Clinical features and risk factors analysis of bronchitis obliterans due to refractory Mycoplasma pneumoniae pneumonia in children: a nomogram prediction model

Background Early prediction of bronchitis obliterans (BO) is of great significance to the improvement of the long-term prognosis of children caused by refractory Mycoplasma pneumoniae pneumonia (RMPP). This study aimed to establish a nomogram model to predict the risk of BO in children due to RMPP. Methods A retrospective observation was conducted to study the clinical data of children with RMPP (1–14 years old) during acute infection. According to whether there is BO observed in the bronchoscope, children were divided into BO and the non-BO groups. The multivariate logistic regression model was used to construct the nomogram model. Results One hundred and forty-one children with RMPP were finally included, of which 65 (46.0%) children with RMPP were complicated by BO. According to the multivariate logistic regression analysis, WBC count, ALB level, consolidation range exceeding 2/3 of lung lobes, timing of macrolides, glucocorticoids or fiber bronchoscopy and plastic bronchitis were independent influencing factors for the occurrence of BO and were incorporated into the nomogram. The area under the receiver operating characteristic curve (AUC-ROC) value of nomogram was 0.899 (95% confidence interval [CI] 0.848–0.950). The Hosmer–Lemeshow test showed good calibration of the nomogram (p = 0.692). Conclusion A nomogram model found by seven risk factor was successfully constructed and can use to early prediction of children with BO due to RMPP.

Clinical Features and Risk Factors Analysis of Bronchitis Obliterans Due to Refractory Mycoplasma Pneumoniae Pneumonia in Children: A Nomogram Prediction Model

BackgroundEarly prediction of bronchitis obliterans (BO) is of great significance to the improvement of the long-term prognosis of children caused by refractory mycoplasma pneumoniae pneumonia (RMPP). This study aimed to establish a nomogram model to predict the risk of BO in children due to RMPP.MethodsA retrospective observation was conducted to study the clinical data of children with RMPP (1-14 years old) during acute infection. According to whether there is BO observed in the bronchoscope, children were divided into BO and the non-BO groups. The multivariate logistic regression model was used to construct the nomogram model.Results141 children with RMPP were finally included, of which 65 (46.0%) children with RMPP were complicated by BO. According to the multivariate logistic regression analysis, WBC count, ALB level, consolidation range exceeding 2/3 of lung lobes, timing of macrolides, glucocorticoids or fiber bronchoscopy and plastic bronchitis were independent influencing factors for the occurrence of BO and were incorporated into the nomogram. The area under the receiver operating characteristic curve (AUC-ROC) value of nomogram was 0.899 (95% confidence interval [CI]: 0.848~0.950). The Hosmer-Lemeshow test showed good calibration of the nomogram (p=0.692).Conclusion: A nomogram model found by seven risk factor was successfully constructed and can use to early prediction of children with BO due to RMPP.

Combined intrapleural and intrabronchial injection of fibrin glue for closing alveolar pleural fistula: a case report

Background The treatment of persistent air leak is a challenge. Herein, we reported the combined intrabronchial and intrapleural injection of fibrin glue using fiber bronchoscopy to seal off an alveolar pleura fistula developed following necrotizing pneumonia in high-risk patient. Case presentation A 74-year-old man was intubated in emergency for acute ischemic stroke. Percutaneous dilatational tracheostomy was then performed, and 15 days later patient returned to spontaneous breathing. However, he developed alveolar pleural fistula following necrotizing pneumonia with persistent air leaks. The intrabronchial and intrapleural injection of fibrin glue using fiber bronchoscopy sealed off the alveolar pleura fistula after that other endoscopic treatments as bronchial valve and intrabronchial fibrin glue application had failed. Conclusions Our strategy is safe and easy to reproduce. It represents an additional method in the armamentarium of the physicians for the management of PAL when all standard strategies are unfeasible or fail.