PEDIATRIC BRONCHOSCOPY: 20-YEAR EXPERIENCE AT A REFERENCE CENTER IN RIO DE JANEIRO
DOI:
https://doi.org/10.47820/recima21.v4i2.2677Keywords:
Children, Pediatric, BronchoscopyAbstract
Objective: to describe 20-year experience of a pediatric bronchoscopy service, highlighting clinical and demographic aspects, indications, endoscopic findings and the occurrence of serious complications. Methods: descriptive, retrospective study of bronchoscopy exams performed from 2000 to 2019, in a pediatric hospital in Rio de Janeiro. Results: 1,372 exams were performed, 795 (58%) of which were boys and 676 (49%) were infants. Fiberoptic bronchoscopy (FB) was the technique used in 940 exams (69%). Stridor was the indication in 315 exams (21%), followed by investigation of radiological images (17%), tracheostomy revision (11%) and tracheal intubation complications (10%). Laryngomalacia was observed in 255 (68%) cases of stridor and inflammation (65-52%) and secretion plugs (34-27%) in cases of atelectasis. Subglottic stenosis was the endoscopic diagnosis in 71 (45%) of the exams performed due to tracheal intubation complications. Granuloma and supraostial malacia were present, respectively, in 35% and 20% of tracheostomized children. The frequency of major complications was 0.22%. There were no deaths. Conclusions: Laryngomalacia was the main diagnosis in cases of stridor. Subglottic stenosis is an important diagnosis in cases with previous tracheal intubation. The high frequency of supraostial complications in tracheostomized children reinforces the need for endoscopic evaluation prior to decannulation. Bronchoscopy proved to be a safe method in the pediatric population.
Downloads
References
Wood RE, Fink RJ. Applications of flexible bronchoscopes in infants and children. Chest 1978; 73: 737- 740.
Nicolai T. The role of rigid and flexible bronchoscopy in children. Paediatr Respir Rev 2011; 12: 190-5.
Faro A, Wood RE, Schechter MS, et al. Official American Thoracic Society technical standards: flexible airway endoscopy in children. Am J Respir Crit Care Med 2015; 191: 1066- 1080.
Midulla F, De Blic J, Barbato A, Bush A, Eber E, Kotecha S, et al.Flexible endoscopy of paediatric airways. Eur Respir J 2003; 22:698-708.
Sanchez I, Pesce C, Navarro M, Holmgren P, Bertrand N, Alvarez G. Experiencia en 10 años de aplicación de fibrobroncoscopia en pacientes pediátricos. Rev Med Chile 2003; 131: 1266-1272.
Lawlor C, Balakrishnan K, Bottero S, Boudewyns A, Campisi P, Carter J et al. International Pediatric Otolaryngology Group (IPOG): Juvenile-onset recurrent respiratory papillomatosis consensus recommendations. International Journal of Pediatric Otorhinolaryngology 128 (2020); 109697
Fortes HR, Ranke FM, Escuissato DL, Neto CAA, Zanetti G, Hochhegger B et al. Recurrent respiratory papillomatosis: A state-of-art review. Respiratory Medicine 2017; 126: 116-121
Boudewyns A, Claes J, Heyning PV. An approach to stridor in infants and children. Eur J Pediatr (2010) 169:135–141
Holinger LD. Evalution of stridor and wheezing. In: Holinger LD, Lusk RP, Green CG, editors. Pediatric laryngology and bronchoesophagology. Lippincott-Raven, Philadelphia; 1997. pp 41-48
Hoeve LJ, Rombout J. Pediatric laryngobronchoscopy. 1332 procedures stored in a data base. Int J Pediatr otorhinolaryngol; 24 (1992): 73-82
Barbato A, Magarotto M, Crivellaro M, Novello AJr, Cracco A, Blic J, Scheinmann P, Warner JO, Zach M. Use of the pediatric bronchoscope, flexible and rigid, in 51 European centres. Eur Respir J 1997; 10: 1761-1766
Le Roux P, de Blic J, Albertini M, Bellon G, Body G, Bremónt F, et al. La fibroscopiebronchique chez l’ enfant. Rev Mal Respir 2004; 21: 1098-106
Watters KF. Tracheostomy in Infants and Children. Respiratory Care 2017 June: vol 62 nº6
Lima ES, Oliveira MAB, Barone CR, Dias KMM, Rossi SD, Schweiger C et al. Incidence and endoscopic characteristics of acute laryngeal lesions in children undergoing endotracheal intubation. Braz J Otorhinolaryngol 2016;82(5):507-511
Sachdev A, Ghimiri A, Gupta N, Gupta D. Pre-decannulation flexible bronchoscopy in tracheostomized children. Pediatr Surg Int 2017 Nov;33(11):1195-1200
Fraga AMA, Reis MC, Zambon MP, Toro IC, Ribeiro JD, Baracat ECE. Foreign body aspiration in children: clinical aspects, radiological aspects and bronchoscopic treatment. J Bras Pneumol. 2008;34(2):74-82
Blic J, Marchac V, Scheinmann P. Complications of flexible bronchoscopy in children: prospective study of 1,328 procedures. Eur Respir J 2002; 20: 1271-1276
Carlens J, Fuge M, Price T, DeLuca D, Price M, Hansen G, et al. Complications and risk factors in pediatric bronchoscopy in a tertiary pediatric respiratory center. Pediatr Pulmonol 2018;53(5):619-627
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2023 RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218
This work is licensed under a Creative Commons Attribution 4.0 International License.
Os direitos autorais dos artigos/resenhas/TCCs publicados pertecem à revista RECIMA21, e seguem o padrão Creative Commons (CC BY 4.0), permitindo a cópia ou reprodução, desde que cite a fonte e respeite os direitos dos autores e contenham menção aos mesmos nos créditos. Toda e qualquer obra publicada na revista, seu conteúdo é de responsabilidade dos autores, cabendo a RECIMA21 apenas ser o veículo de divulgação, seguindo os padrões nacionais e internacionais de publicação.
Clique para ver detalhes 
