Pediatric Airway Endoscopy: Recommendations of the Society for Pediatric Pneumology

Schramm, Dirk; Freitag, Nadine; Nicolaï, Thomas; Wiemers, Anna; Hinrichs, Bernd; Amrhein, P; DiDio, Diana; Eich, Christoph; Landsleitner, Bernd; Eber, Ernst; Hammer, Jürg

doi:10.1159/000517125

Cited by 14 publications

(16 citation statements)

References 111 publications

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“…Even experienced clinicians may need multiple attempts to complete it correctly ( 28 ). Bronchoscopy is commonly employed in pediatric pneumology and intensive care medicine ( 29 , 30 ). Although profound (or general) analgesia is standard for pediatric bronchoscopies ( 30 ), supraglottic airway inspection with a flexible bronchoscope is feasible and safe without sedation ( 31 , 32 ).…”

Section: Discussionmentioning

confidence: 99%

Teaching fiberoptic-assisted tracheoscopy in very low birth weight infants: A randomized controlled simulator study

et al. 2022

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ObjectiveWe developed a fiberoptic-assisted tracheoscopy (FAST) method to avoid direct laryngoscopy during surfactant replacement therapy and compared two training approaches on a very low birth weight (VLBW) infant simulator.DesignThis prospective randomized controlled study was conducted at the Department of Neonatology and Pediatric Intensive Care Medicine of the University Medical Center Hamburg-Eppendorf, Germany.ParticipantsWe recruited physicians, trainees, students, and nurses without prior experience in endoscopic techniques.InterventionsParticipants were assigned randomly to a group that received instructions according to Peyton’s Four-Step Approach and a control group that received standard bedside teaching only.Main outcome measuresPrimary endpoints were the total and the component times required to place the bronchoscope and the method success.ResultsWe recruited 186 participants. Compared with the control group, the Peyton group had a lower mean (±standard deviation) FAST completion time (33.2 ± 27.5 s vs. 79.5 ± 47.9 s, p < 0.001; d = 1.12) and a higher FAST success rate (95% vs. 84%, p = 0.036, V = 0.18).ConclusionAfter standardized training, the vast majority of novices completed FAST successfully. Peyton’s four-step approach resulted in faster and more successful performance than standardized training.

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Section: Discussionmentioning

confidence: 99%

Teaching fiberoptic-assisted tracheoscopy in very low birth weight infants: A randomized controlled simulator study

et al. 2022

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“…Unfortunately, there are no guidelines on the better diagnostic work up for children suspected of VR. However, it's reasonable that children with history of recurrent respiratory symptoms poor response to medical treatment, symptoms and physical examination of airway obstruction, dysphagia, and failure to thrive should undergo to flexible laryngo-tracheo-bronchoscopy to assess for laryngomalacia, vocal fold mobility, tracheal stenosis or malacia [40]. The compression or collapse of 33% or less of the tracheal length is considered suggestive of extrinsic compression, while intrinsic tracheomalacia is considered when more of the trachea (> 33%) is involved [10].…”

Section: Diagnostic Assessment Of Airway Compression/collapsementioning

confidence: 99%

Long term respiratory morbidity in patients with vascular rings: a review

et al. 2023

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Abnormalities in position and/or branching of the aortic arch can lead to vascular rings that may cause narrowing of the tracheal lumen due to external compression, or constriction of the oesophagus, causing symptoms that vary in relation to the anatomical vascular pattern and the relationship between these structures. Respiratory morbidity related to external airways compression is a major concern in children affected by vascular rings. Clinical presentation depends on the severity of the tracheal lumen reduction and the presence of associated tracheomalacia. Recurrent respiratory infections, wheezing, atelectasis, and hyperinflation are mostly reported. As they are nonspecific and therefore difficult to recognize, attention should be given to all children with history of respiratory distress, extubation failure, noisy breathing, and recurrent respiratory infections. Early diagnosis and referral to specialized centres can prevent the long-term complications and improve the respiratory outcomes of these patients.

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“…The Society for Pediatric Pneumology has established guidelines for tracheobronchial foreign body removal, but there is no consensus about anesthetic procedures. 4 Indications for bronchoscopy are based on the clinical diagnosis which can be completed by a virtual endoscopy. Virtual endoscopy is a form of computerized tomography (CT) that generates endoluminal views of the airway.…”

Section: Introductionmentioning

confidence: 99%

Pediatric anesthetic for tracheobronchial foreign body extraction: A survey of practice in France

Loreau,

Caruselli,

Roncin

et al. 2023

Pediatric Anesthesia

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Background Tracheobronchial foreign body aspiration is a classic pediatric emergency, and its associated morbidity particularly depends on the anesthetic management, which differs according to the center and the practitioner. Aims The aim of this study was to evaluate the different anesthetic practices for tracheobronchial foreign body extraction. Methods A survey was sent via email to the member physicians of the Association des Anesthésistes Réanimateurs Pédiatriques d'Expression Française (ADARPEF). The survey included 28 questions about the organizational and anesthetic management of an evolving clinical case. Results A total of 151 physicians responded to the survey. Only 13.2% of the respondents reported that their institution had a management protocol, and 21.7% required a computerized tomography scan before the procedure was performed for children who were asymptomatic or mildly symptomatic during the night. There were 56.3% of the respondents who reported that extraction with a rigid bronchoscope is the only procedure usually performed in their institution. Regarding rigid bronchoscopy, 47.0% used combined intravenous‐inhalation anesthesia. The objective was to maintain the child on spontaneous ventilation for 63.6% of the respondents, but anesthesia management differed according to the physician's experience. Conclusions Our study confirms the diversity of practices concerning anesthetic for tracheobronchial foreign body extraction and found reveal differences in practice according to physician experience.

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Pediatric Airway Endoscopy: Recommendations of the Society for Pediatric Pneumology

Cited by 14 publications

References 111 publications

Teaching fiberoptic-assisted tracheoscopy in very low birth weight infants: A randomized controlled simulator study

Teaching fiberoptic-assisted tracheoscopy in very low birth weight infants: A randomized controlled simulator study

Long term respiratory morbidity in patients with vascular rings: a review

Pediatric anesthetic for tracheobronchial foreign body extraction: A survey of practice in France

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