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Bronchoscopy in Pediatric and Neonatal Intensive Care

  • Daniel TrachselEmail author
  • Jürg Hammer
Chapter
  • 4k Downloads

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.

Keywords

Pulmonary Arterial Hypertension Percutaneous Dilatational Tracheostomy Extubation Failure Flexible Bronchoscopy Lower Respiratory Tract Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Pediatric Intensive Care and PulmonologyUniversity Children’s Hospital (UKBB)BaselSwitzerland
  2. 2.Intensivmedizin und PneumologieUniversitätskinderklinik beider BaselBaselSwitzerland

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