Application of Ultrathin Bronchoscopy under Conditions of Paediatric Intensive Care

Overview

Bronchoscopic examination is a valuable part of diagnostic patterns in pathological respiratory conditions in paediatrics. In addition to using bronchoscopy in basic pneumological diagnosis, it plays a significant part also in intensive care where it helps effectively in the diagnosis of respiratory complications. A problematic group are low birth weight infants where the dimensions of the airways do not allow use of standard instruments. In the submitter paper the authors present results of their experience with an ultrathin bronchoscope in children requiring intensive care. The authors evaluate the results of 45 examinations by means of a flexible bronchoscope with an external diameter of 2.2 mm used in a group of 34 children age 1 day to 7 months with a body weight of 700 to 4000 g at the time of examination.The most frequent indication were problems associated with artificial pulmonary ventilation or unsuccessful extubation of an otherwise stabilized infant. Another frequent indication was impaired aeration of the pulmonary parenchyma arousing suspicion of impaired patency of the airways. In 70% bronchoscopy provided information explaining clinical problems, in 32% the endoscopic finding initiated a change of therapeutic procedures. The most frequent findings were impaired stability of the airways, obstruction of the bronchi by granulation tissue and dysplastic changes of the bronchial tree. Examination by means of an ultrathin bronchoscope was well tolerated by all children and with the exception of short and unimportant drops of the haemoglobin oxygen saturation no complications were recorded.Ultrathin bronchoscopy in an important diagnostic method which makes objective assessment of pathological endobronchial conditions possible and thus also an aimed control of therapeutic procedures in children receiving intensive care.

Key words:
bronchoscopy, ultrathin bronchoscope, bronchopulmonary dysplasia, anomaly of the airways, artifical pulmonary ventilation, respiratory distress, intubation, intensive care