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HK J Paediatr (New Series)
Vol 1. No. 2,
1996
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HK J Paediatr (New Series) 1996;1:202
Proceedings of Clinical Meeting
Review of Paediatric Bronchoscopy Service
DKK Ng, JCS Ho, RKN Yuen DKK Ng, JCS Ho, RKN Yuen Department of Paediatrics, Kwong Wah Hospital
HK J Paediatr (new series) 1996;1:193-206 Annual Scientific Meeting Hong Kong Paediatric Society December 9, 1995 | A review of patients undergoing bronchoscopy in this department from January, 1995 to September, 1995 was conducted. Methods Records of all bronchoscopy were retrieved for the said period. Analysis of age groups, indications for bronchoscopy, bronchoscopic diagnosis and side-effects associated with bronchoscopy were analysed. All patients undergoing bronchoscopy were fasted for six hours before procedures. They were given either chloral hydrate or lytic cocktail before transfer to endoscopy suite. They were than further sedated with midazolam and fentanyl intravenously. During the procedures, they were put under continuous cardiac and oximetry monitor with a doctor other than the bronchoscopist providing close supervision. Flexible bronchoscopes with distal external diameter from 1.8 mm to 4.2 mm are available. Chest radiograph were obtained for each patient afterward. Results 28 patients underwent bronchoscopy during the said period. Age distribution was as followed - less than one-month-old 8(29%), one-month-old to one-year-old: 7(25%), four-year-old to ten-year-old: 5 (18%), older than ten-year-old: 8(28%). Indications for bronchoscopy and the corresponding bronchoscopic diagnoses were listed as followed - suspected choanal stenosis (Dx:nasal septal deviation): 1 (3%), stridor (Dx:laryngomalacia): 5 (18%), obstructive sleep apnoea (Dx: adeno-tonsillar hypertrophy and acquired laryngomalacia): 1 (3%), chronic acquired hoarseness of voice (Dx:subacute laryngitis): 1 (3%), apparent life-threatening event (Dx:normal in three patients, evidence of milk aspiration in one patient): 4 (14%), Pierre-Robin syndrome (Dx:collapsed hypopharynx during inspiration): 1 (3%), acute dyspnoea with pyrexia (Dx:bacterial tracheitis): 1 (3%), suspected foreign body aspiration (Dx:normal): 3 (11 %), recurrent dyspnoea (Dx:normal): 1 (3%), suspected pulmonary tuberculosis (Dx:normal in four patients, endobronchial lesion in one patient, bronchoalveolar lavage, BAL, were done): 5 (18%), persistent lobar consolidation (Dx:normal, BAL performed): 3 (11%), haemoptysis (Dx:normal, BAL performed): 1 (3%), suspected vascular ring(failed bronchoscopy because of unstable patient's condition). There was no side-effects besides the transient desaturation associated with the failed attempt observed in our patients. Conclusion Bronchoscopy is a safe procedure in our hands irrespective of age of patients. It provides useful information for the management of clinical problems which would otherwise involve a prolonged period of observation.
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