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Actualmente, la fibrobroncoscopia (FBC) es una técnica indispensable en las unidades de neumología pediátrica. En nuestro centro se han realizado 69 exploraciones desde abril de 1993 a noviembre de 1994, en niños menores de 14 años. Hemos empleado un fibrobroncoscopio Olympus BF3C20, y sedación diazepam o midazolam, asociada o no a fentanilo y atropina. Se realizaron 59 exploraciones sin intubar, 9 intubados, y uno intubado pero por fuera del tubo endotraqueal. El 60,37% tenía menos de 3 años. Las indicaciones de la FBC fueron: patología de la vía alta (16,98%), patología de la vía aérea inferior (75,47%), y exclusivamente exploradora (7,54%). Los hallazgos endoscópicos fueron: patología de la vía alta (8,6%), patología endobronquial (52,17%); compresión bronquial extrínseca (4,34%) y normal (13,04%). En un 52,17% de los casos se tomaron muestras. No hubo ninguna complicación importante, excepto mínimos descensos de la saturación de oxígeno.
Palabras clave:
Fibrobroncoscopia pediátrica
Fiberoptic bronchoscopy is at present an indispensable technique in pediatric pulmonology. Sixty-nine such procedures were performed at our center between April 1993 and November 1994 on children under 14 years-old. We used an Olympus BF-3C20 fiberoptic bronchoscope, after providing sedation with diazepam or midazolam, sometimes accompanied by fentanyl and atropine. No intubation was required in 59 cases. In 9 cases intubation was orotracheal. In one patient the tubes were inserted outside the trachea. The mdications for bronchoscopy were upper airways disease (16.98%), lower airways disease (75.47%) and exploratory in 7.54%. The endoscopic findings were upper airways disease (8.6%), bronchial disease (52.17%), extrinsic bronchial compression (4.34%) and normal (13.04%). Samples were taken in 52.17%. No important complications occurred but there were slight decreases in oxygen saturation.
Key words:
Pediatric fiberoptic bronchoscopy
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Bibliografía
[1.]
R.E. Wood, R.J. Fink.
Applications of flexible fiberoptic bronchoscopes in infants and children.
Chest, 73 (1978), pp. 737-740
[2.]
S.K. Nagaraj, R. Shott, R. Fellows.
Recurrent lobar atelectasis due to acquired bronchial stenosis in neonates.
J Pediatr Surg, 15 (1980), pp. 411-415
[3.]
R. Vigneswarn, J.M. Whitfield.
The use of a new ultra-thin fiberoptic bronchoscope to determine endotracheal tube position in the sick new-born infant.
Chest, 80 (1981), pp. 174-177
[4.]
R.E. Wood.
Spelunking in the pediatric airway: explorations with the flexible fiberoptic bronchoscope.
Pediatric Clin North Am, 31 (1984), pp. 785-799
[5.]
M. Kattan, Z. Ben-Zvi.
Stridor caused by vocal cord malfunction associated with emotional factors.
Clin Pediatr, 24 (1984), pp. 158-160
[7.]
L. Grylack, K. Anderson.
Diagnosis and treatment of traumatic granuloma in tracheobronchial tree of newborn with history of chronic intubation.
J Pediatr Surg, 19 (1984), pp. 200-201
[8.]
A. Labbe, B. Dalens, J.R. Lusson, P. Dechelotte, M. Meyer.
Flexible bronchoscopy in infants and children.
Endoscopy, 16 (1984), pp. 13-15
[9.]
R.E. Wood, M.W.L. Gauderer.
Flexible fiberoptic bronchoscopy in the management tracheobronchial foreign bodies in children.
The valué of a combined approach with open tube bronchoscopy. J Pediatr Surg, 19 (1984), pp. 693-698
[10.]
S.J. Gould, J.M. Graham.
Adquired subglottic stenosis in neonates.
Clin Otolaryngol, 10 (1985), pp. 299-302
[11.]
R.E. Wood.
Clinical application of ultrathin flexible bronchoscopes.
Pediatr Pulmonol, 1 (1985), pp. 244-248
[12.]
S. Kivity, H. Bibi, Y. Schwarz.
Variable vocal cord dysfunction presenting as wheezing and exercise-induced asthma.
J Asthma, 23 (1986), pp. 241-244
[13.]
J.L. Sotomayor, R.I. Godinez, S. Borden, R.E. Wilmott.
Large airway collapse due to adquired tracheobronchomalacia in infancy.
AJDC, 140 (1986), pp. 367-371
[14.]
L.L. Fan, L.M. Sparks, J.P. Dulinski.
