An Ultrathin Flexible Bronchoscope with an External Channel for Bronchoscopy in Intubated Infants

Abstract

For bronchoscopic procedures in intubated infants, an external channel was attached to an ultrathin flexible bronchoscope without a built-in channel. This modified bronchoscope can be passed through a tracheal tube of 3.5-mm internal diameter and retains adequate flexibility. Thirty-seven bronchoscopic procedures including bronchial suctioning, bronchoalveolar lavage, and drug injection were performed for nine intubated infants; indications for bronchoscopy were bronchial bleeding (n = 4), tracheobronchomalacia (n = 4), pneumonia (n = 4), and atelectasis (n = 2). Bronchoscopic suctioning, which was safely performed under simultaneous ventilatory assist, significantly contributed to airway cleaning. In two cases with atelectasis, full reexpansion of the collapsed lobe was achieved immediately after bronchial toilet. In all four cases with pneumonia, specific pathogens were detected from bronchoalveolar lavage fluid. No complications were noted. We concluded that this modified ultrathin flexible bronchoscope is a safe and useful tool for airway management in intubated infants.