Use of fiberoptic bronchoscopy in asthmatic children with lung collapse

Segmental atelectasis during asthmatic attacks as a consequence of bronchospasm and hypersecretion are very frequent in children. The collapse of a lung instead is a very rare occurrence. We report two patients with acute exacerbation of asthma, showing an in complete response to bronchodilatory therapy. The clinical findings and chest X-ray were suggestive for collapse of a lung. An urgent fiberoptic bronchoscopy revealed obstruction of a stem main bronchus caused by sticky mucopurulent secretions. The aspiration improved dramatically the respiratory distress and the radiological picture. In these cases we recommended to perform an immediate bronchial aspiration by means of a flexible instrument without waiting a further deterioration of respiratory function before taking this decision.