Flexible fiberoptic bronchoscopy in pediatric patients is considered to be a low risk procedure with minimal complications. The purpose of this study was to evaluate the usefulness of routinely performing chest radiography after flexible fiberoptic bronchoscopy with bronchoalveolar lavage in the pediatric patient.
We retrospectively reviewed the charts of 51 pediatric patients that had undergone flexible fiberoptic bronchoscopy with bronchoalveolar lavage. We reviewed the charts for the following parameters: age, diagnosis for which the procedure was performed, chest radiography findings and for any complications that occurred during the procedure that necessitated stopping the procedure.
Patients’ ages ranged from 1 month old to 19 years old. The diagnosis were chronic cough(11), cystic fibrosis(4), foreign body evaluation(2), hoarseness(2), persistent atelectasis(3), recurrent pneumonia(2), stridor(20), tracheomalacia(1), tracheostomy evaluation(1), tuberculosis(2), upper airway obstruction(1), and vocal cord dysfunction(2). 50 of the patients had chest radiographs and 1 patient had a chest CAT scan. The chest radiographs and the CAT scan revealed no complications or acute changes from flexible fiberoptic bronchoscopy with bronchoalveolar lavage. There were no complications that necessitated stopping of the procedure and all procedures were completed.
This study has shown that chest radiography in pediatric patients undergoing flexible fiberoptic bronchoscopy with bronchoalveolar lavage, 4with no intraoperative complications that necessitated the procedure to be stopped, had no clinical usefulness or benefit for the patient.
Chest radiography should not be routinely performed after uncomplicated flexible fiberoptic bronchoscopy with bronchoalveolar lavage. It is not cost effective, adds no benefit to patient management, and exposes the pediatric patient to unecessary radiation.
Susie FitzHarris, None.