Pulmonary Problems in Children with Esophageal Atresia

Abstract

Most children with esophageal atresia (EA) have pulmonary problems. The causes include associated malformations of the central airways, tracheomalacia, consequences of intubation and mechanical ventilation, as well as prematurity. This leads to an increased frequency of pulmonary infections with bacterial involvement. Long-term consequences are bronchiectasis and other structural damage to the lungs, resulting in a restrictive ventilatory defect, reduced physical resilience, and increased mortality. To prevent these late pulmonary complications, early and consistent multidisciplinary follow-up care and treatment for children with EA are essential, with continuation into adulthood. Only a few large centers can maintain such structures and acquire the necessary expertise.

Keywords

oesophageal atresia/esophageal atresia - pulmonary complications - bronchiectasis - tracheomalacia - pulmonary destruction

• Literatur/References

• 1 Koumbourlis AC, Belessis Y, Cataletto M. et al. Care recommendations for the respiratory complications of esophageal atresia-tracheoesophageal fistula. Pediatr Pulmonol 2020; 55: 2713-2729
• 2 Lejeune S, Sfeir R, Rousseau V. et al. Esophageal atresia and respiratory morbidity. Pediatrics 2021; 148: e2020049778
• 3 Brooks G, Gazzaneo M, Bertozzi M. et al. Systematic review of long term follow-up and transitional care in adolescents and adults with esophageal atresia – why is transitional care mandatory?. Eur J Pediatr 2023; 182: 2057-2066
• 4 Gatzinsky V, Wennergren G, Jönsson L. et al. Impaired peripheral airway function in adults following repair of esophageal atresia. J Pediatr Surg 2014; 49: 1347-1352
• 5 Arneitz C, Windhaber J, Castellani C. et al. Cardiorespiratory performance capacity and airway microbiome in patients following primary repair of esophageal atresia. Pediatr Res 2021; 90: 66-73
• 6 Pedersen RN, Markøw S, Kruse-Andersen S. et al. Long-term pulmonary function in esophageal atresia – a case-control study. Pediatr Pulmonol 2017; 52: 98-106
• 7 DeBoer E, Prager JD, Ruiz AG. et al. Multidisciplinary care of children with repaired esophageal atresia and tracheoesophageal fistula. Pediatr Pulmonol 2016; 51: 576-581
• 8 Patria MF, Ghislanzoni S, Macchini F. et al. Respiratory morbidity in children with repaired congenital esophageal atresia with or without tracheoesophageal fistula. Int J Environ Res Public Health 2017; 14: 1136
• 9 Krishnan U, Dumont MW, Slater H. et al. The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia – tracheoesophageal fistula. Nat Rev Gastroenterol Hepatol 2023; 20: 735-755
• 10 König TT, Frankenbach ML, Gianicolo E. et al. Habitual physical activity in patients born with oesophageal atresia: a multicenter cross-sectional study and comparison to a healthy reference cohort matched for gender and age. Eur J Pediatr 2023; 182: 2655-2663
• 11 Møinichen UI, Mikkelsen A, Gunderson R. et al. New insights in the prevalence of scoliosis and musculoskeletal asymmetries in adolescents with esophageal atresia. J Pediatr Surg 2023; 58: 412-419
• 12 Patria MF, Longhi B, Lelii M. et al. Children with recurrent pneumonia and non-cystic fibrosis bronchiectasis. Ital J Pediatr 2016; 42: 13
• 13 Tuğcu GD, Soyer T, Polat SE. et al. Evaluation of pulmonary complications and affecting factors in children for repaired esophageal atresia and tracheoesophageal fistula. Respir Med 2021; 181: 106376
• 14 Porcaro F, Valfré L, Aufiero LR. et al. Respiratory problems in children with esophageal atresia and tracheoesophageal fistula. Ital J Pediatr 2017; 43: 77
• 15 Beucher J, Wagnon J, Daniel V. et al. Long-Term evaluation of respiratory status after esophageal atresia repair. Pediatr Pulmonol 2013; 48: 188-194
• 16 Dittrich R, Stock P, Rothe K. et al. Pulmonary outcome of esophageal atresia patients and its potential causes in early childhood. J Pediatr Surg 2017; 52: 1255-1259
• 17 Donoso F, Hedenström H, Malinovschi A. et al. Pulmonary function in children and adolescents after esophageal atresia repair. Pediatr Pulmonol 2020; 55: 206-213
• 18 Mirra V, Maglione M, Di Micco LL. et al. Longitudinal follow-up of chronic pulmonary manifestations in esophageal atresia: a clinical algorithm and review of the literature. Pediatr Neonatol 2017; 58: 8-15