Bronchoscopy in Pediatric Critical Care

Abstract

Flexible Bronchoscopy is a virtual emise through the tracheo-bronchial tree. Real time evaluation of the airways in 3 dimensions makes it an invaluable tool for the diagnosis of conditions like tracheomalacia, bronchomalacia, tracheo-esophageal fistula, mucus plugs and many more indications, which would otherwise be left to the imagination and heroic computerized reconstructions and manipulations of the radiologist. In today’s age we have entered a whole new world of interventional pulmonology, wherein therapeutic interventions like removal of foreign bodies, balloon dilatation of stenotic segments, intra-bronchial instillation of glue, removal of mucus plugs and such other techniques are possible. To a novice, bronchoscopy done in the intensive care setting, where most of the patients are intubated would be so veiy exciting and deceptively easy. After all, no sweat lost while tumbling over the dreadful twists and turns of the upper airways, no chance of accidental entry of the esophagus and most of all, no embarrassments to be faced when the scope does not enter the glottis in a few attempts. But, the fact remains that especially in these high-risk patients, one has to be absolutely sure of the justification of the procedure, since bronchoscopy is an invasive procedure, which can cause a lot of hemodynamic alterations especially in critically ill patients.

Keywords

• flexible bronchoscopy
• critically ill patients
• hemodynamic alterations
• pediatric.