Rigid bronchoscopies were performed on 34 children, and flexible bronchoscopies on six children.
Thirty-one children in Grade I dyspnea underwent early bronchoscopies. Rigid bronchoscopies were performed on 26 patients (83.9%) while flexible bronchoscopies on six patients (19.4%).
According to our experience airway complications including bronchospasm, laryngospasm and laryngeal edema during or after anesthesia were observed more commonly in children with a chronic history and organic material (walnut, peanut, wheat, chestnut) aspiration, in foreign bodies which led to trauma in the pulmonary parenchyma (needle, bone, pen tip, toy parts), in prolonged bronchoscopies (>1 hour), in children who had active lung infection or upper respiratory tract infection during the procedure.
Data of the bronchoscopies performed between 2006 and 2011 in the operation room of Pediatric Surgery in Cerrahpasa Medical Faculty Age of the patient (years) (mean [+ or -] SD) 3.71 [+ or -] 2.48 Gender N (%) Male 298 (74%) Female 103 (26%) Symptoms Acute cough 329 (82%) Dyspnea 88 (21.8%) Wheezing 28 (7%) Cyanosis 10 (2.5%) Physical examination Wheezing 164 (40.9%) Stridor 90 (22.5%) Decrease in lung sounds unilaterally 132 (33%) Normal lung sounds 80 (20%) SpO2 %95 48 (12%) Lung graphy findings Air trapping 229 (57%) Atelectasia 20 (5%) Foreign body appearance 57 (14.2) Normal appearance 84 (21%) Pneumiae 32 (8%) Pneumothorax 8 (2%) Localization Right main bronchus 197 (49.1%) Left main bronchus 98 (24.4%) Other 35 (8.7%) No foreign body 71 (17.7%) Table 2.
In the 12 months before the first patient's bronchoscopy on June 4, 2008, approximately 4,900 endoscopies had been performed in the suite, including 500 bronchoscopies. On July 21, 2008, as part of the clinical surveillance, the medical center's laboratory director reported to ADHS a cluster of four patients who had Legionella isolated from specimens obtained during bronchoscopies.
Investigators identified no other source of nonsterile water used during bronchoscopies, or other pertinent breaches in infection control practices or bronchoscope sterilization or reprocessing.
Exclusion criteria were patients who needed emergent bronchoscopies
and those who had negative bronchoscopies
We feel it would be worthwhile to perform it routinely in all such diagnostic bronchoscopies
were performed using three Olympus BF-P20D (Olympus America, Inc., Melville, New York) bronchoscopes, each processed in the same STERIS System 1 processor.
1): The total numbers of bronchoscopies
performed for foreign body bronchus across the year were eighty (80).
Bronchoscopy is the procedure of choice for diagnosis and removal of the foreign body as well.7,8 Theimportant point is a large number of negative bronchoscopies
in published studies which demonstrates that failed bronchoscopy to find the foreign body is much better than imposing the morbidity or even mortality to the patient from missing AFA diagnosis.3 Clinicians specially pediatricians should remember that "all that wheezes is not asthma" and normal or nonspecific CXR even a normal chest CT doesn't rule out a foreign body aspiration and in any child with stridor, wheezing or combination of these two,foreign body aspiration should be considered and if primary workup is not conclusive then bronchoscopy is a worthy tool to help the physician to be directedto correct diagnosis.3
The three patients who sustained second degree surface burns (with 1%, 4% and 5% total surface area burned) were found to have grades G1, G2, and G1 respectively at the time of their bronchoscopies
. The patient that had sustained lower limb crush injury syndrome was classified as G1.