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Pediatric Bronchoscopy and LUS

Recruiting
Conditions
Atelectasis
Atelectasis, Postoperative Pulmonary
Registration Number
NCT06658613
Lead Sponsor
Marmara University
Brief Summary

Rigid bronchoscopy is commonly used for diagnosing and treating lung and airway diseases, including foreign body removal. Patients often experience atelectasis post-procedure, which lung ultrasound (LUS) can effectively detect. LUS is a rapid, noninvasive imaging technique that provides real-time evaluation without the need for patient transportation. In this observational study, researchers will assess the incidence and severity of atelectasis in patients undergoing elective rigid bronchoscopy, comparing those who were intubated and awakened post-procedure with those who were not intubated. The study aims to determine whether intubation influences the development of atelectasis after bronchoscopy.

Detailed Description

Rigid bronchoscopy has been used for many years in the diagnosis and treatment of various primary diseases of the lungs and airways, removal of tracheobronchial foreign bodies and therapeutic procedures for central airway pathologies. Most patients have atelectasis after the procedure. Lung ultrasound (LUS) has begun to take its place in clinical use as a new tool for the detection of both acute and chronical pathologies in the perioperative period and intensive care follow-up of patients. Its use is rapid, noninvasive, point-of-care, without radiation and no need patient transportation. The imaging pattern of atelectasis is similar to that of lung consolidation, and the B line image and loss of lung shear are considered typical findings. Atelectasis after a bronchoscopy procedure can be recognized with LUS. As standard procedure, after bronchoscopy, patients are given drugs (neostigmine or sugammadex) to reverse the effect of muscle relaxants and are allowed to wake up. During this time, patients are sometimes intubated until their respiratory function is fully restored and the patient wakes up. Which patient is intubated depends on factors such as the patient's comorbidities, lung capacity, the procedure performed and the clinician's preference. Intubation may reduce the development of atelectasis due to positive airway pressure. In this observational study, we aim to determine the frequency and degree of atelectasis in patients undergoing elective rigid bronchoscopy using lung ultrasound. Specifically, we will compare the frequency and degree of atelectasis in patients who were intubated and awakened after bronchoscopy and those who were awakened without intubation.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Elective rigid bronchoscopy
  • American Society of Anaesthesiologists (ASA) physical status I or II
Exclusion Criteria
  • Emergent rigid bronchoscopy
  • ASA III or above
  • Patients left intubated after the procedure

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
AtelectasisFrom the preinduction period in the operating theater to the postoperative recovery of the patient again in the operating theater.

Lung ultrasound score (LUS) will be used for the detection of atelectasis. Each lung will be evaluated separately and scores will be recorded. Scores will be obtained from 6 regions for each lung (anterior superior/inferior, middle superior/inferior, posterior superior/inferior) for a total of 12 regions for each patient. Scoring will be based on the 'B lines' pattern seen on LUS (B0, B1, B2, B3, indicating progressive atelectasis). A score of 0 to 3 points will be given for each lung field measured, for a total LUS of 0-36.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Marmara University Pendik Training and Research Hospital

🇹🇷

Istanbul, Turkey

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