The yield of flexible fiberoptic bronchoscopy in pediatric intensive care patients.
OBJECTIVE
To evaluate the contribution of flexible fiberoptic bronchoscopy (FFB) and BAL to the clinical management of patients in a pediatric ICU (PICU).


METHODS
A retrospective study based on medical records in a six-bed pediatric ICU of a tertiary care children's hospital serving as a referral center for airway surgery.


METHODS
One hundred consecutive infants and children hospitalized in a PICU, who underwent FFB with or without BAL.


RESULTS
One hundred fifty-five procedures were performed, for the following causes: search for airways anatomic pathologies (114 of 155 procedures, 74%), including 55 procedures during the perioperative period of airway surgery; treatment of atelectasis (35 of 155 procedures, 22.5%); and BAL (30 of 155 procedures, 19%). Thirty-five percent of procedures had more than one cause. Airway pathology was observed in 79 of 114 procedures (69%). Management changed from conservative to surgical in 44 of 114 procedures (39%). In airway surgery cases, reoperation subsequent to postoperative FFB took place in 35%. BAL results changed antimicrobial treatment in 15 of 30 cases, with clinical improvement in 10 of 30 cases (33%). Treatment of atelectasis was successful in 26 of 35 cases (74.3%). No procedure-related mortality, life-threatening complications, or significant changes in patient status occurred.


CONCLUSIONS
FFB is an important and safe procedure in very sick infants and children with a variety of respiratory diseases, and significantly contributes to their management. FFB should be considered to be a PICU staff expertise.
Pediatric Intensive Care, Dana Children's Hospital, Tel-Aviv Medical Center, 6 Weizman Street, Tel-Aviv 64239, Israel.
Dan
D
Bar-Zohar
Yakov
Y
Sivan
D000293:Adolescent; D018893:Bronchoalveolar Lavage; D001999:Bronchoscopy / Q000379:methods; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012086:Reoperation; D012121:Respiration, Artificial; D012140:Respiratory Tract Diseases / Q000175:diagnosis*; D012189:Retrospective Studies