Applications of an ultrathin flexible bronchoscope for neonatal and pediatric airway problems.
Chest, 89 (1986), pp. 673-676
[15.]
J.S. Wagener.
Fatality following fiberoptic: bronchoscopy in a 2 years-old child.
Pediatric Pulmonol, 3 (1987), pp. 197-199
[16.]
J.M. Sherman.
Rigid o flexible bronchoscopy in children.
Pediatric Pulmonol, 3 (1987), pp. 141-144
[17.]
D.A. Bowdler, J.H. Rogers.
Subglottic stenosis in children: a conservative approach.
Clin Otoralyngol, 12 (1987), pp. 383-388
[18.]
R.F. Ward, J.E. Arnold, G.B. Healy.
Flexible minibronchoscopy in children.
Ann Otol Rhinol Laryngol, 96 (1987), pp. 645-649
[19.]
P.P. Kleeman, Jantzen J-PAH, P. Bonfil.
The ultra-thin bronchoscope in management of the difficult pediatric airway.
Can J Anaesth, 34 (1987), pp. 606-608
[20.]
R.E. Wood, D. Postma.
Endoscopy of the airway in infants and children.
J Pediatr, 112 (1988), pp. 1-6
[21.]
R.C. Cohn, C. Kercsmar, D. Dearborn.
Safety and efficacy of flexible endoscopy in children with bronchopulmonary dysplasia.
AJDC, 142 (1988), pp. 1.225-1.228
[22.]
C.M. Krecsmar, R.J. Martin, R.L. Chatburn, V.A. Cario.
Hallazgos broncoscópicos en recién nacidos tratados con ventilación de alta frecuencia frente a la convencional.
Pediatrics (ed. esp.), 26 (1988), pp. 333-336
[23.]
L.R. Frankel, D.W. Smith, N.J. Lewiston.
Bronchoalveolar lavage for diagnosis of pneumonía in the immunocompromised child.
Pediatrics, 81 (1988), pp. 785-788
[24.]
E.N. Pattishall, B.E. Noyes, D.M. Orenstein.
Use of bronchoalveolar lavage in immunocompromised children with pneumonía.
Pediatr Pulmonol, 5 (1988), pp. 1-5
[25.]
M.J. Rock, C.H.G. Green, R.M. Pauli, M.E. Peters.
Tracheomalacia and bronchomalacia associated with Larsen syndrome.
Pediatric Pulmonology, 5 (1988), pp. 55-59
[26.]
L.L. Fan, L.M. Sparks, E.J. Fix.
Flexible fiberoptic endoscopy for airway problem in pediatric intensive care unit.
Chest, 93 (1988), pp. 556-560
[27.]
P. Howardy-Hansen, P. Berthelsen.
Fiberoptic bronchoscopic nasotracheal intubation with Pierre Robin syndrome.
Anaesthesia, 43 (1988), pp. 121
[28.]
D.C. Stokes, J.L. Shenep, D. Partham, P.M. Bozeman, W. Mariencheck, P. Mackert.
Role of flexible bronchoscopy in the diagnosis of pulmonary infiltrates in pediatric patients with cancer.
J Pediatr, 115 (1989), pp. 561-567
[29.]
J. De Blic, S. Blanche, C. Danel, M. Le Bourgeois, M. Caniglia, P. Sheinmann.
Bronchoalveolar lavage in VIH infected patients with interstitial pneumonitis.
Arch Dis Child, 64 (1989), pp. 1.2461.250
[30.]
N.N. Finer, P.C. Etches.
Fiberoptic bronchoscopy in the neonate.
Pediatric Pulmonology, 7 (1989), pp. 116-120
[31.]
E.S. Shinwell, R.D. Higgins, R.L. Auten, D.L. Shapiro.
Fiberoptic bronchoscopy in the treatment of intubated neonates.
AJDC, 143 (1989), pp. 1.064-1.065
[32.]
J.M. Sherman, H. Nelson.
Decreased incidence of subglotic stenosis using an “Appropriate-Sized” endotracheal tube in neonates.
Pediatric Pulmonology, 6 (1989), pp. 183-185
[33.]
G.B. Healy.
Subglottic stenosis.
Otolaryngol Clin Nort Am, 22 (1989), pp. 599-606
[34.]
S.J. Gould, J.M. Graham.
Long term pathological sequelae of.neonatal endotracheal intubation.
J Laryng Otol, 103 (1989), pp. 622-625
[35.]
D.B. Baines, M.A. Goodrick, E.J. Beckenham, J.H. Overton.
Fiberoptically guided endotracheal intubation in a child.
Anaesth Intestive Care, 17 (1989), pp. 354
[36.]
