Pediatric Pulmonology

Pediatric Bronchoscopy

Bronchoscopy is an essential procedure performed by pulmonologists to visually examine the airways. Primarily used for diagnosis of infectious, structural, and functional abnormalities of airways and peripheral lung tissue, it can also be used to treat specific conditions. Information obtained during bronchoscopy can contribute to definitive diagnoses in approximately 80% of cases. Patient safety and comfort are primary concerns for all patients. Many Center for Pediatric Pulmonary Medicine patients have complex multisystem illnesses or require ICU level care, and a higher rate of procedural complications might be expected. Other than transient hypoxemia, multiple series report complication rates < 5%.¹ Common minor complications include airway bleeding, epistaxis, and excessive cough. Major complications include apnea, bradycardia, postprocedure atelectasis, and sustained oxygen desaturations < 90% related to laryngospasm or bronchospasm. In 2018, only two patients (1.25%) experienced fever - a minor complication. Two patients, who were medically fragile, had major complications requiring a higher level of care and respiratory support.

Pediatric Bronchoscopy Outcomes (N = 384)

2016 - 2018

Complications 2016 2017 2018
Major, N (%) 0 (0.00) 0 (0.00) 2 (1.25)
Minor, N (%) 1 (1.09) 4 (3.00) 2 (1.25)
No complications, N (%) 90 (98.91) 129 (97.00) 156 (97.50)
References

¹Midulla F, de Blic J, Barbato A, Busch A, Eber E, Kotecha S, Haxby E, Moretti C, Pohunek P, Ratjen F; ERS Task Force. Flexible endoscopy of paediatric airways. Eur Respir J. 2003 Oct;22(4):698-708.