Clinical applications of ultrathin flexible bronchoscopes

Three different models of ultrathin flexible fiberoptic bronchoscopes (1.8, 2.3, and 2.7 mm in diameter) were used in 190 examinations of pediatric patients. These instruments facilitate clinical procedures and evaluations that are difficult if not impossible with previous bronchoscopes. New applications include endoscopic transnasal intubation with endotracheal tubes as small as 3.0 mm (ID), inspection of the upper lobe segments in infants weighing less than 2.5 kg, and evaluation of the lower airways through endotracheal tubes as small as 2.5 mm (ID) or tracheostomy tubes as small as no. 00 (3.1 mm ID). Although these instruments have no suction channel and are thus incapable of removing airway secretions or obtaining specimens, they are extremely useful for many clinical purposes in infants and young children.