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Bronchoscopy in Pediatric and Neonatal Intensive Care

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Pediatric and Neonatal Mechanical Ventilation

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Abstract

Since the introduction of the flexible bronchoscope by Ikeda in 1968 (Ikeda 1968), technical refinements of the equipment have greatly facilitated its use in the care of critically ill children on invasive mechanical ventilation. The ever-thinner instruments allow performing bronchoscopy through endotracheal tubes (ETT) as thin as 2.5 mm in internal diameter, and the procedure has become a valuable tool for various diagnostic purposes and therapeutic measures in intensive care. Despite the apparent simplicity of the procedure, flexible bronchoscopy in the critically ill should be performed by the experienced bronchoscopist in an expeditious and deliberate manner, with assisting personnel paying close attention to vital parameters. The secured airway and the preestablished sedation may create a treacherous sense of security, and distraction caused by captivating events and findings on the screen, pointedly referred to as the “bronchoscopy hypnosis” (Wood 1990), carries the risk of subtle signs of cardiorespiratory instability going unnoticed and precipitating into a serious critical incident. With due respect to the potential risks, however, bronchoscopy is astoundingly safe in even the sickest patients.

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Authors and Affiliations

  1. Pediatric Intensive Care and Pulmonology, University Children’s Hospital (UKBB), Spitalstrasse 33, CH-4031, Basel, Switzerland

    Daniel Trachsel

  2. Intensivmedizin und Pneumologie, Universitätskinderklinik beider Basel, Römergasse 8, Basel, CH-4005, Switzerland

    Jürg Hammer

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  1. Daniel Trachsel
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  2. Jürg Hammer
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Correspondence to Daniel Trachsel .

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Editors and Affiliations

  1. Service of Neonatology and Pediatric Intensive Care, Department of Pediatrics, University Hospital of Geneva, Geneve, Switzerland

    Peter C. Rimensberger

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Trachsel, D., Hammer, J. (2015). Bronchoscopy in Pediatric and Neonatal Intensive Care. In: Rimensberger, P. (eds) Pediatric and Neonatal Mechanical Ventilation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-01219-8_37

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  • DOI: https://doi.org/10.1007/978-3-642-01219-8_37

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