictor for the subsequent development of tracheomalacia in this population.