The role of rigid bronchoscope combined with high frequency ventilation in the diagnosis and treatment of infantile acute fibrinous laryngotracheobronchitis

Abstract

Objective:To explore the role of rigid bronchoscope combined with high frequency ventilation in the diagnosis and treatment of infantile acute fibrinous laryngotracheobronchitis. Method:The clinical data of 7 children with acute fibrinous laryngotracheobronchitis were analyzed retrospectively. Laryngology and bronchoscopy were conducted by hard tube bronchoscopy combined with high frequency ventilation in all cases. During the operation, a large quantity of membranous scabs was removed from subglottic area, trachea and bronchus. Result:Six cases were treated by emergency operation and cured. One patient was treated with mechanical ventilation for 48 hours because of respiratory failure. Then the operation was performed to remove the endogenous foreign body since no improvement was observed after prolonged ventilation. This patient died of multiple organ failure. The histopathological examination of these 7 cases of endogenous foreign bodies showed fibrinous exudation and necrosis, accompanied by a large quantity of inflammatory cells infiltration. Conclusion:Removal of the plastic endogenous foreign bodies which block the respiratory tract by rigid bronchoscope and high frequency ventilation under general anesthesia facilitates the diagnosis and treatment of acute fibrinous laryngotracheobronchitis in pediatric patients. Prompt surgical intervention could relieve the obstruction of respiratory tract, which is crucial to reduce mortality.