Flexible fiberoptic bronchoscopy – a bedside technique for neonatologists

Kohelet, David; Arbel, Eliana; Shinwell, Eric S.

doi:10.3109/14767058.2010.501123

Cited by 17 publications

(27 citation statements)

References 19 publications

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“…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%

“…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%

“…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] . Lower airway findings included airway stenosis, compression, malacia, mucus plugs, thrombus, and malpositioned endotracheal tube [3,14,15,17,18,20,21,23,24,31,32] .…”

Section: Diagnostic Yield Of Ffbmentioning

confidence: 99%

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

Field-Ridley

Sethi

Murthi

et al. 2015

WJCCM

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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.

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Section: Diagnostic Yield Of Ffbmentioning

confidence: 99%

Section: Diagnostic Yield Of Ffbmentioning

confidence: 99%

Section: Diagnostic Yield Of Ffbmentioning

confidence: 99%

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

Field-Ridley

Sethi

Murthi

et al. 2015

WJCCM

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“…Ultra-thin bronchoscopes offers new diagnostic opportunities, particularly to neonatologists [5]. Furthermore, ultra-thin bronchoscopes are of limited diagnostic value when excessive bronchial secretions obstruct the view of the working field because of the abscence of the suction channel.…”

Section: Discussionmentioning

confidence: 99%

Flexible Fiberoptic Bronchoscopy Through the Laryngeal Mask Airway in a Small Premature Infant

Gedik

Çakır

Topuz

2016

Turk Toraks Dergisi

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Flexible bronchoscopy (FB) can be used safely for wider indications in children. Ultra-thin bronchoscopes are used for premature or newborn infants and are of limited diagnostic value. Bronchoscopes with a suction channel, may lead to problems when the nasal passage is narrow, particularly in patients under 2.5 kg. In addition, it may cause bronchospasm and hypoxia in small infants during the procedure because of an almost complete obstruction of the airway. A laryngeal mask airway (LMA) may prevent both bronchospasm and hypoxia because it does not need a nasal route. In addition, the LMA allows positive pressure ventilation during the procedure. We performed FB with a 3.7 mm bronchoscope through the LMA in a 75-day-old and 1910 g premature baby with atelectasis. This is the first and successful FB experience in such a small premature infant reported in the literature using a 3.7 mm bronchoscope through the LMA. INTRODUCTIONFlexible endoscopy of pediatric airways was first reported in 1978. Since then, the technique has continued to develop, and the number of flexible bronchoscopy (FB) procedures in pediatric patients has increased with the availability of smaller devices. FB in children of the age group of 0-18 years can be used safely for wider indications in children of different weights and ages. Pediatric airway bronchoscopy may involve the inspection of the nose, pharynx, larynx, trachea, and bronchi. Diagnostic indications include the evaluation of stridor, an unexplained or persistant wheeze or cough, possible malformations, recurrent atelectasis or infiltrations, hemoptysis, and collection of specimens. No certain contraindications for bronchoscopy were noted [1]. The laryngeal mask airway (LMA) has been used since 1983, and the use of bronchoscopy via the LMA of infants and children has increased with the availbility of smaller sizes of the LMA [2]. We performed FB with a 3.7 mm bronchoscope via the LMA in a 75-day-old 1910 g premature baby with atelectasis. This is the first and successful FB experience in such a small premature infant reported in the literature using a 3.7 mm bronchoscope through the LMA.

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“…The spectrum of disease ranges from airway disease associated with congenital heart disease, acquired tracheabronchomalacia requiring long-term ventilation to subglottic stenosis requiring tracheostomy. Fiber-optic bronchoscopy in the ICU is required to assess the airways of these neonates and children to assure correct management [15][16][17][18][19][20]. Performing a bronchoscopy safely in the ICU requires a different skill set as in the ICU there is an increased risk of developing complications and managing them in an unfamiliar environment.…”

Section: Indications For Bronchoscopy In Children In Lmicmentioning

confidence: 99%

The need for bronchoscopic services for children in low and middle-income countries

Goussard

Gie

2016

Expert Review of Respiratory Medicine

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Flexible fiberoptic bronchoscopy – a bedside technique for neonatologists

Abstract: FFB is a useful and safe procedure that belongs in the neonatologists' armamentarium.

Cited by 17 publications

References 19 publications

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

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

Flexible Fiberoptic Bronchoscopy Through the Laryngeal Mask Airway in a Small Premature Infant

The need for bronchoscopic services for children in low and middle-income countries

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