ABSTRACT
Objective: To evaluate the safety and effectiveness using adult flexible bronchoscopy via laryngeal mask airway [LMA] under general anesthesia in children aged 2 - 5 years
Design: Retrospective study
Setting: Yuhuangding Hospital, Yantai, China
Subjects: The procedures of bronchoscopy were performed with an adult flexible bronchoscope via LMA under general anaesthesia. Indications and complications were analyzed, retrospectively
Intervention[s]: Expanding the wide use of pediatric flexible bronchoscopy to diagnostic and interventional bronchoscopy
Main outcome measure[s]: Performed using SPSS17.0
Results: The indications for bronchoscopy included tracheal mucous plugs removal in 108 cases with pneumonia, tracheobronchial foreign bodies removal in 82 cases, endobronchial biopsy in 66 cases, bronchoscopic cryosurgery in 23 cases with tracheal granulation tissue formation after long-term endotracheal intubation, balloon dilatation in 11 cases with lobar bronchial stenosis and bronchoscopic management in 12 cases with traumatic tracheobronchial injuries. Complications were reported for 193 cases, with an overall complication rate of 63.9%. The incidence rate was highest in children aged 2 - 3 years, and decreased with age. Hypoxia and post bronchoscopy cough were the most complication in all patients. Acute hypoxia during bronchoscopy happened in 5 [1.6%] cases and was relieved quickly by intermittent withdrawal of the bronchoscope. Most post bronchoscopy cough without respiratory distress or hypoxia could be seen in 188 [62.3%] cases and resolved within four hours after inhalation of budesonide
Conclusion: An adult flexible bronchoscope via LMA could be safely and effectively used for interventional bronchoscopy in 2 - 5 years old children with different kinds of the proximal airway diseases
ABSTRACT
Objective To explore the effect of intravenous immunoglobulin (IVIG) on immunity and outcome for sepsis in children.Methods Eighty-four children who met the diagnosis of sepsis were included in study and divided into treatment group (36 cases) and control group (48 cases ).The patients in teatment group were administered IVIG with the dose of 1 g/kg.Peripheral venous blood samples of patients in both groups were collected before (0 h),24 h,72 h and 5 d after administration to detect the numbers of immunocyte including CD3 +,CD4 +,CD56 +,CD19 +,CD8 +cells by flow cytometry and the levels of cytokines including tumor necrosis factor (TNF)-at,interleukin (IL)-10,IL-1 7 by enzyme linked immunosorbent assay.The numbers of immunocyte and levels of cytokines and TNF-a/IL-10 were compared and the mortality at 28 days was assessed between two groups.Results The numbers of CD3 +,CD4 +,CD56 +,CD19 +cells and the levels of TNF-a,IL-17 and TNF-α/IL-10 of patients in teatment group were significantly decreased than those in control group at 24 h,72 h and 5 d afte administration ( P ＜0.05 ) and showed downtrend.However,the level of IL-10 increased significantly (P ＜ 0.05 ) and showed uptrend in treatment group.The number of CD8+ cells had no change.No difference of mortality was observed between two groups (27.7％,10/36 vs 16.6％,8/48,x2 =1.50,P =0.169,OR =1.92,95％ CI:0.671 ～5.510).Conclusion IVIG can suppress the immunity of children with sepsis and has no survival benefit.