Bronchoscopie bij kinderen: indicaties, bevindingen en complicaties van 54 procedures in een algemeen ziekenhuis

Over a 2½-yr period, indication, findings, and complications of 54 paediatric bronchoscopies carried out in our hospital were recorded prospectively. Four patients underwent rigid bronchoscopy for removal of an aspirated foreign body. In the other 50 patients, flexibele bronchoscopy was performed under general anaesthesia while the patient was breathing spontaneously through a laryngeal mask airway. Mean age of the patients (range) was 60 months (5 days-14 yrs). The most common indications for bronchoscopy were severe/therapy-resistant asthma/wheeze (31%), recurrent pneumonia (22%) and progressive stridor (11%). Thirty seven out of 54 bronchoscopies (69%) yielded results with clear diagnostic or therapeutic consequences. The most common findings were stenosis or malacia of the lower airways, which was found in 47% and 50% of patients with therapy-resistant asthma and recurrent pneumonia, respectively. Complications were rare and mild; there were no severe complications. Bronchoscopy is a useful diagnostic procedure in children with severe or therapy-resistant asthma or recurrent pneumonia, and it can be carried out safely in a general hospital by an experienced bronchoscopist and while the patient is under general anaesthesia with monitoring of vital functions.