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A study to evaluate the effect of widening of upper airway on lower airway obstructio

Not Applicable
Conditions
Health Condition 1: Q320- Congenital tracheomalaciaHealth Condition 2: O- Medical and Surgical
Registration Number
CTRI/2023/06/054248
Lead Sponsor
All India Institute of Medical Sciences, New Delhi
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Open to Recruitment
Sex
Not specified
Target Recruitment
0
Inclusion Criteria

Age group of 1 month - 5 years with noisy breathing/stridor

Endoscopic confirmation of co-existing laryngomalacia and tracheomalacia

More than 50% collapse in the trachea during expiration / inspiration on dynamic flexible bronchoscopy.

Any degree of laryngomalacia

Presence of at least two of the following clinical features

1. Failure to thrive (z-score of weight for age less than 2)

2. 3 or more hospitalizations for LTM related complications

3. Severe respiratory distress necessitating endotracheal intubation

4. Episodes of bradycardia/ cyanosis/ apnea due to Laryngotracheomalacia

5. SPO2 less than 90% at room air without the support of O2/ CPAP

6. Previously tracheostomized for LTM with failed attempts at decannulation

Parents giving informed written consent to participate in the study.

Exclusion Criteria

Laryngeal/ tracheal narrowing due to external compression

Patients not consenting for surgery

Severe neurological/ cardiac comorbidities / poor pulmonary reserve

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
1. Change in severity of tracheomalacia (bronchoscopic assessment of site of airway collapse, degree of airway collapse and duration of collapse in relation to breathing cycle) after 1 month post surgery <br/ ><br>2. Effect on overall clinical status related to laryngotracheomalacia <br/ ><br>i) Frequency of hospitalizations 1 month before and after procedure <br/ ><br>ii) Frequency of life threatening events (cyanotic spells/ acute respiratory distress/ bradycardia/ apnoea/ hypoxia) in 1 month after post operativeTimepoint: 1 month post operative
Secondary Outcome Measures
NameTimeMethod
1. Direct evidence of effect clinical parameters <br/ ><br>i) Grading of stridor based on appearance in breathing cycle <br/ ><br>ii) Oxygen saturation levels, heart rate , respiratory rate <br/ ><br>2. Indirect evidence of effect of surgical intervention on clinical parameters <br/ ><br>i) Change in weight- weight gain/ change in z score using WHO growth chart <br/ ><br>ii) Parental perspective on effect on symptomsTimepoint: 1 month
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