Decompression of enlarged mediastinal lymph nodes due to mycobacterium tuberculosis causing severe airway obstruction in children

The Annals of Thoracic Surgery
Pierre GoussardG J Roussouw

Abstract

Large airway compression by enlarged tuberculosis (TB) lymph nodes results in life-threatening airway obstruction in a small proportion of children. The indications, safety, and efficacy of TB lymph node decompression are inadequately described. This study aims to describe the indications and efficacy of TB lymph node decompression in children with severe airway compression and investigate variables influencing outcome. A prospective cohort of children (aged 3 months to 13 years) with life-threatening airway obstruction resulting from TB lymph node compression of the large airways were enrolled. The site and degree of airway obstruction were assessed by bronchoscopy and chest computed tomography scan. Of the 250 children enrolled, 34% (n = 86) required transthoracic lymph node decompression, 29% as an urgent procedure and 71% (n = 63) after failing 1 month of antituberculosis treatment that included glucosteroids. Compression (less than 75%) of the bronchus intermedius (odds ratio 2.28, 95% confidence interval: 1.29 to 4.02) and left main bronchus (odds ratio 3.34, 95% confidence interval: 1.73 to 6.83) were the best predictors for lymph node decompression. Human immunodeficiency virus status, drug resistance, and malnutrition ...Continue Reading

References

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Citations

Mar 8, 2016·Expert Review of Respiratory Medicine·P Goussard, R P Gie
Apr 7, 2015·The Annals of Thoracic Surgery·John A Odell
Feb 16, 2017·AJR. American Journal of Roentgenology·Mark C LiszewskiEdward Y Lee
Mar 24, 2018·The Pediatric Infectious Disease Journal·Kathryn M HulmePaul D Robinson
Dec 19, 2019·Journal of Paediatrics and Child Health·Yang WenChaomin Wan
Jan 23, 2018·Paediatrics and International Child Health·Benjamin Wybrand BarnardRichard Denys Pitcher

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