Tracheal disorders of the newborn

\ua9 ERS 2021.Tracheal disorders presenting during the neonatal period range from minor problems requiring no specific intervention to life-threatening abnormalities. Tracheomalacia is the most common disorder, and may be primary, due to an intrinsic problem with the development of tracheal cartilaginous rings, or secondary to external compression, most commonly by a vascular ring caused by abnormal development of the great vessels. Tracheo-oesophageal fistulae are relatively common. Less frequent but potentially life-threatening disorders include tracheal stenosis or agenesis. The most appropriate investigations depend on the clinical situation but usually involve chest radiography, CT, bronchoscopy and tracheobronchography. A multidisciplinary approach in a specialist centre is crucial, involving respiratory physicians, neonatologists, radiologists, anaesthetists, cardiologists and surgeons as required. Management varies from a conservative approach to long-term pressure support, airway stenting or surgery