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Bronchial Thermoplasty

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Diagnostic and Interventional Bronchoscopy in Children

Part of the book series: Respiratory Medicine ((RM))

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Abstract

About 10% of children have severe persistent disease, and these children are at risk for many long-term adverse events related to their disease. Biologic therapy shows promise in reducing medication burden, decreasing severe exacerbations, and improving quality of life in both children and adults; but not all children meet eligibility criteria for one of these drugs and some do not respond. Moreover, these drugs are expensive, require frequent and long-term administration, and not all children who are eligible for therapy receive it. Bronchial thermoplasty (BTP) is a procedure which is FDA-approved for use in adults with severe asthma that delivers targeted radiofrequency energy to large airways, resulting in ablation of smooth muscle. It has been shown to decrease the frequency of severe exacerbations and healthcare utilization for several years following the procedure. Given the long-term efficacy and safety demonstrated in adults, it could be considered as an intervention in adolescents who have severe persistent disease despite treatment with targeted biologic therapies or those treated with high-dose inhaled corticosteroids and/or systemic corticosteroid treatment that do not qualify for biologic therapy. Future directions would include elucidation of factors that predict a response to BTP and are relevant to the adolescent population.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, USA

    Sara Zak, Dan Benscoter & Theresa W. Guilbert

  2. Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Dan Benscoter & Theresa W. Guilbert

  3. Department of Medicine, University of Kansas School of Medicine, Kansas City, KS, USA

    Mario Castro

Authors
  1. Sara Zak
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  2. Dan Benscoter
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  3. Mario Castro
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  4. Theresa W. Guilbert
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Corresponding author

Correspondence to Theresa W. Guilbert .

Editor information

Editors and Affiliations

  1. Division of Pulmonary Medicine, Children’s Hospital of Philadelphia Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA

    Samuel Goldfarb

  2. Division of Pulmonary Medicine & Center for Pediatric Airway Disorders, Children’s Hospital of Philadelphia University of Pennsylvania School of Medicine, Philadelphia, PA, USA

    Joseph Piccione

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Zak, S., Benscoter, D., Castro, M., Guilbert, T.W. (2021). Bronchial Thermoplasty. In: Goldfarb, S., Piccione, J. (eds) Diagnostic and Interventional Bronchoscopy in Children. Respiratory Medicine. Humana, Cham. https://doi.org/10.1007/978-3-030-54924-4_42

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  • DOI: https://doi.org/10.1007/978-3-030-54924-4_42

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  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-030-54923-7

  • Online ISBN: 978-3-030-54924-4

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