engleski

Flexible bronchoscopy in children

Aim: To evaluate characteristics of flexible bronchoscopy (FB) in children. Methods: analysis of 214 FB (Fujinon YP-2, Olympus BF-XP 40) in the Pediatric Clinic and PICU during the years 1999-2005. Results: Average age 8.3±5.1 years. Main indications were bronchopneumonia 84(39%), TB 29(14%), atelectasis 21(10%), aspiration of a foreign body 18(8%) and polytrauma 15(7%). Main method of anesthesia was deep sedation (Fentanyl, Midazolam) in 98(46%) then local anesthesia (Lidocain) 97(45%) and general anesthesia in 14 children (6%). Bronchoscope was mostly introduced transnasally in 136 (64%), orally 33(15%) and through a ET tube in 24(11%) children. Frequent results were hyperemia of mucosa 125(58%), hypersecretion 97(45%), oedema of mucosa 35(16%), pus secretion 34(16%), narrowed and blocked airways 29 (14%) and bleeding 14 (7%). Bronchoscopic biopsy revealed one NonHodgkin lymphoma of bronchi. Microbiology results: predominantly Pseudomonas aeruginosa 15(7%), Staphylococcus aureus 11(5%), Klebsiella pneumoniae 7(3%), Haemophilus influenzae 6(3%). One sample was positive for acidoresistant bacilli and Mycobacterium tuberculosis. Complications: One pneumothorax, 2 cases of bigeminia. Conclusion: FB is a reliable method of diagnosing and treatment of pediatric pulmonary patients. The most acceptable methods in children are with local anesthetics and deep sedation.

flexible bronchoscopy; children; anesthesia

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