Kubra Melike Bozkanat
Clinical Assistant Professor, Pediatrics - Pulmonary Medicine
All Publications
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Interventional pulmonology across the globe.
Current opinion in pediatrics
2025
Abstract
PURPOSE OF REVIEW: Pediatric interventional pulmonology (PIP) is an evolving subspecialty aiming at respiratory diseases in children through procedural interventions. This review discusses recent developments and challenges in global adoption of these advancements.RECENT FINDINGS: Innovations such as ultra-thin cryoprobes and bronchoscopes allow for diagnostic and interventional procedures in pediatric airways. Cryotherapy demonstrates advantages in obtaining biopsies, treating airway stenosis, and extracting foreign bodies. Endobronchial ultrasound has improved the accuracy of diagnosing lymphadenopathy and pulmonary lesions, but its large size and high cost limit its use in resource-poor areas. Other newer techniques, such as tracheoesophageal fistula repair and endobronchial valves for air leaks, are promising but lack strong evidence for widespread adoption. Geographical and economic disparities impede progress, with high-income countries pioneering innovation, and low- and middle-income areas facing access and training challenges.SUMMARY: While PIP does have the potential to be transformational, global disparities in its adoption are significant. International collaborations, standardized training, and resources are paramount. This can be achieved through virtual training platforms and global conferences that will help narrow the gaps, ensuring equitable PIP growth to benefit pediatric respiratory care globally.
View details for DOI 10.1097/MOP.0000000000001470
View details for PubMedID 40207965
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Transbronchial cryo-nodal biopsies in children: A case series.
Pediatric pulmonology
2025; 60 (1): e27291
View details for DOI 10.1002/ppul.27291
View details for PubMedID 39508304
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Pediatric interventional bronchoscopy: from early limitations to achievable opportunities.
Current opinion in pulmonary medicine
2024; 30 (1): 107-117
Abstract
The rapid evolution of bronchoscopy equipment and technologies, from the introduction of the 1.1 mm flexible cryoprobe to the use of navigational and robotic bronchoscopy, has afforded unprecedented opportunities for pediatric advanced diagnostic and interventional bronchoscopy. While there is growing interest among pediatric pulmonologists to incorporate these new techniques into their practice, the current pediatric landscape is characterized by few practicing interventional bronchoscopists, scant published literature, and no formal training programs.While the majority of the published literature consists of case reports and small case series, the increased application of new techniques is starting to yield larger and more structured studies that will be able to provide more objective commentary on the proposed indications, safety, and efficacy of such techniques in the pediatric population.For many decades, progress in pediatric advanced diagnostic and interventional bronchoscopy was slow and deliberate, limited by the lack of appropriately sized equipment and experienced interventional bronchoscopists. The current opportunities afforded require equal, or perhaps even more, vigilance as pediatric pulmonologists employ new equipment and technologies and define new practices and standards of care. Importantly, this review is meant to serve as a general conspectus of pediatric advanced diagnostic and interventional bronchoscopy and not a consensus guideline for the performance of advanced or even routine bronchoscopy in the pediatric population. For technical standards of pediatric bronchoscopy, refer to existing guidelines [1,2] .
View details for DOI 10.1097/MCP.0000000000001029
View details for PubMedID 37933635
View details for PubMedCentralID PMC10842060
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Pathogenic bacteria in bronchoalveolar lavage cultures and pediatric laryngotracheal reconstruction outcomes.
Pediatric pulmonology
2023; 58 (5): 1438-1443
Abstract
The primary objective was to determine if treating pathogenic bacteria in bronchoalveolar lavage (BAL) cultures improves outcomes after pediatric double stage laryngotracheal reconstruction (dsLTR).Case series with chart review.Tertiary children's hospital.All children (<18 years) obtaining flexible bronchoscopy with BAL cultures before dsLTR between 2016 and 2022 were included. Cultures identified abnormal bacterial growth or normal respiratory flora. Thirty-day postoperative surgical site or lung infections were captured and tracheostomy decannulation rates were obtained for children with at least 12 months of follow-up.Twenty-seven children obtained presurgical BAL cultures before dsLTR. Median age at reconstruction was 2.9 years (interquartile range: 2.3-3.5) and 89% (24/27) had high grade subglottic stenosis. Positive cultures were obtained in 56% of children (N = 15) with Pseudomonas aeruginosa (40%, 6/15) and methicillin-resistant Staphylococcus aureus (33%, 5/15) the most frequent organisms. All children with positive cultures were treated based on culture and sensitivity data. Postoperative infections developed in 22% (6/27) of children with equal distribution of surgical site and respiratory infections among children with pathogenic bacteria and normal respiratory flora. At 12 months after surgery, the decannulation rate was no different between those treated and not treated for a presurgical positive BAL culture (47% vs. 58%, p = 0.70).Pathogenic bacteria are common in BAL cultures from tracheostomy-dependent children before dsLTR. Treatment keeps respiratory infections and decannulation rates similar to children with negative cultures, suggesting continued benefit of flexible bronchoscopy and BAL in preparation for these surgeries.
View details for DOI 10.1002/ppul.26338
View details for PubMedID 36721379
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Challenges Faced by Women with Cystic Fibrosis.
Clinics in chest medicine
2021; 42 (3): 517-530
Abstract
Women with cystic fibrosis (CF) face several unaddressed concerns related to their health. These areas of concern include explanations and guidance on a sex disparity in outcomes, timing of puberty, effects of contraception, prevalence of infertility and impact of pregnancy, and prevention of urinary incontinence and osteoporosis. These understudied topics leave women with numerous unanswered questions about how to manage sexual and reproductive health in the setting of CF. Because people with CF are living longer and healthier lives, there is an increasing awareness of these important aspects of care and multiple ongoing studies to address these understudied topics.
View details for DOI 10.1016/j.ccm.2021.04.010
View details for PubMedID 34353456