R.E. Wood, J.R. Pick.
Model Systems for learning pediatric flexible bronchoscopy.
Pediatric Pulmonology, 8 (1990), pp. 168-171
[37.]
R.E. Wood.
Pitfalls in the use of the flexible bronchoscope in pediatric patients.
Chest, 97 (1990), pp. 199-203
[38.]
Y. Amitai, E. Zylber, A. Avital, D. Zangen, N. Noviski.
Serum lidocaine concentrations in children during bronchoscopy with topical anesthesia.
Chest, 98 (1990), pp. 1.370-1.373
[39.]
R.G. Azizkhan, S.R. Lacey, R.E. Wood.
Acquired symptomatic bronchial stenosis in infant: successful management using an Argon laser.
J Pediatr Surg, 25 (1990), pp. 19-24
[40.]
M.M. Logvinoff, K.Y. Lau, D.B. Weinstein, P. Chandra.
Episodic stridor in a child secondary to vocal cord dysfunction.
Pediatric Pulmonology, 9 (1990), pp. 46-48
[41.]
D.E. Schellhause, L.M. Grahan, E.J. Fix, L.M. Sparks, L.L. Fan.
Diagnosis of tracheal injury in mechanically ventilated premature infants by flexible bronchoscopy. A pilot study.
Chest, 98 (1990), pp. 1.219-1.225
[42.]
H.J. Puhakka, P. Kero, P. Valli, E. Isalo, M. Erkinjuntti.
Subglottic stenosis in neonates and children.
Acta Pediatr Scand, 79 (1990), pp. 397-401
[43.]
R.E. Wood, R.G. Azizkhan, J. Sidman, S.R. Lacey, A. Drake.
Surgical applications of ultrathin flexible bronchoscopes in infants.
Ann Otol Rhinol Laryngol, 100 (1990), pp. 116
[44.]
J. Raine, J.O. Warner.
Fiberoptic bronchoscopy without general anaesthetic.
Arch Dis Child, 66 (1991), pp. 481-484
[45.]
B.M. Schnapf.
Oxygen desaturation during fiberoptic bronchoscopy in pediatric patients.
Chest, 99 (1991), pp. 591-594
[46.]
J.A. Birriel, J.A. Adams, M.A. Saldana, K. Mavunda, S. Goldfinger, D. Vernon, et al.
Diagnóstico de enfermedad pulmonar en el síndrome de inmunodeficiencia adquirida (sida) en pediatría.
Papel de la broncoscopia flexible y del lavado broncoalveolar. Pediatrics (ed. esp.), 31 (1991), pp. 312-314
[47.]
F.C. Chaten, S.E. Lucking, E.S. Young, J.J. Mickell.
Stridor: intracranial pathology causing postextubation vocal cords paralysis.
Pediatrics, 87 (1991), pp. 39-43
[48.]
A. Malfroot, F.V. Tussenbroek, G.V. Nooten, I. Dab.
Endoscopio diagnosis and closure of a bronchopleural fístula.
Pediatric Pulmonology, 11 (1991), pp. 280-282
[49.]
J. De Blic, C. Delacourt, P. Scheinmann.
Ultrathin flexible bronchoscopy in neonatal intensive care units.
Arch Dis Child, 66 (1991), pp. 1.383-1.385
[50.]
C.G. Green.
Assessment of the pediatric airway by flexible bronchoscopy.
RespirCare, 36 (1991), pp. 555-568
[51.]
M. Bruce, D.O. Schnapf.
Oxygen desaturation during fiberoptic bronchoscopy in pediatric patients.
Chest, 99 (1991), pp. 591-594
[52.]
J. Pérez-Frías, E. Pérez-Ruiz, I. Duran Hidalgo, G. Milano Manso, A. Martínez Valverde.
Fibrobroncoscopia en el paciente pediátrico, sin anestesia general.
An Esp Pediatr, 37 (1992), pp. 42-46
[53.]
D.C. Stokes.
Guest editorial: is there room for another pediatric bronchoscope?.
Pediatric Pulmonology, 12 (1992), pp. 201-202
[54.]
W.M. Foster, A.N. Hubewith.
Aerosolized lidocaine reduced doses of topical anesthetic for bronchoscopy.
Am Rev Resp Dis, 146 (1992), pp. 520-522
[55.]
P.M. Bozeman, D.C. Stokes.
Diagnostic methods in pulmonary infections of immunocompromised children: bronchoscopy, needle aspiration and open biopsy.
Infections in immunocompromised infant and children., pp. 805-816
[56.]
N.N. Finer, D. Muzyka.
Flexible endoscopic intubation of the neonate.
