PP22 CLINICAL ANALYSIS AND LONG-TERM RESULTS OF POST INFECTIOUS BRONCHIOLITIS OBLITERANS IN SOUTHERN SARAWAK

Yee Seng Lai1, Swee Wei Tan1, Alison Yih Hua Ting2
1Sarawak General Hospital, Kuching, Sarawak
2Timberland Medical Centre, Kuching, Sarawak

Introduction: 

Bronchiolitis obliterans (BO) is a rare, chronic obstructive lung disease, often initiated by injury of the bronchiolar epithelium followed by an inflammatory response and progressive fibrosis of small airways resulting in nonuniform irreversible luminal obliteration or narrowing. Post Infectious Bronchiolitis Obliterans (PIBO) in children mostly follows a severe viral lower respiratory tract infection.

Objectives:

This study aimed to evaluate the clinical features, etiology of PIBO in our local paediatric population over the past ten years and follow up on their treatment outcomes.

Methodology:

The medical records of 42 paediatric patients with PIBO from January 2013 until December 2023 were evaluated retrospectively. 

Results:

The incidence of PIBO in our local population showed a greater male predominance (78.6%) and higher incidence among the Malay (54.8%). The mean age of affected patients was 15.8 months ( ± 13.2 months). Most patients presented with cough (95.2%) and rapid breathing (81%). The main pathogen was adenovirus (45.2%). 40% of total patients required invasive ventilation with mean duration of 9.3 days (± 9.5 days). Average length of stay was 9.3 weeks (± 9.7 weeks). Majority of patients required home oxygen therapy (73.8%) with mean usage duration of 31.3 months (± 29.3 months). Up to 21.4% patients were on home non-invasive ventilation with mean usage duration of 50.2 months (± 28.3 months).  The remaining 4.8% patients were discharged on room air. 57.6% patients had re-hospitalisation after initial discharge. Only 28.6% patients were able to perform Spirometry and all of them showed obstructive pattern. Two of our patients died from severe pulmonary complications. 

Conclusion: 

Adenovirus is the most common pathogen of PIBO in our local paediatric population. Younger aged patients had higher morbidities and required long term oxygen or non-invasive ventilation.