OBJECTIVETo investigate the value of electronic bronchoscopy in the etiological diagnosis and treatment of pediatric intensive care patients with difficult ventilator weaning.

METHODSA retrospective analysis was performed for the clinical data of 92 pediatric intensive care patients with difficult ventilator weaning and underwent electronic bronchoscopy.

RESULTSAmong all the 92 children, the most common underlying disease was respiratory system disease (39 children). Electronic bronchoscopy found abnormalities in 87 children (95%), mainly excessive airway secretions and abnormal airway structure. There was no difference in the severity of tracheobronchial stenosis and tracheobronchomalacia shown by electronic bronchoscopy in children suffering from congenital heart disease (CHD), with and without difficult ventilator weaning. When used to predict difficult ventilator weaning in children with CHD, tracheobronchial stenosis or tracheobronchomalacia had a sensitivity of 68.4% and a specificity of 66.7%. Among the 36 children with atelectasis caused by excessive secretion or phlegm-induced airway obstruction, 23 achieved full or partial re-expansion after bronchial lavage and/or one-lung ventilation.

CONCLUSIONSElectronic bronchoscopy helps to clarify the cause of difficult ventilator weaning and perform treatment under an electronic bronchoscope accordingly in pediatric intensive care patients with difficult ventilator weaning. Tracheobronchial stenosis and tracheobronchomalacia shown by electronic bronchoscopy cannot not be used as an index for the prediction of ventilator weaning in children with CHD.