Pediatric Pulmonology, 12 (1992), pp. 48-51
[57.]
E.S. Shinwell.
Ultrathin fiberoptic bronchoscopy for airway toilet in neonatal pulmonary atelesctasis.
Pediatric Pulm, 13 (1992), pp. 48-49
[58.]
K.B. Stigers, J.H. Woodring, J.F. Kanga.
The clinical and imaging spectrum of findings in patients with congenital lobar emphysema.
Pediatric Pulmonology, (1992), pp. 160-170
[59.]
K.S. McCoy, C.H.E. Bagwell, M. Wagner, J. Sallent, M. O’Keefe, P.C. Kosch.
Spirometric and endoscopy evaluation of airway collapse in infants with bronchopulmonary dysplasia.
Pediatric Pulmonology, 14 (1992), pp. 23-27
[60.]
J. De Blic, P. Scheinmann.
Fiberoptic bronchoscopy in infants.
Arch Dis Child, 67 (1992), pp. 159-161
[61.]
R.G. Azizkhan, D.L. Grimmer, F.B. Askin, S.R. Lacvey, D.F. Merten, R.E. Wood.
Adquired lobar emphysema (overinflation): clinical and pathological evaluation of infants requiring lobectomy.
J Pediatr Surg, 27 (1992), pp. 1.145-1.152
[62.]
M. Keszler, F.C. Rycman, J.V. McDonald, L.D. Sweet, M.G. Morant, M.J. Boegli, C. Cox, C.A. Leftridge.
A prospective, multicenter, randomized study of high versus low positive end espiratory pressure during extracorpored membrane oxygenation.
J Ped, 120 (1992), pp. 107-113
[63.]
Medical Section of American Lung Association.
Flexible endoscopy of the pediatric airway.
Am Rev Respir Dis, 145 (1992), pp. 233-235
[64.]
J. Pérez Frías, A. Pérez Ruiz, B. González Martín, B. Picazo, A. Martínez Valverde.
Fibrobroncoscopia infantil.
Adaptación a los consensos de la American Thoracic Society. Arch Bronchoneumol, 29 (1993), pp. 73-76
[65.]
J. Sánchez Lastres, A. Rodríguez Núñez, A. Bautista Casanovas, R. Cánovas, A. Gancedo.
Tuberculosis endotraqueal y endobronquial.
Variabilidad de su presentación clínica e importancia diagnóstica y terapéutica de la endoscopia flexible. An Esp Pediatr, 38 (1993), pp. 359-361
[66.]
L.M. Franchi, J.C. Maggi, E. Nussbaum.
Continuous end-tidal C02 in pediatric bronchoscopy.
Pediatric Pulmonol, 16 (1993), pp. 153-157
[67.]
R.E. Wood.
So who needs a bronchoscopy, anyway?.
Pediatric Pulmonol, 15 (1993), pp. 204
[68.]
A. Bautista Casanovas, E. Estévez Martínez, R. Buznego Sánchez, E. Rodríguez Pérez, R. Cabañas Gancedo, R. Varela Cibes.
Fibrobroncoscopia pediátrica. A propósito de 55 niños explorados.
An Esp Pediatr, 39 (1993), pp. 313-316
[69.]
P.J. Dickstein, S.M.M. Amaral, A.M.L.F. Silva, P.A. Daltro, A.J. Ferreira, A. Aiex.
Bronchial mucous gland adenoma presenting as bronchogenic cyst.
Pediatric Pulmonology, 16 (1993), pp. 370-374
[70.]
R. Lenoir, A. Goossens, D. Tempels, M. Alexander, I. Dad.
Bronchoscopic diagnosis of an unusual presentation of pulmonary actinomycosis.
Pediatric Pulmonology, 16 (1993), pp. 138-140
[71.]
P.H. Sammut, S.T. Howard, J. Linder, J.L. Colombo.
Unusual form of endobronchial aspergillosis in a patient with cystic fibrosis.
Pediatric Pulmonology, 16 (1993), pp. 69-73
[72.]
K. Chadelat, A. Baculard, A. Grimfeld, G. Tournier, M. Boule, L. Boccon-Gibod, et al.
Pulmonary sarcoidosis in children: serial evaluation of bronchoalveolar lavage cells during corticosteroid treatment.
Pediatric Pulmonology, 16 (1993), pp. 41-47
[73.]
A.A. Udassin, J. Bar-Ziv, J. Schachter, S. Godfrey, C. Springer.
Bronchogenic cyst associated with left lower lobe bronchiectasis.
Pediatric Pulmonology, 16 (1993), pp. 323-325
[74.]
