Therapeutic rigid bronchoscopy in the neonatal intensive care unit

Often the acutely ill neonate requires endoscopic intervention for deteriorating respiratory status in spite of vigorous pulmonary toilet. Although fiberoptic bronchoscopy has been suggested at times, its mechanical airway obstruction would preclude its use in the very sick child. Rigid endoscopy using a ventilating bronchoscope may be safely and effectively used in the neonatal unit for bedside therapy, avoiding the risk to transfer to and from an operating room. Five case studies are presented outlining the indications and utility of this procedure.