Flexible bronchoscopy and bronchoalveolar lavage in pediatric patients with lung disease

Efrati, Ori; Sadeh-Gornik, Udi; Modan‐Moses, Dalit; Barak, Asher; Szeinberg, Amir; Vardi, Amir; Paret, Gidon; Toren, Amos; Vilozni, Daphna; Yahav, Yaacov

doi:10.1097/pcc.0b013e31819372ea

Cited by 65 publications

(54 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…External airway compression was the most commonly reported finding [15][16][17][18]20,21,34] . In patients with hemoptysis, FFB identified a cause in 56% of patients (range 20%-100%; 14/25) [5,15,25,30] .…”

Section: Diagnostic Yield Of Ffbmentioning

confidence: 99%

“…Almost all FFB were performed at the bedside, with the exception of routine evaluation for esophageal atresia, where the procedure took place in the operating room [14] . The patient populations undergoing FFB included patients evaluated for a spectrum of anatomic airway or intrinsic pulmonary abnormalities, including patients with congenital heart disease (CHD) (7/27; 26% studies) and patients on extracorporeal life support (ECLS) (4/27; 15% studies) [4,[15][16][17][18][19][20][21][22][23] . FFB was performed multiple times on patients in 55% of the studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Six studies reported a change in clinical management secondary to FFB in 28.9% (range 21.9%-69.2%; 157/540) [4,[14][15][16]24] . Changes in clinical management included unanticipated surgical intervention, modification of surgical intervention, and alteration of endotracheal suctioning techniques.…”

Section: Diagnostic Yield Of Ffbmentioning

confidence: 99%

“…De Blic et al [4] reported that in children with CHD, FFB findings of external compression of the airways by cardiovascular anomalies prompted earlier cardiac surgery in 50% (5/10) [4] . Twenty-one studies reported an overall diagnostic yield of 82% using FFB (range 45.2%-100%; 3791/4 622) [3][4][5][14][15][16][17][18][20][21][22][23][24][25][26][27][28][29][30][31][32][33] . [27] , 2011 [20,24,31] .…”

Section: Diagnostic Yield Of Ffbmentioning

confidence: 99%

“…The populations with the highest diagnostic yield of FFB were patients with extubation failure, patients with CHD, patients with hemoptysis, and patients undergoing ECLS. In patients with extubation failure, FFB identified a cause, such as mucus plugs, laryngotracheomalacia, laryngeal trauma/edema or compression, in 69.9% (range 50%-90.5%; 51/73) [3,[16][17][18][19][20][21]24,27,31,32] .…”

Section: Diagnostic Yield Of Ffbmentioning

confidence: 99%

See 4 more Smart Citations

Utility of flexible fiberoptic bronchoscopy for critically ill pediatric patients: A systematic review

Field-Ridley

Sethi

Murthi

et al. 2015

WJCCM

View full text Add to dashboard Cite

AIM:To investigate the diagnostic yield, therapeutic efficacy, and rate of adverse events related to flexible fiberoptic bronchoscopy (FFB) in critically ill children. METHODS:We searched PubMed, SCOPUS, OVID, and EMBASE databases through July 2014 for English language publications studying FFB performed in the intensive care unit in children < 18 years old. We identified 666 studies, of which 89 full-text studies were screened for further review. Two reviewers independently determined that 27 of these studies met inclusion criteria and extracted data. We examined the diagnostic yield of FFB among upper and lower airway evaluations, as well as the utility of bronchoalveolar lavage (BAL). RESULTS:We found that FFB led to a change in medical management in 28.9% (range 21.9%-69.2%) of critically ill children. The diagnostic yield of FFB was 82% (range 45.2%-100%). Infectious organisms were identified in 25.7% (17.6%-75%) of BALs performed, resulting in a change of antimicrobial management in 19.1% (range: 12.2%-75%). FFB successfully reexpanded atelectasis or removed mucus plugs in 60.3% (range: 23.8%-100%) of patients with atelectasis. Adverse events were reported in 12.9% (range: 0.5%-71.4%) of patients. The most common adverse effects of FFB were transient hypotension, hypoxia and/ or bradycardia that resolved with minimal intervention, such as oxygen supplementation or removal of the bronchoscope. Serious adverse events were uncommon; 2.1% of adverse events required intervention such as bag-mask ventilation or intubation and atropine for hypoxia and bradycardia, normal saline boluses for hypotension, or lavage and suctioning for hemorrhage. CONCLUSION:FFB is safe and effective for diagnostic and therapeutic use in critically ill pediatric patients.

show abstract