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Safety of endobronchial biopsy in 170 children with chronic respiratory symptoms
P S Salva1, C Theroux, D Schwartz
1Pediatric Pulmonology of Western New England, Springfield, Massachusetts, USA. pedipulm@cox.net
Insights
Pediatric bronchial biopsy is safe and effective for diagnosing chronic respiratory symptoms in children. This outpatient procedure provides adequate specimens for evaluation with minimal complications, encouraging its clinical use.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Medical Procedures
Background:
- Limited data exists on pediatric bronchial biopsy safety and efficacy.
- Concerns regarding procedure safety have restricted its use in children.
- This study aimed to develop a safe and effective method for pediatric bronchial biopsy.
Purpose of the Study:
- To evaluate the safety and efficacy of endobronchial biopsy in children.
- To establish a reliable method for obtaining adequate biopsy specimens in pediatric patients.
- To encourage the use of bronchial biopsy in diagnosing pediatric respiratory conditions.
Main Methods:
- 170 children (2.5-16 years) with chronic respiratory symptoms underwent the procedure.
- General anesthesia and a laryngeal mask airway were used.
- Bronchoalveolar lavage and at least three endobronchial biopsies were obtained via flexible bronchoscope.
Main Results:
- The procedure was safe, with no significant complications like pneumothorax or excessive bleeding.
- Average procedure and recovery times were 12 and 90 minutes, respectively.
- The primary limitation was airway size relative to the bronchoscope.
Conclusions:
- Endobronchial biopsy is a safe and effective procedure for evaluating pediatric chronic respiratory symptoms.
- The method yields adequate specimens for diagnosis.
- Clinicians should consider incorporating this procedure into their diagnostic toolkit for children.
Background:
There is a paucity of bronchial biopsy data in children. A major limitation is concern over the safety of the procedure. This paper reports the results of efforts to develop a method that is safe and provides adequate specimen for evaluation.
Methods:
170 children aged 2.5 to 16 years with chronic respiratory symptoms were studied under general anaesthesia in an outpatient surgery setting. Bronchoalveolar lavage and biopsies were obtained using a 4.9 mm flexible bronchoscope through a laryngeal mask airway. At least three bioipsies were taken.
Results:
No patient required topical adrenaline to control bleeding, nor was there a change in the state of any of the patients. There were no episodes of pneumothorax, haemoptysis, pneumonia, or significant fever. All children less than four years old received a single dose of antibiotic intravenously after the procedure. The average length of time for the procedure was 12 minutes (range 6 to 27). Recovery time averaged 90 minutes. The limiting factor was the ability of the child's airway to accomodate the bronchoscope.
Conclusions:
This report should encourage clinicians to incorporate endobronchial biopsy into the evaluation of children with difficult respiratory problems.
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