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Study the Diagnostic and Therapeutic Role of Flexible Bronchoscopy in the Patients Attending Assuit University Children Hospita

Not yet recruiting
Conditions
Chest Disorder
Registration Number
NCT07043309
Lead Sponsor
Assiut University
Brief Summary

Bronchoscopyhasbeenutilizedinchildrenforlongforthediagnosisofairwayabnormalitiesand obtainingbronchoalveolarlavage.Thoughtherehasbeenrapidgrowthofbronchoscopic interventionsinadultpatients,useinchildrenhasbeenlimited.Newerbronchoscopictechnologies andinstrumentsarefocussedlargelyonadultpatients.Riskofsedationandsmallairwaysizealso havebeenlimitingfactors.Butrecentadvancesinequipmentsintheformofhinnerbronchoscopes withworkingchannelsandthinnerinstrumentshavefacilitatedbronchoscopicinterventionsin children.(1) Pediatricflexiblelaryngotrachealbronchoscopy(FB)isahighlyversatileandeffectivediagnostic andtherapeutictoolwithanimportantroleinpediatricrespiratorymedicine. Itwasfirstdescribedin 1968andappliedinthepediatricpopulation10yearslater.(2,3,4) Nowadays,FBisanintegralpartofthemaagementofneonates, infants,andchildrenwithvarious lungandairwaydiseases. InternationalrecommendationsonpediatricFBhavebeenpublishedby theEuropeanRespiratorySociety(ERS)andtheAmericanThoracicSocietyanddescribethe indications,thefacilities,andequipmentneededfortheprocedure,careoftheinstrumentsinvolved, techniques,andsuggestionsforsedationandpatientmanagement.(5-7) FBcanbeperformedfordiagnosticand/ortherapeuticpurposes.Itenablesanassessmentofthe airway'sanatomicalfeaturesandthecollectionofsamplesfromthedistalairways(bronchoalveolar lavage\[BAL\],bronchialbrushing,bronchialbiopsy)forpathologicalandmicrobiological examination.IndicationsfordiagnosticFB includestridor,persistent/re-currentwheezing,chronic cough(productiveorotherwise),recurrentpneumonia,suspectedforeignbodyaspiration, hemoptysisandpulmonaryhemorrhage,suspectedstructuralanomaliesorendobronchial lesions, radiographicabnormalities(atelectasis,recurrent/persistentconsolidations,atypicalandunknown infiltrates, localizedhyperinflation),monitoringoflungallograftorartificialairway,andobstructive sleepapnea)6,7). IndicationsfortherapeuticFB includerestoringairwaypatencyincasesofmucusplugsorblood clots,treatingalveolarfillingdisorders(alveolarproteinosisandlipidpneumonia),controlling hemorrhage,dilatingastenoticairway,andbronchoscopicintubation.(7) Theneedforgeneralanaesthesiainthesepatientsincreasestheproblemsofairwaybecauseof theneedtoshareanalreadycompromisedairwaywiththeendoscopist.Asimpleandsafemethod isdescribed.Generalanaesthesiaisinducedeitherbyintravenousorinhalationtechnique The childbreathesspontaneouslyviaamaskwithahighinspiredoxygenconcentrationandhalothane

a$thecordsaresprayedwithlignocaine.TheBodaisuction-safeswivel-Yconnector(Sontek MedicalInc.CatalogNo:SMI-1002)isaversatileplasticadapterwithstandard15mmfittingswhich sitswellbetweentheRendellBaker-SoucekmaskandtheAyre'sT-piece.(8,9) toevaluatetheindications\&thefindingandtheadverseeventsofflexiblebronchoscopyat pediatric bronchoscopyunitatassuituniversitychildrenhospital

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Age group of children ≥1≤18 years

    • All children in pediatric bronchoscopy unit
    • Both sex
    • Children first guardians accepted to participate in the current study
Exclusion Criteria
  • age less than1year or more than 18 years

    • Children first guardians refused to participate in the current study

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
the adverse events of flexible bronchoscopybaseline

Severedesaturation(SaO2\<80%)duringbronchoscopy

Secondary Outcome Measures
NameTimeMethod
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