Pediatric Flexible Bronchoscopy and Its Application in Infantile Atelectasis

Abstract

Forty-six pediatric flexible fiberoptic bronchoscopies were done on 29 infants under 1 year of age, including a 2.3-kg 1-week-old infant girl, and 17 small children between 1 and 2 years of age with persistent unilobar or multilobar atelectasis and declining PaO2 or rising PaCO2. Atelectasis resolved in all 29 infants (100%) and 10 of 17 (59%) small children after direct visualization, bronchial washing, and removal of mucous plugs and/or secretions using a flexible fiberoptic bronchoscope (FFB). The procedure was not associated with any mortality or significant morbidity. Only one infant experienced minor epistaxis and another had transient minimal stridor. None of the 17 small children developed complications. The procedure resulted in resolution of respiratory distress and cough within 24 hours, as well as early hospital discharge in all patients regardless of complete or partial radiographic expansion. Arterial blood gases were improved or normalized in 16 patients. When utilized for selective aspiration of mucous plugs or bronchial secretions, pediatric flexible bronchoscopy is particularly helpful in children with segmental or lobar atelectasis.