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An Ischemic Lesion

Jeffrey B. Hanson, MD; Gail Waldstein, MD; Jacinto A. Hernandez, MD; Leland L. Fan, MD

Am J Dis Child. 1988;142(10):1094-1098.

Abstract
• Neonates with necrotizing tracheobronchitis present a diverse clinical spectrum from asymptomatic disease to severe airway obstruction. A retrospective clinicopathologic study of 206 neonatal autopsy reports spanning a three-year period yielded 122 cases of necrotizing tracheobronchitis with an incidence of 59%. All study patients received treatment prior to the development of high-frequency ventilator jet, oscillator, or interruption. The site and submucosal depth of airway involvement was variable. The most commonly affected anatomic site was the middle or thoracic trachea (56%). The common cause identified was severe ischemia to the airway mucosa and submucosa, occurring with profound birth asphyxia and/or shock. The presence of ischemia supports the concept that decreased tracheoperfusion may be an important factor in the development of tracheobronchial abnormalities.

(AJDC 1988;142:1094-1098)

Author Affiliations
From the Department of Perinatology, The Children's Hospital, Denver.

Footnotes
Accepted for publication June 11, 1988.

Reprint requests to Department of Perinatology, The Children's Hospital, 1056 E 19th Ave, Denver, CO 80218 (Dr Hanson).

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