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

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

doi:10.7581/pard.2011.21.4.313

Journal List > Pediatr Allergy Respir Dis > v.21(4) > 1033142

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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

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.

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Keywords: Pediatrics, Flexible, Bronchoscopy

References

1. Nussbaum E. Pediatric fiberoptic bronchoscopy: clinical experience with 2,836 bronchoscopies. Pediatr Crit Care Med. 2002; 3:171–6.

2. Tang LF, Chen ZM. Fiberoptic bronchoscopy in neonatal and pediatric intensive care units: a 5-year experience. Med Princ Pract. 2009; 18:305–9.

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.

4. Kim CK, Chung CY. Usefulness of the flexible bronchoscopy for pediatric respiratory diseases. J Korean Pediatr Soc. 1999; 42:783–9.

5. Kim KW. Clinical applications of pediatric bronchoscopy in pediatric pulmonary diseases. Pediatr Allergy Respir Dis(Korea). 2000; 10:233–41.

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.

7. Davidson MG, Coutts J, Bell G. Flexible bronchoscopy in pediatric intensive care. Pediatr Pulmonol. 2008; 43:1188–92.

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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