Rationale: Bronchiectasis is a well-known sequela of chronic pulmonary aspiration that can result in significant respiratory morbidity and death; however, its true prevalence is unknown. Objectives: This study describes the prevalence, time course for development, and risk factors for bronchiectasis in children with chronic pulmonary aspiration.
Methods: Medical records were reviewed for all patients diagnosed with chronic pulmonary aspiration by swallow study or airway endoscopy in our airway center over a 21 month period. All patients underwent rigid and flexible bronchoscopy, and high resolution chest computed tomography. Prevalence, distribution, and risk factors for bronchiectasis were identified.
Measurements and Main Results: One hundred subjects age 6 months to 19 years were identified. Overall, 66% had bronchiectasis, including 51% of those less than 2 years old. The youngest was 8 months old. Severe neurological impairment (OR 9.45, p < 0.004) and history of gastroesophageal reflux (OR 3.36, p = 0.036) were identified as risk factors. Clinical history, exam, and other co-morbidities did not predict bronchiectasis. Sixteen subjects with bronchiectasis had repeat chest computed tomography with 44% demonstrating improvement or resolution.
Conclusions: Bronchiectasis is highly prevalent in patients with chronic pulmonary aspiration and its presence in children as young as eight months demonstrates that it can develop rapidly in this disease. Early identification of bronchiectasis, along with interventions aimed at preventing further airway damage, may minimize morbidity and mortality in patients with chronic pulmonary aspiration.