Flexible bronchoscopy contribution in the approach of diagnosis and treatment of children’s respiratory diseases: the experience of a unique pediatric unit in Tunisia

Hamouda, S.; Oueslati, Amal; Belhadj, Imen; Khalsi, F.; Tinsa, Faten; Boussetta, Khadija

doi:10.4314/ahs.v16i1.7

Cited by 10 publications

(7 citation statements)

References 22 publications

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“…Currently, no specific therapy has demonstrated efficacy in the treatment of adenovirus pneumonia [ 17 ]. FOB with BAL has now become an important diagnostic and therapeutic procedure for respiratory diseases, including adenovirus pneumonia [ 18 ]. There is paucity of data on BAL for the treatment of adenovirus pneumonia in children.…”

Section: Discussionmentioning

confidence: 99%

Influence of the timing of bronchoscopic alveolar lavage on children with adenovirus pneumonia: a comparative study

Fan

Shi

et al. 2021

BMC Pulm Med

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Background Adenovirus pneumonia is prone to severe clinical and imaging manifestations in children. Bronchoscopic alveolar lavage (BAL) is an important adjunctive therapy for patients with severe imaging findings. The study aimed to evaluate the effect of the timing on the efficacy of bronchoalveolar lavage in children with adenovirus pneumonia. Methods This study included 134 patients with adenovirus pneumonia treated with BAL at Guangzhou Women and Children's Medical Center from January 2019 to January 2020.They were classified into the severe and mild groups. Based on the timing of BAL, each group was divided into the early BAL layer (received BAL within 1–9 days of the illness course) and the late BAL layer (received BAL within 10–14 days of the illness course). The clinical data of patients with different BAL timings were analyzed in two groups. Results Among the 134 patients, 70 were categorized into the mild group and 64 were categorized into the severe group. Of the 134 patients, 42 patients received BAL early (mild group: n = 21 and severe group: n = 21) and 92 patients received BAL later (mild group: n = 49 and severe group: n = 43). In the mild group, the fever and hospital duration were shorter in patients who received BAL early than in those who received BAL later (p < 0.05). However, in the severe group, there were no statistically significant differences in the fever and hospital duration between patients who received BAL early and those who received BAL later. However, the need for mechanical ventilation and the incidence of BAL complications, such as new need for oxygen, were higher in patients who received BAL early than in those who received BAL later in the severe group (p < 0.05). Conclusion For mild adenovirus pneumonia, early BAL may shorten the fever and hospital duration. However, early BAL in severe cases might not shorten the course of the disease or improve prognosis and may even increase the risks of mechanical ventilation and BAL complications.

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Section: Discussionmentioning

confidence: 99%

Influence of the timing of bronchoscopic alveolar lavage on children with adenovirus pneumonia: a comparative study

Fan

Shi

et al. 2021

BMC Pulm Med

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“…Bronchial foreign body aspiration often occurs in children younger than 3 years of age and is more frequent in boys than girls. [ 16 , 17 ] However, aspiration of beads is more common in girls, likely because girls use beads more often as toys. A foreign body is more commonly located in the right bronchus, which may be related to the anatomic features of the right main bronchus: the angle in the right bronchus is smaller while the diameter of the right bronchus is larger than that of the left bronchus.…”

Section: Discussionmentioning

confidence: 99%

Successful retrieval of a plastic bead from the airway of a child by flexible bronchoscopy and a balloon-tipped catheter

Wang

Zhang²,

Li³

et al. 2018

Medicine

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Rationale:Bronchial foreign body aspiration is a critical condition that jeopardizes the respiratory function of children. Prompt diagnosis and removal of the foreign body can reduce occurrence of foreign body complications and mortality. Aspiration of spherical plastic beads is rare, and the bead is difficult to retrieve.Patient concerns:An 8-year-old girl developed cough, transient throat wheezing, and intermittent cough after she accidentally inhaled a plastic bead 7 hours ago. Chest computed tomography scan revealed a round shadow 1.2 cm in diameter in the right main bronchus.Diagnoses:Foreign body in the right main bronchus.Interventions:Retrieval by balloon-tipped catheter via flexible bronchoscopy was undertaken.Outcomes:The bead was successfully retrieved and the child recovered uneventfully.Lessons:Foreign body aspiration in children constitutes a medical emergency in severe cases. Flexible bronchoscopy and balloon-tipped catheter retrieval can be used as an effective noninvasive treatment for aspiration of plastic beads.

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“…The gold standard for diagnosing and managing FB aspiration is rigid endoscopy under general anesthesia . In doubtful cases, flexible bronchoscopy can be used to exclude the presence of FB in the distal airways . A tracheotomy or open chest surgery may be required when conventional bronchoscopy fails to extract the FB or in resource‐limited settings where rigid bronchoscopy is not available.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 In doubtful cases, flexible bronchoscopy can be used to exclude the presence of FB in the distal airways. 5 A tracheotomy 6 or open chest surgery 7 may be required when conventional bronchoscopy fails to extract the FB or in resource-limited settings where rigid bronchoscopy is not available. In this case, a long sharp chain was aspirated by a 1-yearold child and removed by bronchoscopy and tracheotomy jointly under general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Anesthetic management in a 1‐year‐old child undergoing removal of a large metal tracheobronchial foreign body

Ren

Jian-min

Zhong

2019

Pediatric Investigation

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Introduction Pediatric tracheobronchial foreign body aspiration can be a life‐threatening emergency, especially in young children because of their decreased respiratory reserve and smaller‐diameter airways. Case presentation We herein present a case in which a 1‐year‐old female child aspirated a 9‐cm long metal chain into the lower trachea and right main bronchus. The chain was removed via low tracheotomy and rigid bronchoscopy under general anesthesia. An intravenous anesthetic alone with a muscle relaxant was used to ensure an immobile airway during surgery instead of the more commonly used inhalation anesthetics with spontaneous ventilation. Conclusion The case re‐affirms that the removal of some large and irregular airway foreign bodies is a challenging procedure that requires a proper anesthetic plan and coordination with surgeons.

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Flexible bronchoscopy contribution in the approach of diagnosis and treatment of children’s respiratory diseases: the experience of a unique pediatric unit in Tunisia

Cited by 10 publications

References 22 publications

Influence of the timing of bronchoscopic alveolar lavage on children with adenovirus pneumonia: a comparative study

Influence of the timing of bronchoscopic alveolar lavage on children with adenovirus pneumonia: a comparative study

Successful retrieval of a plastic bead from the airway of a child by flexible bronchoscopy and a balloon-tipped catheter

Anesthetic management in a 1‐year‐old child undergoing removal of a large metal tracheobronchial foreign body

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