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Moon, Lee, Chun, Yoon, Kim, and Lee: Pediatric Flexible Bronchoscopy: Clinical Experience of 100 Cases of Bronchoscopy from a Single Institute
Abstract

Pediatr Allergy Respir Dis 2011;21(4):313-318.

Published online: 20 January 2011

DOI: https://doi.org/10.7581/pard.2011.21.4.313

Pediatric Flexible Bronchoscopy: Clinical Experience of 100 Cases of Bronchoscopy from a Single Institute

Cheong Jun Moon, MD, Eun Jung Lee, MD, Yoon Hong Chun, MD, Jong-seo Yoon, MD, Hyun Hee Kim, MD, Joon Sung Lee, MD

Department of Pediatrics, The Catholic University of Korea School of Medicine, Seoul, Korea

책임저자:전윤홍, 서울시 서초구 반포동 505번지 가톨릭대학교 의과대학 서울성모병원 소아청소년과 Tel: 02)2258-7612 Fax: 02)537-4544 E-mail: yoonhong76@gmail.com

Received 15 July 2011       Revised 23 August 2011       Accepted 12 September 2011

Copyright © 2011 The Korean Academy of Pediatric Allergy and Respiratory Disease

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Flexible bronchoscopy is effectively used in the diagnosis and treatment of respiratory diseases in children. This report attempted to analyze the indication, effectiveness, and complications of bronchoscopy in children who visited a single tertiary care, university-based hospital in Korea.

Methods

A retrospective review was conducted of the medical records of a total of 100 cases of flexible bronchoscopy that were performed at the Department of Pediatrics of the Catholic University of Korea Seoul St. Marys Hospital from April 8, 2007 to June 16, 2010.'

Results

A total of 85 patients (48 males and 37 females) were involved in the study. The range in age was 5 days old to 18 years old. Eighty cases were for diagnosis, 7 cases for treatment, and 13 cases for both. The purpose of flexible bronchoscopy was accomplished in 67 of 100 cases. In 60 cases where bronchoalveolar lavage was provided, microbial organisms were identified in 38 cases. Minor complications were observed in 12 cases.

Conclusion

Pediatric flexible bronchoscopy is shown to be an effective and safe diagnostic and interventional tool, even in young or immunocompromised hosts. This study also found that children under one year of age were more frequently treated with bronchoscopy and that the detection rate in microbiological diagnosis was improved due to the introduction of the virus polymerase chain reaction method.

Keywords: Pediatrics, Flexible, Bronchoscopy

References

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3. Efrati O, Sadeh-Gornik U, Modan-Moses D, Ba-rak A, Szeinberg A, Vardi A, et al. Flexible bronchoscopy and bronchoalveolar lavage in pediatric patients with lung disease. Pediatr Crit Care Med. 2009; 10:80–4.
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4. Kim CK, Chung CY. Usefulness of the flexible bronchoscopy for pediatric respiratory diseases. J Korean Pediatr Soc. 1999; 42:783–9.
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6. Kabra SK, Lodha R, Ramesh P, Sarthi M. Fiberoptic bronchoscopy in children an audit from a tertiary care center. Indian Pediatr. 2008; 45:917–9.
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8. Efrati O, Gonik U, Bielorai B, Modan-Moses D, Neumann Y, Szeinberg A, et al. Fiberoptic bronchoscopy and bronchoalveolar lavage for the evaluation of pulmonary disease in children with primary immunodeficiency and cancer. Pediatr Blood Cancer. 2007; 48:324–9.
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Table 1.
Characteristics of Patients
Characteristic Value
Gender (%)
  Male: Female 48:37
Age  
  1 mo ≤ 2
  1 mo-1 yr 43
  1 yr-3 yr 11
  3 yr-10 yr 14
  10 yr-14 yr 10
  14 yr ≥ 20
Underlying diseases  
  No underlying diseases 32
Hemato-oncologic diseases 25
  Neurologic disease 12
  Cardiologic disease 4
  Prematurity 8
  Other anomaly 4
Table 2.
Indications for Pediatric Flexib ble Bron-choscopy
Variable Value
Purpose (%)
  Diagnostic 80
  Therapeutic 7
  Diagnostic and therapeutic 13
  Total 100
Indications (%) 33
  Pneumonia (persistent or in immunocompromised patients) 18
  Suspected congenital airway obstruction 15
  Persistent atelectasis 8
  Endotracheal tube extubation failure 4
  Foreign body aspiration 3
  Hemoptysis 19
  Others  
  Total 100
Table 3.
Yield of Pediatric Bronchoscopy
Variable Value
Bronchoscope insertion route  
  Nasopharyngeal 79
  Endotracheal tube 20
  Tracheostomy 1
Goal attainment 67
Changed treatment 34
Diagnosis change after procedure  
  Structural anomaly identification 33
  Microbiological identification 20
  Foreign body detection 4
  Other 1
Bronchoalveolar lavage-positive for microbes 38/60
Microbiological identification
  Tuberculosis 6
  Staphylococcus aureus 3
  Streptococcus pneumoniae 2
  Mycoplasma pneumoniae 2
  Raoutella ornitholytica 1
  Serratia marcescens 1
  Aspergillus 5
  Acinobacterbaumanni 1
  Acinobacter haemolyticus 1
  Pneumocystic carinii 1
  Enterobactor aerogenes 1
  Viruses 20

Values are presented as number of cases.

Table 4.
Complications of Pediatric Bronchoscopy
Complications∗ No. of cases
Convulsion 3
Fever 4
Dyspnea 2
Bleeding 1
Hypotension 1
Vomiting 1

∗ Twelve of total 100 cases.

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