Bronchoscopy and anesthesia for preschool-aged patients: a review of 228 cases.
Pediatric bronchoscopy is a complicated, high-risk procedure. From May 2000 to May 2002, we performed bronchoscopy in 228 preschool-aged children (newborn to 6 years old) under general anesthesia with a Storz-Hopkins rigid pediatric bronchoscope. The final diagnosis and complications during anesthesia were recorded. The most common findings from bronchoscopic examination were subglottic stenosis (or granuloma) (67, 29.4%), laryngomalacia (64, 28.1%), tracheal stenosis (or malacia) (29, 12.7%), pneumonia (23, 10.1%), and atelectasis (16, 7.0%). The main complications during anesthesia were arrhythmias, oxygen desaturation, and CO2 retention (high end-tidal CO2). The most serious complication was pneumothorax in one patient. Either endotracheal intubation or tracheostomy was required in 61% of the patients in this series to secure a patent airway after bronchoscopy. Bronchoscopy is necessary as a diagnostic and therapeutic tool for certain airway diseases or anomalies in pediatric patients. It requires cooperation between the endoscopist and anesthesiologist to insure the patient's safety.
Wu
Kuo-Hua
KH
Department of Anesthesiology, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.
Man
Tien-Tien
TT
Wong
Kar-Lok
KL
Lin
Chih-Fu
CF
Chen
Chien-Chuan
CC
Cheng
Ching-Rong
CR
D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods; D001982:Bronchial Diseases / Q000175:diagnosis*; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011030:Pneumothorax / Q000209:etiology; D012141:Respiratory Tract Infections / Q000175:diagnosis*