Flexible Bronchoscopy as a Valuable Diagnostic and Therapeutic Tool in Pediatric Intensive Care Patients: A Report on 5 Years of Experience

作者：Peng Yu Yun; Soong Wen Jue^*; Lee Yu Sheng; Tsao Pei Chen; Yang Chia Feng; Jeng Mei Jy

来源：Pediatric Pulmonology, 2011, 46(10): 1031-1037.

DOI：10.1002/ppul.21464

• bronchoscopy
• flexible endoscopy
• intensive care
• interventional bronchoscopy

Objective: To evaluate the clinical role of flexible bronchoscopy (FB) in pediatric and neonatal intensive care units (ICUs). Design: A retrospective review of all patients receiving FB procedures between January 2005 and December 2009. Setting: Pediatric and neonatal ICUs of a tertiary care multi-disciplinary teaching hospital located in northern Taiwan. Patients: A total of 358 ICU patients (223 males) who received 725 FB procedures. Measurements and Main Results: The medical records were reviewed and analyzed. Mean age for the first time FB was 35.7 (+/-48.9 SD) months old and 68.2% of them were <3 years old. Among them, unexplained retraction or tachypnea (32.0%) and stridor (20.1%) were the two leading indications for FB. The positive finding rate of FB was 87.2%, with airway malacia (47.8%) being the most common, especially in patients <3 years old. Positive lesion sites were approximately equally distributed between the upper (51.1%) and lower (50.6%) airways. Concomitant findings in the esophagus were found in 15.4% of the patients. There were 518 interventional FBs (71.4%, 518/725 procedures) which were performed on 201 (56.1%, 201/358) patients; FB-aided endotracheal intubation (180/518, 34.7%) and laser therapy (109/518, 21.0%) were the two leading techniques used. No patient suffered from any long-term complications or mortality associated with the FB procedures. Conclusions: FB is a safe and valuable diagnostic and therapeutic tool for patients in pediatric and neonatal ICUs. Pediatr Pulmonol. 2011;46:1031-1037.

• 出版日期2011-10