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Systematic Bronchoscopy: the Four Landmarks Approach
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Flexible fiberoptic bronchoscopy--a bedside technique for neonatologists.

David Kohelet1, Eliana Arbel, Eric S Shinwell

  • 1Department of Neonatology, Edith Wolfson Medical Center, Holon, Israel.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|July 13, 2010
PubMed
Summary

Flexible fiberoptic bronchoscopy (FFB) offers neonatologists diagnostic and therapeutic benefits for neonates. This safe bedside procedure aids in diagnosing airway issues and managing conditions like atelectasis.

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Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Medical Technology

Background:

  • Flexible fiberoptic bronchoscopy (FFB) is underutilized in neonates, often requiring external specialists.
  • Modern ultra-thin bronchoscopes present new bedside diagnostic and therapeutic possibilities for neonatologists.

Purpose of the Study:

  • To evaluate the diagnostic utility of FFB in neonates.
  • To assess the therapeutic potential and safety of FFB performed by neonatologists.
  • To establish FFB as a valuable bedside tool for neonatologists.

Main Methods:

  • Retrospective case series of 19 neonates undergoing FFB.
  • Procedures conducted in two Neonatal Intensive Care Units (NICUs).
  • Data collected on indications, findings, and outcomes.

Main Results:

  • 60% of 25 FFBs revealed airway pathology.
  • Successful atelectasis treatment in 70% of cases.
  • FFB influenced antibiotic therapy in 50% of BAL cases; no mortality, 4% serious adverse events (pneumothorax).

Conclusions:

  • FFB is a safe and effective procedure for neonates.
  • FFB provides significant diagnostic and therapeutic value.
  • Neonatologists should incorporate FFB into their clinical practice.