Atelectasis in children: Results of flexible fiberoptic bronchoscopy

Pulmonary atelectasis is a significant respiratory problem in children. This study aimed to investigate the underlying causes of atelectasis and evaluate the outcomes of flexible fiberoptic bronchoscopy (FFB) in pediatric patients with this condition.

Clinical data and outcomes of 110 children who underwent FFB were retrospectively analyzed based on radiological imaging obtained at three and six months following the procedure, and the patients were categorized into three groups: Group 1 (complete resolution of atelectasis), Group 2 (partial resolution), and Group 3 (no resolution).

Between January 2016 and December 2023, a total of 110 pediatric patients with pulmonary atelectasis underwent FFB. The most common bronchoscopic findings were mucus plugs and secretions (50%), foreign body aspiration (7.3%), and congenital airway anomalies (3.6%). In 30% of the patients, bronchoscopy findings were normal. Complete resolution of atelectasis was observed in 55.4% of patients following FFB. The median duration of atelectasis in Group 3 was 90 days, significantly longer than that found in the other two groups (p= 0.002). Additionally, the median hospitalization period prior to bronchoscopy in Group 3 was 21 days, which was also longer than that found in the other groups (p= 0.004). The median atelectasis score in Group 1 was 2.34 (range: 0.9-3.1), significantly lower than in Groups 2 and 3 (p= 0.005).

FFB is an effective tool for identifying the etiology of atelectasis in children. Prolonged duration of atelectasis and the presence of comorbidities were identified as risk factors for persistent, non-resolving atelectasis.