Background and aims In 2011 we started implementing flexible bronchoscopy in our PICU for management of critically ill patients and children with home ventilation. It was our goal to implement this technique as a routine diagnostic an interventional tool and to characterise possible benefits and risks.
Methods This is a prospective study performed in a 10-bed paediatric ICU of a tertiary care children’s hospital. All patients who underwent a bronchoscopy in the years 2012–2013 were included in this study. Olympus and Storz bronchoscopes with 2.2 mm, 2.8 mm and 3.8 mm diameter were used and every procedure was video documented. All procedures were performed by trained paediatric intensive care specialist.
Results 151 procedures were performed in 96 patients. Indications were: Treatment of atelectasis and obstruction (78 of 151 procedures), with improvement in ventilation parameters in 61 of 78 procedures (78%); search for airways anatomic pathologies (45 of 151 procedures), with pathological findings in 26 of 45 procedures (58%); Pneumonia and undetermined lung disease in which cases BAL was preformed (29 of 151 procedures), with changed antimicrobial treatment in 17 of 29 cases (59%). We didn’t observe any procedure-related mortality or serious complications.
Conclusions Flexible bronchoscopy is a very safe and useful procedure in critical ill infants and children with a variety of diseases, and significantly contributes to their management. In our opinion bronchoscopy should be a routine technique in paediatric intensive care units.
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