Pediatric interventional flexible bronchoscopy

Abstract

Pediatric interventional flexible bronchoscopy (IFB) procedures are difficult to standardize because of a lack of consensus across different countries. The current literature are scant with retrospective case series or case reports in single center only. The main aim of IFB is to keep an enough and patent central airway lumen. The prerequisites are secure environment, skillful technique, appropriate instruments, clear airway vision, and maintenance of cardiopulmonary status of patients. Noninvasive ventilation (NIV) with pharyngeal oxygen with intermittent nose-closure and abdomen-compression or Soong's ventilation is the preferred method in the author's center as it provides a simple and reliable ventilation support during IFB. Pulmonologists should be trained in basic IFB procedures such as tracheobronchial intubation, bronchoalveolar lavage, balloon dilatation, laser ablation, cryotherapy, or even stent placement and maintenance. Pulmonologists should achieve and maintain high skill levels during their career. There is a rapidly evolving IFB role for in the intensive care units (ICUs) because of critical and cardiopulmonary compromised patients. IFB procedures require intense training and a multidisciplinary approach for patient care. With developing technology, the role of IFB is destined to grow. The IFB modality of using short-length bronchoscopes, supported with a NIV and ICU facilities is a viable, instant, and effective management in pediatric patients. Successful IFB could result in rapid weaning of respiratory supports in ICU without the need for transport to the operation theater and more invasive procedure.