Radiological, Endoscopic, and Functional Disorders in Children with Respiratory Diseases Complicated by Respiratory Failure

Purpose: The aim of this study was to reveal the correlation between clinical, radiological, functional patterns in comparison with bronchofibroscopy and morphocytological studies of children with respiratory diseases complicated by respiratory failure (RF). Materials and Methods: The prospective study, conducted from 2000 to 2020, included 305 children aged from 1 day to 18 years with respiratory diseases complicated by RF (acute and chronic) of varying severity. After the initial ICU examination and hospital examinations, children of the examined group underwent the definition of the degree of RF and radiological examination. All the children underwent bronchofibroscopy, during the stabilization of the process or convalescence acute RF and with chronic RF during the remission of the disease underwent evaluation of the mucociliary apparatus by means of a bronchial biopsy of the bronchial mucosa. 68 сhildren and adolescents performed a comprehensive function of external respiration study. Results: Acute RF of II-III degree was noted for 228 children (75% of the total number): all of them were newborn babies (89), for 70% of children in early childhood (96) and older children (43). Chronic RF (CRF) was noted for 77 children (25%). 6 to 20 years after the initiation of the disease 45% of them were still under observation and had CRF. X-ray abnormalities revealed in 239 children (79%). For neonates there was a significantly bigger (76.4%, p <0.001) increased interstitial markings. CT result's evaluation of children with CRF showed that reliably often, in 59% of cases, there were overinflation with areas of consolidation and air traps (p <0.001). Catarrhal changes in the mucous membrane of bronchi were revealed endoscopically in 94% of the patients, with predominantly mucosal hypersecretion in 74%. Obstructive disorders were detected during complex research of external respiration in 2/3 of examined patients. Conclusion: Clinical and radiologic features of pulmonary diseases complicated by RF in different periods of childhood are of the same type. Exception is increased airiness of the pulmonary tissue with upper respiratory defects and an overinflation with areas of consolidation in children of the older age group with CRF. The main causes of RF in newborns are functional and anatomical narrowing of the respiratory tract. Diagnostic bronchofibroscopic should be performed at the earliest possible time for children with stridor breathing and hyperinflation and children on artificial lung ventilation to identify congenital malformations as a cause of RF. Keywords: Respirator