Dan Bar-Zohar1, Yakov Sivan. 1. Pediatric Intensive Care, Dana Children's Hospital, Tel-Aviv Medical Center, 6 Weizman Street, Tel-Aviv 64239, Israel.
Abstract
STUDY OBJECTIVE: To evaluate the contribution of flexible fiberoptic bronchoscopy (FFB) and BAL to the clinical management of patients in a pediatric ICU (PICU). SETTING AND DESIGN: A retrospective study based on medical records in a six-bed pediatric ICU of a tertiary care children's hospital serving as a referral center for airway surgery. PATIENTS AND PARTICIPANTS: One hundred consecutive infants and children hospitalized in a PICU, who underwent FFB with or without BAL. MEASUREMENTS AND RESULTS: One hundred fifty-five procedures were performed, for the following causes: search for airways anatomic pathologies (114 of 155 procedures, 74%), including 55 procedures during the perioperative period of airway surgery; treatment of atelectasis (35 of 155 procedures, 22.5%); and BAL (30 of 155 procedures, 19%). Thirty-five percent of procedures had more than one cause. Airway pathology was observed in 79 of 114 procedures (69%). Management changed from conservative to surgical in 44 of 114 procedures (39%). In airway surgery cases, reoperation subsequent to postoperative FFB took place in 35%. BAL results changed antimicrobial treatment in 15 of 30 cases, with clinical improvement in 10 of 30 cases (33%). Treatment of atelectasis was successful in 26 of 35 cases (74.3%). No procedure-related mortality, life-threatening complications, or significant changes in patient status occurred. CONCLUSIONS: FFB is an important and safe procedure in very sick infants and children with a variety of respiratory diseases, and significantly contributes to their management. FFB should be considered to be a PICU staff expertise.
STUDY OBJECTIVE: To evaluate the contribution of flexible fiberoptic bronchoscopy (FFB) and BAL to the clinical management of patients in a pediatric ICU (PICU). SETTING AND DESIGN: A retrospective study based on medical records in a six-bed pediatric ICU of a tertiary care children's hospital serving as a referral center for airway surgery. PATIENTS AND PARTICIPANTS: One hundred consecutive infants and children hospitalized in a PICU, who underwent FFB with or without BAL. MEASUREMENTS AND RESULTS: One hundred fifty-five procedures were performed, for the following causes: search for airways anatomic pathologies (114 of 155 procedures, 74%), including 55 procedures during the perioperative period of airway surgery; treatment of atelectasis (35 of 155 procedures, 22.5%); and BAL (30 of 155 procedures, 19%). Thirty-five percent of procedures had more than one cause. Airway pathology was observed in 79 of 114 procedures (69%). Management changed from conservative to surgical in 44 of 114 procedures (39%). In airway surgery cases, reoperation subsequent to postoperative FFB took place in 35%. BAL results changed antimicrobial treatment in 15 of 30 cases, with clinical improvement in 10 of 30 cases (33%). Treatment of atelectasis was successful in 26 of 35 cases (74.3%). No procedure-related mortality, life-threatening complications, or significant changes in patient status occurred. CONCLUSIONS:FFB is an important and safe procedure in very sick infants and children with a variety of respiratory diseases, and significantly contributes to their management. FFB should be considered to be a PICU staff expertise.
Authors: Soumendu S Manna; Andrew Durward; Shyamala Moganasundram; Shane M Tibby; Ian A Murdoch Journal: Intensive Care Med Date: 2006-08-29 Impact factor: 17.440
Authors: John S Bradley; Carrie L Byington; Samir S Shah; Brian Alverson; Edward R Carter; Christopher Harrison; Sheldon L Kaplan; Sharon E Mace; George H McCracken; Matthew R Moore; Shawn D St Peter; Jana A Stockwell; Jack T Swanson Journal: Clin Infect Dis Date: 2011-08-31 Impact factor: 9.079