K.H. Karlson, C.B. Pickert, S.M. Schexnayder, M.J. Hevlitt.
Flexible fiberoptic bronchoscopy in children on extracorporeal membrane oxygenation.
Pediatric Pulmonol, 16 (1993), pp. 215-218
[75.]
S.C. Elkerbout, R.A. Van Lingen, J. Gerritsen, R.J. Roorda.
Endoscopio bailon dilatation of adquired airway stenosis in newborn infants: a promising treatment.
Arch Dis Child, 68 (1993), pp. 37-40
[76.]
J. Pérez Frías, E. Pérez Ruiz, A. Martínez Valverde.
Fibrobroncoscopia en pediatría.
An Esp Pediatr, 40 (1994), pp. 165-170
[77.]
A. Visca, D. Castellano.
Preparation of pediatric patients for flexible bronchoscopy: evaluation of two methods.
J Bronchology, 1 (1994), pp. 130-132
[78.]
M. Castro, D.E. Midthun, E.S. Edell, M.J. Stelck, U.B.S. Prakash.
Flexible bronchoscopic removal bodies from pediatric airway.
Journal of Branchology, 1 (1994), pp. 92-98
[79.]
R.E. Wood.
Flexible bronchoscopy to remove foreign bodies in children.
Yes, maybe, but. Branchology, 1 (1994), pp. 87
[80.]
J. Akhter, M. Gaspar, A. Bassuk, J. Roberts.
Indavertent removal of foreign body via a flexible fiberoptic bronchoscope in a 4 years-old boy.
Pediatr Pulmonol, 18 (1994), pp. 51-52
[81.]
Y. Matsuhima, O. Taira, F.I. Miura, E. Takahashi, K. Hagiwara, H. Kato.
Pediatric flexible bronchoscopy without intubation: report on the results of a questionnaire.
J Branchology, 1 (1994), pp. 288-294
[82.]
S. Godfrey, C. Springer, C. Maayna, A. Avital, E. Vatashy, B. Blein.
Is there a place for rigid bronchoscopy in the management of pediatric lung disease?.
Pediatric Pulmonol, 3 (1978), pp. 179-184
[83.]
R. Jobs, M.C. Puzo, J. Castella, J.A. Fernández, C. Abeledo, G. Hernández.
Intubación endotraqueal difícil: utilidad del broncofibroscopio.
Archivos Bronconeumol, 29 (1993), pp. 165-167
[84.]
J. De Blic, P. McKelvie, M. Le Bourgeois, S. Blanche, M.R. Benoist, P. Scheinmann.
Value of bronchoalveolar lavage in the management of severe acute pneumonia and interstitial pneumonitis in the immunocompromised child.
Thorax, 42 (1987), pp. 759-765
[85.]
E. Brauer, G. Thompson.
Tracheobronquial aspergillosis.
J Bronchology, 1 (1994), pp. 133-134
[86.]
J. De Blic, I. Azevedo, C.P. Burren, M. Le Bourgeois, D. Lallemand, P. Scheinmann.
The value of flexible bronchoscopy in childhood pulmonary tuberculosis.
Chest, 100 (1991), pp. 688-692
[87.]
H.S. Chan, A. Sun, G.B. Hoheisel.
Endobronchial tuberculosis, is corticosteroid treatment useful?. A report of 8 cases and review of the literature.
Postgrad Med J, 66 (1990), pp. 822-826
[88.]
M.S.M. Ip, S.Y. So, W.K. Lam, C.K. Mock.
Endobronchial tuberculosis revisited.
Chest, 89 (1986), pp. 727-730
[89.]
A. Volckaert, R. Roeis, P. Van Der Niepen, W. Schandevyl.
Endobronchial tuberculosis: report of three cases.
Eur J Respir Dis, 70 (1987), pp. 99-100
[90.]
L.K. Lacquect, A.M. Lacquet.
Congenital lobar emphysema.
Prog Pediatr Surg, 10 (1977), pp. 307-322
[91.]
E.H. Walters, P.V. Gardiner.
Bronchoalveolar lavage as research tool.
Thorax, 46 (1991), pp. 613-618
[92.]
M.R. Aust, U.B.S. Prakash, J.C. Me Dougal, J.W. Segura, M.J. Stelck, J.P. Utz.
Bronchoscopic broncholithotripsy.
J Branchology, 1 (1994), pp. 37-41
[93.]
J.A. Matute de Cárdenas, A. Encinas Goenechea, A. Vilariño Mosquera, F.J. Berchi.
Exploración endoscópica de la vía aérea neonatal.
An Esp Pediatr, 40 (1994), pp. 348-352
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