The application of bronchofibroscope in PICU / 中国小儿急救医学

ABSTRACT

Objective To explore the efficacy and safety of clinical application of bronchofibroscope (BFS) in PICU. Methods Seventy-nine critically ill children in our PICU were operated with BFS in 89 cases and the etiology of these children was analyzed. The blood-gas analysis and oxygenation index both before and after the treatment had been compared, and syndrome was observed as well. For 40 cases in which critically ill children received bronchoalveolar lavage in addition to mechanical ventilation, and the index of respiratory mechanics was analyzed. Analysis and summary had been performed on the culture results of bronchoalveolar lavage fluid in 74 cases. Results The primary disease in these cases was mainly respiratory diseases (64/79). There was no major change in oxygenation index and blood pH ( P ＞0. 05 ) before and after operation with BFS. No severe syndrome,such as sudden cardiac arrest and pneumothorax, was recorded. However,transient decrease in SpO2 was most frequently observed in minor syndromes (15/79). The children treated with mechanical ventilation were recorded with significant decrease in air way resistance ( P ＜ 0. 05 ) after bronchoalveolar lavage. However,dynamic compliance and work of breathing only changed slightly (P ＞0. 05 ). The culture positive rate of bronchoalveolar lavage fluid was 29. 1% (23/79) ,mainly gram-negative bacteria, which coincided with disease spectrum of PICU. Conclusion The application of BFS in PICU can improve salve and tracheobronchial management for critically ill children. The diagnosis and treatment is safe and reliable by strictly grasping the examination indication by BFS under the custody of PICU.