Pediatric bronchoscopy: recent advances and clinical challenges.

Area of Science:

• Pediatric Pulmonology
• Interventional Bronchoscopy

Background:

• Bronchoscopy equipment has evolved, enabling more therapeutic and interventional procedures in pediatrics.
• Advances include smaller instruments and larger working channels, enhancing diagnostic and treatment capabilities.

Purpose of the Study:

• To review recent advancements and clinical challenges in pediatric bronchoscopy.
• To cover new technologies such as single-use bronchoscopes, endobronchial ultrasound, and cryoprobes.
• To discuss the application of bronchoscopy in conditions like preschool wheezing and asthma.

Main Methods:

• A literature review was conducted using PubMed.
• Searched for articles on pediatric and interventional bronchoscopy published within the last 5 years.
• Included studies on rigid bronchoscopy and various interventional techniques.

Main Results:

• Indications for interventional bronchoscopy have expanded to include balloon dilatation, endoscopic intubation, airway stents, whole lung lavage, fistula closure, foreign body removal, laser, and microdebrider use.
• Experience with bronchoscopes during the COVID-19 pandemic has informed safer practices.
• Despite increased procedures, there is a noted scarcity of published evidence.

Conclusions:

• Pediatric interventional pulmonology is growing, with increasing numbers of procedures being performed.
• Development of specialized training courses for pediatric interventional bronchoscopy is recommended.
• The COVID-19 pandemic experience has led to improved safety protocols in bronchoscopy practices.