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[Pediatric fiber bronchoscopy. Apropos 55 children examined]
A Bautista Casasnovas1, E Estévez Martínez, R Buznego Sánchez
1Servicio de Cirugía Pediátrica, Hospital General de Galicia, Santiago de Compostela, La Coruña.
Insights
Flexible fiberoptic bronchoscopy (FFB) is a safe and effective diagnostic tool for pediatric respiratory conditions. This procedure, often performed with sedation, offers advantages over rigid bronchoscopy, avoiding general anesthesia.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Medical Technology
Context:
- Flexible fiberoptic bronchoscopy (FFB) is an essential diagnostic tool in pediatric respiratory care.
- Evaluating conditions such as stridor, recurrent pneumonia, atelectasis, and suspected foreign bodies requires precise visualization of the airways.
- Traditional methods may involve more invasive techniques or general anesthesia.
Purpose:
- To evaluate the safety and efficacy of flexible fiberoptic bronchoscopy (FFB) in a pediatric population.
- To assess the diagnostic yield of FFB for various respiratory indications.
- To compare FFB with rigid bronchoscopy and explore anesthetic options.
Summary:
- This study reports on 55 pediatric cases undergoing FFB using sedation and local anesthesia or laryngeal mask airway.
- FFB successfully established a diagnosis in 70% of cases, with indications including stridor, pneumonia, atelectasis, foreign body, tuberculosis, and tracheostomy evaluation.
- One case of severe hypoxia required intubation; otherwise, the procedure was well-tolerated, demonstrating high diagnostic accuracy.
Impact:
- FFB provides a safe and effective alternative to rigid bronchoscopy in children.
- The use of sedation and laryngeal mask airway allows FFB to be performed across all pediatric age groups without general anesthesia.
- This technique enhances diagnostic capabilities for pediatric airway diseases, potentially improving patient outcomes.
Abstract:
We present our experience with 55 children in which we performed flexible fiberoptic bronchoscopy (FFB) using an Olympus BF3C20 instrument and by using sedation and local anaesthesia or laryngeal mask airway. Indications for performing this procedure were stridor, opportunist or recurrent pneumonia, persistent atelectasis, a suspected foreign body, confirmation of endobronchial tuberculosis and evaluation of tracheostomy. In 70% of the cases, the diagnosis was made by the FFB and 14 cases were normal. One child with severe hypoxia presented respiratory arrest and need intubation. Our results suggest that FFB is safe, has advantages over rigid bronchoscopy, avoids general anaesthetic and with laryngeal mask airway is possible to perform in patients of every age.