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Bronchoscopy |

The Yield of Flexible Fiberoptic Bronchoscopy in Pediatric Intensive Care Patients*

Dan Bar-Zohar, MD; Yakov Sivan, MD
Author and Funding Information

*From the Pediatric Intensive Care Unit, Dana Children’s Hospital, Tel-Aviv Sourasky Medical Center, Tel-Aviv University Sackler Faculty of Medicine, Tel-Aviv, Israel.

Correspondence to: Yakov Sivan, MD, Pediatric Intensive Care, Dana Children’s Hospital, Tel-Aviv Medical Center, 6, Weizman St, Tel-Aviv 64239, Israel; e-mail: sivan@post.tau.ac.il



Chest. 2004;126(4):1353-1359. doi:10.1378/chest.126.4.1353
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Study objective: To evaluate the contribution of flexible fiberoptic bronchoscopy (FFB) and BAL to the clinical management of patients in a pediatric ICU (PICU).

Setting and design: A retrospective study based on medical records in a six-bed pediatric ICU of a tertiary care children’s hospital serving as a referral center for airway surgery.

Patients and participants: One hundred consecutive infants and children hospitalized in a PICU, who underwent FFB with or without BAL.

Measurements and results: One hundred fifty-five procedures were performed, for the following causes: search for airways anatomic pathologies (114 of 155 procedures, 74%), including 55 procedures during the perioperative period of airway surgery; treatment of atelectasis (35 of 155 procedures, 22.5%); and BAL (30 of 155 procedures, 19%). Thirty-five percent of procedures had more than one cause. Airway pathology was observed in 79 of 114 procedures (69%). Management changed from conservative to surgical in 44 of 114 procedures (39%). In airway surgery cases, reoperation subsequent to postoperative FFB took place in 35%. BAL results changed antimicrobial treatment in 15 of 30 cases, with clinical improvement in 10 of 30 cases (33%). Treatment of atelectasis was successful in 26 of 35 cases (74.3%). No procedure-related mortality, life-threatening complications, or significant changes in patient status occurred.

Conclusions: FFB is an important and safe procedure in very sick infants and children with a variety of respiratory diseases, and significantly contributes to their management. FFB should be considered to be a PICU staff expertise.

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