Related Experiment Video
Updated: Sep 27, 2026
Systematic Bronchoscopy: the Four Landmarks Approach
Published on: June 23, 2023
Bronchoscopy and anesthesia for preschool-aged patients: a review of 228 cases
Kuo-Hua Wu1, Tien-Tien Man, Kar-Lok Wong
1Department of Anesthesiology, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.
Insights
Pediatric bronchoscopy in children under six is a high-risk procedure. Common findings include subglottic stenosis and laryngomalacia, with anesthesia complications like arrhythmias and oxygen desaturation.
Area of Science:
- Pediatric Pulmonology
- Pediatric Anesthesiology
- Pediatric Otolaryngology
Background:
- Pediatric bronchoscopy is a complex procedure with inherent risks.
- Effective management requires careful consideration of potential complications and patient safety.
Purpose of the Study:
- To evaluate the diagnostic and therapeutic utility of pediatric bronchoscopy.
- To identify common findings and anesthesia-related complications in preschool-aged children undergoing the procedure.
Main Methods:
- A retrospective review of 228 pediatric bronchoscopies performed between May 2000 and May 2002.
- Procedures were conducted under general anesthesia using a Storz-Hopkins rigid pediatric bronchoscope.
- Data collected included final diagnoses and intraoperative anesthetic complications.
Main Results:
- The most frequent diagnoses were subglottic stenosis/granuloma (29.4%) and laryngomalacia (28.1%).
- Tracheal stenosis/malacia (12.7%), pneumonia (10.1%), and atelectasis (7.0%) were also common findings.
- Anesthesia complications included arrhythmias, oxygen desaturation, and elevated end-tidal CO2; one case of pneumothorax occurred.
Conclusions:
- Pediatric bronchoscopy is an essential diagnostic and therapeutic tool for pediatric airway conditions.
- Close collaboration between endoscopists and anesthesiologists is crucial for ensuring patient safety during the procedure.
- A significant percentage of patients (61%) required airway support (intubation or tracheostomy) post-procedure.
Abstract:
Pediatric bronchoscopy is a complicated, high-risk procedure. From May 2000 to May 2002, we performed bronchoscopy in 228 preschool-aged children (newborn to 6 years old) under general anesthesia with a Storz-Hopkins rigid pediatric bronchoscope. The final diagnosis and complications during anesthesia were recorded. The most common findings from bronchoscopic examination were subglottic stenosis (or granuloma) (67, 29.4%), laryngomalacia (64, 28.1%), tracheal stenosis (or malacia) (29, 12.7%), pneumonia (23, 10.1%), and atelectasis (16, 7.0%). The main complications during anesthesia were arrhythmias, oxygen desaturation, and CO2 retention (high end-tidal CO2). The most serious complication was pneumothorax in one patient. Either endotracheal intubation or tracheostomy was required in 61% of the patients in this series to secure a patent airway after bronchoscopy. Bronchoscopy is necessary as a diagnostic and therapeutic tool for certain airway diseases or anomalies in pediatric patients. It requires cooperation between the endoscopist and anesthesiologist to insure the patient's safety.
Related Concept Videos
01:30Endoscopic Studies I: Bronchoscopy and Thoracoscopy
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due to...
01:26Endoscopic Studies II: Thoracocentesis
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
01:30Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques