Bodo Niggemann1, Marion Haack, Andreas Machotta. 1. Department of Pediatric Pneumology and Immunology, University Hospital Charite of Humboldt University, Berlin, Germany. bodo.niggemann@charite.de
Abstract
BACKGROUND: Bronchoscopies are performed in childhood for diagnostic reasons (e.g. evaluation of stridor, unexplained cough, possible malformations) and therapeutic reasons (e.g. foreign body removal, management of the difficult airway). METHODS: Various procedures of entering the pediatric airways are presented, based on an overview of the literature and the experience of the authors. RESULTS: The advantages and disadvantages of direct fibreoptic bronchoscopy, bronchoscopy via face mask, via laryngeal mask airway, via tracheal tube, and for combined flexible and rigid bronchoscopy are discussed. In addition, practical aspects of bronchoscopy are considered, including local anesthesia, oxygen supplementation, monitoring, antibiotic treatment. CONCLUSIONS: Although inspection of the pediatric airways has become a well-accepted routine procedure with a high diagnostic yield, and bronchoscopies are well tolerated, it is important that the most appropriate means of access to the airways is chosen according to the indications and the age of the child.
BACKGROUND: Bronchoscopies are performed in childhood for diagnostic reasons (e.g. evaluation of stridor, unexplained cough, possible malformations) and therapeutic reasons (e.g. foreign body removal, management of the difficult airway). METHODS: Various procedures of entering the pediatric airways are presented, based on an overview of the literature and the experience of the authors. RESULTS: The advantages and disadvantages of direct fibreoptic bronchoscopy, bronchoscopy via face mask, via laryngeal mask airway, via tracheal tube, and for combined flexible and rigid bronchoscopy are discussed. In addition, practical aspects of bronchoscopy are considered, including local anesthesia, oxygen supplementation, monitoring, antibiotic treatment. CONCLUSIONS: Although inspection of the pediatric airways has become a well-accepted routine procedure with a high diagnostic yield, and bronchoscopies are well tolerated, it is important that the most appropriate means of access to the airways is chosen according to the indications and the age of the child.
Authors: Debra Boyer; Mary Nevin; Carey C Thomson; Don B Sanders; Stamatia Alexiou; Samuel B Goldfarb; Jennifer L Nicholas; Paul G Thacker; Andrea M Coverstone; Albert Faro; George Cheng; Adnan Majid; Paul E Moore Journal: Ann Am Thorac Soc Date: 2015-11