Fibreoptic bronchoscopy without general anaesthetic.
We have used flexible fibreoptic bronchoscopy using sedation and local anaesthesia in 50 children aged 2-19 years (median 10) using an Olympus BFP20 instrument. Indications were opportunistic pneumonias (n = 11), persistent atelectasis (n = 11), recurrent pneumonia (n = 7), miscellaneous lower airway disease (n = 7), recurrent wheezing (n = 3), haemoptysis (3), to diagnose infection or rejection of heart-lung transplants (n = 3), stridor (n = 2), suspected airway compression (n = 1), evaluation of tracheostomy (n = 1), and suspected foreign body (n = 1). In 43 cases (86%) the diagnosis was related to the primary indication. In five (10%) unrelated abnormalities were found, and five (10%) were normal. In 13 (26%) treatment was altered as a result of flexible fibreoptic bronchoscopy. Complications were transient respiratory arrest (n = 2), hypoxia (n = 2), pneumonia (n = 2), and laryngospasm (n = 1). All complications were followed by complete recovery. Our results suggest that flexible fibreoptic bronchoscopy is safe. Advantages over rigid bronchoscopy include greater visual range, fewer complications, and the avoidance of a general anaesthetic. Though invasive it can yield important diagnostic and therapeutic information.
Raine
J
J
Department of Paediatrics, Royal Brompton and National Heart Hospital, London.
Warner
J O
JO
D000293:Adolescent; D000328:Adult; D000772:Anesthesia, Local; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D005336:Fiber Optic Technology; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D007826:Laryngismus / Q000209:etiology; D008012:Lidocaine; D008171:Lung Diseases / Q000175:diagnosis; D008614:Meperidine; D008874:Midazolam; D011014:Pneumonia / Q000209:etiology; D012131:Respiratory Insufficiency / Q000209:etiology
D008012:Lidocaine; D008614:Meperidine; D008874:Midazolam