Flexible fiberoptic bronchoscopy in the neonatal intensive care unit.

The pediatric otolaryngologist is often asked to evaluate intubated patients in the neonatal intensive care unit (NICU) because of sudden deterioration in respiratory status unresponsive to medical management. Previously, evaluation of infants required transportation to the operating room for rigid endoscopy. At the present time, however, flexible fiberoptic bronchoscopy may be performed on such patients in the NICU as an initial diagnostic or therapeutic measure. The procedure is performed through an endotracheal tube or tracheostomy tube already in place, thereby assuring maintenance of a safe airway. Ten representative cases are presented detailing the indications, technique and potential applications in the NICU.