Should there be a management plan of children with post infectious bronchiolitis obliterans and bronchiectasis?
Guidelines on follow up of children with post infectious bronchiolitis obliterans(PIBO) and/or bronchiectasis(BE) are scarce. Orientations are derived from other chronic lung diseases and adult studies. Aim: describe the management plan of children with PIBO and/or BE and analyse if it varies with lung function(LF) Methods: Retrospective review of medical records of children with PIBO and BE followed in a tertiary hospital for 2consecutive years(2018 9) Diagnosis based on history, LF and HRCT findings. Frequency of physician visits, spirometries and respiratory microbiology surveillance/year were recorded, as best LF parameters and nutritional status/year.Descriptive and regression analysis was done. Results: During the study period, 28 children [20 boys, median age 13.5yrs (7.1, 18.2) median duration of follow up 9.6yrs(2.5, 15.4) 16 with BOPI (plus BE 6; average z score BMI 0.7, FEV1 3.2, FEV1/FVC 2.6) and 12 with BE (average z score BMI 0.4, FEV1 0.5, FEV1/FVC 0.1) were regularly observed, on average, 2.7times/year (1 to 7) and performed 1.8spirometries/year (1 to 4) but only 4 had respiratory samples collected. 14 had been prescribed mucus clearance devices or educated on respiratory rehabilitation. No association between clinic visits and FEV1 was found. During this period,3 non residents in Portugal were also observed,7 initiated follow up and 10 were transferred/lost to follow up. Method: Respiratory microbiology surveillance was low. In this small sample, LF alone did not instruct on follow up. In the absence of guidelines, management is tailored to patients. Future directions should dictate minimal follow up requirements for children with BOPI and BE.