Pediatric Bronchoscopy and LUS

Overview

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.

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.