Related Experiment Video
Updated: Aug 9, 2025
Author Spotlight: Learning Systematic Bronchoscopy in a Simulation-Base Setting
Published on: June 23, 2023
Flexible bronchoscopy in pediatric patients with Down syndrome: A case-control study of the indications, findings,
Noga Arwas1,2, Aviv Goldbart1,2,3, Micha Aviram1,2,3
1Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel.
Insights
Flexible bronchoscopy in children with Down syndrome (DS) revealed unique respiratory findings and higher complication rates. Cardiac anomalies and pulmonary hypertension significantly increase complication risks in these pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Medical Genetics
- Respiratory Medicine
Background:
- Children with Down syndrome (DS) frequently require flexible bronchoscopies (FB) due to respiratory issues.
- Understanding the specific indications and outcomes of FB in this population is crucial for optimizing care.
Purpose of the Study:
- To investigate the indications, findings, and complications associated with flexible bronchoscopies in pediatric patients with Down syndrome.
- To compare these outcomes with a matched control group of pediatric patients without Down syndrome.
Main Methods:
- A retrospective case-control study was conducted involving pediatric patients who underwent FB between 2004 and 2021.
- Down syndrome patients were matched 1:3 with controls based on age, gender, and ethnicity.
- Data on demographics, comorbidities, indications, findings, and complications were analyzed.
Main Results:
- Down syndrome patients showed higher rates of obstructive sleep apnea and oxygen dependence as indications for FB.
- Abnormal findings like soft palate incompetence and tracheal bronchus were more prevalent in DS patients.
- Complications were more frequent in DS patients, with cardiac anomalies and pulmonary hypertension identified as significant risk factors.
Conclusions:
- Flexible bronchoscopy in pediatric Down syndrome patients presents distinct indications and findings.
- Patients with Down syndrome, particularly those with cardiac anomalies and pulmonary hypertension, face elevated risks of complications during FB.
Background:
Children with Down syndrome (DS) often undergo flexible bronchoscopies (FB) due to common respiratory symptoms.
Objective:
To examine the indications, findings, and complications of FB in pediatric DS patients.
Methods:
A retrospective case-control study on FB performed in DS pediatric patients between 2004 and 2021 in a tertiary center. DS patients were matched to controls (1:3) based on age, gender, and ethnicity. Data collected included demographics, comorbidities, indications, findings, and complications.
Results:
Fifty DS patients (median age 1.36 years, 56% males) and 150 controls (median age 1.27 years, 56% males), were included. Evaluation for obstructive sleep apnea and oxygen dependence were more common indications among DS (38% vs. 8%, 22% vs. 4%, p < 0.01, respectively). Normal bronchoscopy was less frequent in DS compared with controls (8% vs. 28%, p = 0.01). Soft palate incompetence and tracheal bronchus were more frequent in DS (12% vs. 3.3%, p = 0.024, 8% vs. 0.7%, p = 0.02, respectively). Complications were more frequent in DS (22% vs. 9.3%, incidence rate ratio [IRR] 2.36, p = 0.028). In DS, cardiac anomalies (IRR 3.96, p < 0.01), pulmonary hypertension (IRR 3.76, p = 0.006), and pediatric intensive care unit (PICU) hospitalization before the procedure (IRR 4.2, p < 0.001) were associated with higher complication rates. In a multivariate regression model, history of cardiac disease and PICU hospitalization before the procedure, but not DS, were independent risk factors for complications with an IRR of 4 and 3.1, respectively (p = 0.006, p = 0.05).
Conclusion:
DS pediatric patients undergoing FB are a unique population with specific indications and findings. DS pediatric patients with cardiac anomalies and pulmonary hypertension are at the highest risk for complications.
Related Concept Videos
01:30Endoscopic Studies I: Bronchoscopy and Thoracoscopy
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
01:30Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
01:26Endoscopic Studies II: Thoracocentesis
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History