How to enter the pediatric airway for bronchoscopy.
BACKGROUND
Bronchoscopies are performed in childhood for diagnostic reasons (e.g. evaluation of stridor, unexplained cough, possible malformations) and therapeutic reasons (e.g. foreign body removal, management of the difficult airway).


METHODS
Various procedures of entering the pediatric airways are presented, based on an overview of the literature and the experience of the authors.


RESULTS
The advantages and disadvantages of direct fibreoptic bronchoscopy, bronchoscopy via face mask, via laryngeal mask airway, via tracheal tube, and for combined flexible and rigid bronchoscopy are discussed. In addition, practical aspects of bronchoscopy are considered, including local anesthesia, oxygen supplementation, monitoring, antibiotic treatment.


CONCLUSIONS
Although inspection of the pediatric airways has become a well-accepted routine procedure with a high diagnostic yield, and bronchoscopies are well tolerated, it is important that the most appropriate means of access to the airways is chosen according to the indications and the age of the child.
Niggemann
Bodo
B
Department of Pediatric Pneumology and Immunology, University Hospital Charite of Humboldt University, Berlin, Germany. bodo.niggemann@charite.de
Haack
Marion
M
Machotta
Andreas
A
D000367:Age Factors; D001999:Bronchoscopy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn