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Systematic Bronchoscopy: the Four Landmarks Approach

Systematic Bronchoscopy: the Four Landmarks Approach

Published on: June 23, 2023

Flexible bronchoscopy in pediatric intensive care.

Mark G Davidson¹, Jonathan Coutts, Graham Bell

¹Royal Hospital for Sick Children, Yorkhill, Glasgow, United Kingdom. mark.davidson3@ggc.scot.nhs.uk

Pediatric Pulmonology

|November 15, 2008

Summary

Flexible bronchoscopy (FB) in paediatric intensive care yields high diagnostic and therapeutic benefits. This routine tool aids in identifying airway abnormalities and guiding patient management, improving outcomes.

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Guidelines for Elective Pediatric Fiberoptic Intubation

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

Area of Science:

Pediatric Critical Care Medicine
Pulmonology
Interventional Pulmonology

Background:

Flexible bronchoscopy (FB) is an essential tool in managing critically ill children.
Establishing the benefits of an FB service in a Paediatric Intensive Care Unit (PICU) is crucial for optimizing patient care.

Purpose of the Study:

To define the diagnostic and therapeutic benefits of a flexible bronchoscopy (FB) service within a Paediatric Intensive Care Unit (PICU).

Main Methods:

A review of the first 200 flexible bronchoscopies (FB) performed in a large UK-based cardiac and medical PICU.
Patient data including ventilation modes and diagnoses were collected, with FB findings correlated to microbiology results from broncho-alveolar lavage (BAL).

Main Results:

The majority of FBs (161/200) were diagnostic, with 114 excluding airway abnormalities and 47 aiding pneumonia diagnosis.
Therapeutic interventions were performed in 39 cases. Abnormal findings were common (68%), including airway obstructions (16%) and anomalies (24%).
Endotracheal tube misplacement was noted in 14.5%. Microbiological results altered management in 46.1% of BAL cases. 80 procedures were done on extracorporeal life support with high stability.

Conclusions:

Flexible bronchoscopy offers a high yield of anatomical and microbiological findings in the PICU setting.
FB should be integrated as a routine diagnostic and therapeutic modality in paediatric intensive care.