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Flexible Fiber-optic Bronchoscopy-directed Interventions in Children with Congenital Heart Diseases

Anil Sachdev1, Ritika Chhawchharia1, Dhiren Gupta1

  • 1Department of Pediatrics, Sir Ganga Ram Hospital, New Delhi, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|July 31, 2020
PubMed

Insights

Flexible fiber-optic bronchoscopy (FFB) is a safe and valuable tool for diagnosing and treating pulmonary issues in children with congenital heart disease (CHD). It aids in guiding interventions, improving outcomes in pediatric cardiac intensive care units.

Area of Science:

  • Pediatric Cardiology
  • Pulmonology
  • Critical Care Medicine

Background:

  • Pulmonary and cardiac diseases are closely linked in children, necessitating integrated evaluation.
  • Flexible fiber-optic bronchoscopy (FFB) offers diagnostic and therapeutic benefits in pediatric cardiac intensive care units (PCICU).

Purpose of the Study:

  • To assess the utility and safety of FFB in pediatric patients with congenital heart disease (CHD).

Main Methods:

  • A retrospective descriptive study analyzed 71 FFBs performed on 58 children with CHD in a PCICU over six years (2012-2017).
  • Data included patient demographics, cardiac lesions, indications for FFB, findings, and interventions performed.

Main Results:

  • Common indications included persistent atelectasis, prolonged oxygen need, and stridor.
  • Tracheobronchitis and tracheobronchomalacia were the most frequent findings.
  • FFB guided interventions such as slide tracheoplasty, tracheostomy, and tailored antibiotic therapy based on bronchoalveolar lavage (BAL) cultures.
  • Complications were generally minor and transient.

Conclusions:

  • Bedside FFB is a safe and effective diagnostic modality in children with cardiac diseases.
  • FFB plays a crucial role in guiding therapeutic interventions, improving patient management in PCICU settings.
Abstract

Keywords:
Airway anomaliesBronchoalveolar lavageCongenital heart diseaseFlexible fiber-optic bronchoscopyInterventionsPediatric intensive care.

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