Rationale Flexible bronchoscopy (FB) with bronchoalveolar lavage (BAL) is an increasingly important investigation in paediatric respiratory medicine and greatly facilitates diagnostic tests deep in the airway. In this study we aimed to (1)assess indications (2)assess diagnostic yield (3)analyse changes in patient management (4)assess FB complication rate and (5)to determine if international best practice guidelines are being followed based on FB procedure, equipment and patient care. Methods A retrospective review of 158 paediatric FB performed by a single operator over a 4 year period was undertaken. Patient details, indication for procedure, co-morbidities, clinical and radiological information, bronchoscopic appearances, microbiological findings, histopathological findings and complications related to procedure were available. Care of equipment and operating procedures were examined. All findings were assessed for adherence to international best practice guidelines on best practice. Results 158 flexible bronchoscopies were performed under general anaesthesia in theatre. The age range was between one month and 17 years. Male to female ratio was equivocal, 51% and 49% respectively. Indications for bronchoscopy included lower respiratory tract infection, chronic cough (unresponsive to asthma therapy), persistent lobar collapse/atelectasis, cystic fibrosis, bronchiectasis, primary ciliary dyskinesia and haemoptysis. Normal airway anatomy was seen in the majority of cases. Abnormal bronchoscopic findings included purulent secretions +/- occluding airway, bronchomalacia, abnormal anatomy of the bronchial tree, alveolar haemorrhage and carcinoid tumour. The commonest organisms cultured included Haemophilus Influenzae and Moraxella Catarrhalis. CMV was identified and Aspergillus Fumigatus was the only fungus identified. Haemosiderin and lipid laden macrophages were tested in all patients. Equipment care, bronchoscopy procedure and post operative patient care were in adherence with best practice guidelines. Conclusion Paediatric FB is a safe and useful procedure when clinically indicated. In our hands it is a safe procedure.
Poster Board # G33
Full conference title:
American Thoracic Society International Conference
- ATS 2010