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[Endoscopic bronchial exploration under local anesthesia in children]
J C Dubus1, J M Garnier, D Unal
1Service de médecine infantile, hôpital d'enfants de La Timone, Marseille, France.
Insights
Flexible fiberoptic bronchoscopy in children is a safe and effective procedure for diagnosing and treating respiratory conditions. This diagnostic tool led to treatment changes in 68% of pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Diagnostic Procedures
- Respiratory Medicine
Context:
- Flexible fiberoptic bronchoscopy is increasingly utilized in pediatric care.
- Local anesthesia is a common approach for pediatric bronchoscopies.
- A wide range of pediatric respiratory conditions necessitate bronchoscopic evaluation.
Purpose:
- To evaluate the safety and efficacy of flexible fiberoptic bronchoscopy in pediatric patients.
- To determine the diagnostic yield and therapeutic impact of the procedure in children.
- To assess the complication rate associated with flexible fiberoptic bronchoscopy under local anesthesia.
Summary:
- 142 flexible fiberoptic bronchoscopies were performed on 123 children (15 days to 17 years) under local anesthesia.
- Indications included tuberculosis, persistent/recurrent pneumonia, foreign body suspicion, asthma, atelectasis, and bronchial obstruction.
- The procedure was abnormal in 80% of patients, leading to treatment changes in 68%, with a low complication rate (3.5%).
Impact:
- Flexible fiberoptic bronchoscopy is a safe and essential diagnostic and therapeutic tool for pediatric respiratory disorders.
- The procedure demonstrates a high diagnostic yield and significant impact on treatment decisions in children.
- Local anesthesia enhances the safety profile, making it a valuable option for pediatric patients.
Abstract:
One hundred and forty-two flexible fiberoptic bronchoscopies were carried out in 1 year, under local anaesthesia, in 123 children aged between 15 days and 17 years. Indications were tuberculosis (n = 26), persistent pneumonia (n = 20), suspected foreign body or control after extraction (n = 18), asthma (n = 17), atelectasis (n = 14), recurrent pneumonia (n = 13), opportunistic pneumonia (n = 11), permanent bronchial obstruction (n = 10), miscellaneous disease (n = 13). Fiberoptic bronchoscopy was abnormal in 101 patients (80%) and led to a change in the treatment in 84 cases (68%). True complications (n = 5) were all transient and were followed by complete recovery. Flexible fiberoptic bronchoscopy under local anaesthesia is a simple and safe procedure. It is an essential diagnostic and therapeutic tool in the management of pediatric respiratory disorders.