title: Chest radiography does not alter the treatment course for children after rigid bronchoscopy.
abstract: The purpose of this study was to evaluate the usefulness of chest radiography in the direction of postbronchoscopy clinical therapy. From 2001 to 2011, 368 rigid bronchoscopies were performed at a single institution in 221 children. Indications for bronchoscopy, concomitant bronchoscopic procedures, and results of postoperative chest radiography were evaluated. Rigid bronchoscopy was performed in children at a median age of 2.21 years (range, two days to 20 years). Chest radiography was performed at the discretion of the primary surgeon after 275 (74.7%) procedures. Malpositioning of the endotracheal or tracheostomy tube occurred in 1.5 per cent (n = three of 203) of ventilated patients postbronchoscopy. Pneumothorax occurred in 0.5 per cent (n = two of 368) of children and followed laser degranulation (n = one of 117 [0.9%]) and removal of an aspirated foreign body (n = one of 80 [1.3%]). Neither child required tube thoracostomy. Three children necessitated intraoperative tube thoracostomy placement for symptomatic pneumothoraces before radiographic assessment. No children sustained postprocedural complications in the absence of postbronchoscopy radiography. Postbronchoscopy chest radiography in the absence of defined symptomatology is not associated with a change in the postprocedural treatment course, suggesting selective application may be appropriate after at-risk bronchoscopic interventions. Such practice will limit the future cost and radiation exposure associated with this common procedure.
authors.affiliation: Department of Surgery, The University of Virginia Health System, Charlottesville, Virginia, USA.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Stone
authors.forename: John D
authors.initials: JD
authors.lastname: Tillou
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Guidry
authors.forename: Sara K
authors.initials: SK
authors.lastname: Rasmussen
authors.forename: Bartholomew J
authors.initials: BJ
authors.lastname: Kane
authors.forename: Eugene D
authors.initials: ED
authors.lastname: McGahren
authors.forename: Bradley M
authors.initials: BM
authors.lastname: Rodgers
mesh_terms: D000293:Adolescent; D001999:Bronchoscopy / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011030:Pneumothorax / Q000000981:diagnostic imaging* / Q000209:etiology; D011829:Radiation Dosage; D013902:Radiography, Thoracic; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult