Flexible Bronchoscopy in Non-resolving Pneumonia

Bhat, Javeed I.; Wani, Wasim Ahmad; Ahmad, Qazi Iqbal; Charoo, Bashir Ahmad; Ali, Syed Wajid; Ahangar, Ambreen Ali; Ahmad, Mashkoor

doi:10.1007/s12098-017-2372-7

Cited by 12 publications

(7 citation statements)

References 7 publications

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“…In view of the prediction, the nomogram could serve as a tool to select patients for evaluating the necessity of flexible bronchoscopy. In general, the presence of persistent atelectasis in chest imaging is a strong indicator for flexible bronchoscopy intervention 27,28 . Thus early bronchoscopic examination may be necessary for children with MPP presented with clinical sign of atelectasis, regardless of the presence of BMP.…”

Section: Discussionmentioning

confidence: 99%

Nomogram for Prediction of Bronchial Mucus Plugs in Children with Mycoplasma pneumoniae Pneumonia

Sheng

et al. 2020

Sci Rep

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the presence of bronchial mucus plugs (BMp) in children with Mycoplasma pneumoniae pneumonia (MPP) results in delayed clinical and radiographic resolution and long-standing pulmonary sequelae. The predictive factors associated with BMP formation remains poorly defined. Nomograms to predict BMp presence in children with Mpp were proposed using a cohort of patients who underwent bronchoscopy intervention at Children's Hospital in Eastern China. Patients with MPP in an earlier period formed the training cohort (n = 872) for nomogram development, and those thereafter formed the validation cohort (n = 399) to confirmed model's performance. BMP in children with MPP were found in 196 (22.5%) and 91(22.8%) patients in the training and validation cohorts, respectively. the independent risk factors associated with BMp were age >5years (OR 2.06; 95% CI 1.43 to 2.98), higher IL-10 level (>10 ng/L, 2.19; 95% CI 1.46 to 3.28), higher IFN-γ level (>30 ng/L, 1.69; 95% CI 1.13 to 2.54), and presence of complication (3.43; 95% CI 1.45 to 8.09). Incorporating these 4 factors, the nomogram achieved good concordance indexes of 0.771(95% CI, 0.734-0.808) and 0.796 (95% CI, 0.744-0.848) in predicting BMP in the training and validation cohorts, respectively. The nomogram achieved an optimal prediction of BMP in children with MPP. Using this model, the risk of BMP formation would be determined, contributing to a rational therapeutic choice.

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Section: Discussionmentioning

confidence: 99%

Nomogram for Prediction of Bronchial Mucus Plugs in Children with Mycoplasma pneumoniae Pneumonia

Sheng

et al. 2020

Sci Rep

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“…Similarly, culture of the tracheal aspirate has a high chance of contamination with colonizing microorganisms [12]. BAL microbiology is a very good marker for the diagnosis of lung infection [13]. In a study by Wang, et al [14] on risk factors of extubation failure in ELBW infants, atelectasis was also found as one of the causes of extubation failure.…”

Section: Discussionmentioning

confidence: 99%

Role of Flexible Bronchoscopy in Ventilator-Dependent Neonates

et al. 2020

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Objective To assess the usefulness and safety of flexible bronchoscopy in ventilated neonates with extubation failure. Method This was a prospective observational study. Flexible bronchoscopy was done in eligible patients with failure of extubation form invasive ventilation. The main outcome measure was to find the presence of any anatomic or dynamic abnormalities of the airways of these patients and the organism profile of bronchoalveolar lavage (BAL) fluid. Results Forty-eight babies (68.8% preterm) were enrolled in the study. The most common finding on bronchoscopy was airway edema seen in 13 (27%) patients. BAL culture was positive in 29 (74%) patients. Overall treatment was modified in 35 (73%) patients based on bronchoscopy findings/BAL culture. Majority of infants (83.3%) tolerated the procedure very well. Conclusion Flexible bronchoscopy provides useful information in the management of newborn babies with extubation failure.

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“…Most common infectious etiology identified from BAL was bacterial as in most other studies. 7 Effriti et al in their study had reported microbial isolation rates close to 20%. 8 The bacterial isolation rates from BAL in our study was significantly higher at 25% and in 3 of those cases a change in antibiotics led to improvement of patient condition.…”

Section: Discussionmentioning

confidence: 85%

Pediatric Flexible Bronchoscopy Under Conscious Sedation in an Endoscopy Suite – Is It Feasible, Safe and Yielding?: An Observational Study

Augustine¹,

Rajesh²,

Jose³

2018

IJCMR

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Introduction: The first description of bronchoscopy in pediatric practice was in 1978. Current study aimed to record the safety and diagnostic yield of performing fibre optic bronchoscopy (FB) in children under sedation and the rate of occurrence of serious adverse events. Material and Methods: Bronchoscopy case records of 16 patients who underwent FB were accessed. 14 of them as intensivist supervised in a suite and 2 in the PICU. Baseline clinical characteristics including duration of symptoms, presence of fever, hypoxia, leukocytosis were recorded. Procedural complications and serious adverse events were noted. Microbial yield was compared with clinical and lab parameters. Results: Most of the Pediatric bronchoscopy patients present with acute indications. Cough is a universal symptoms followed by fever (50%). Commonest radiological zone of involvement is right middle followed by right upper. Microbial yield from the broncho-alveoloar lavage was close to 60%. Serious adverse event happened in only one patient. Conclusion: Pediatric bronchoscopy is a safe, high yielding procedure, which can be performed under conscious sedation under an intensivist's supervision.

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Flexible Bronchoscopy in Non-resolving Pneumonia

Cited by 12 publications

References 7 publications

Nomogram for Prediction of Bronchial Mucus Plugs in Children with Mycoplasma pneumoniae Pneumonia

Nomogram for Prediction of Bronchial Mucus Plugs in Children with Mycoplasma pneumoniae Pneumonia

Role of Flexible Bronchoscopy in Ventilator-Dependent Neonates

Pediatric Flexible Bronchoscopy Under Conscious Sedation in an Endoscopy Suite – Is It Feasible, Safe and Yielding?: An Observational Study

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