Application of flexible fiberoptic bronchoscopy in critically ill children with continuous invasive respirato-ry support
10.3760/cma.j.issn.1673-4912.2017.12.010
- VernacularTitle:纤维支气管镜在危重患儿不间断有创呼吸支持中的应用
- Author:
Xiong ZHOU
1
;
Xinping ZHANG
;
Jie HE
;
Meiyu YANG
;
Jianghua FAN
;
Zili CAI
;
Yu QIU
;
Jianshe CAO
;
Yuanhong YUAN
Author Information
1. 湖南省儿童医院重症医学一科
- Keywords:
Fiberoptic bronchoscopy;
Critically ill;
Uninterrupted;
Invasive breathing support;
Severe pneumonia
- From:
Chinese Pediatric Emergency Medicine
2017;24(12):916-920
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the role and effectiveness of flexible fiberoptic brochoscopy ( FFB) in critically ill children with continuous invasive respiratory support. Methods From July 2014 to June 2017,135 critically ill children with severe pneumonia had received continuous invasive respiratory sup-port and undergone FFB in the pediatric intensive care unit( PICU) of our hospital. These patients were en-rolled into the therapy group. Another 104 severe pneumonia patients who had not received FFB were enrolled into the control group. Clinical characteristics of both groups were collected and compared. Results No sig-nificant differences were detected in patients′gender, age, PCIS, usage of antibiotics, and the levels of CRP and PCT assayed at the time of admission to PICU between the therapy group and control group(P>0. 05). The positive rate of bacteria culture of the bronchoscopic lavage was 78. 52％( 106 cases ) in the therapy group,and it was significantly higher than that in the control group(60. 58％,63 cases) (χ2 =5. 681,P <0. 005). For 106 cases in the therapy group,117 bacteria strains were identified,while there were 72 bacteria strains found in 63 cases with positive bacteria culture in the control group. Gram negative bacteria were the most common type,followed by Gram positive bacteria. The third most common pathogenic microbes were fungi,with a significantly higher frequency in the therapy group. No significant differences were found in PaO2 and oxygenation index between both groups before FFB. However,in a half hour after FFB,the PaO2 and oxygenation index significantly increased in the therapy group,and higher than those in the control group (P<0. 005). The levels of CRP and PCT assayed before and the first day after FFB were not significantly changed(P>0. 05). But the levels of CRP and PCT in the therapy group significantly decreased in the third day after FFB,and more than those in the control group. Furthermore,duration of invasive respiratory sup-port,and the stay of PICU were significantly shorter in the therapy group(P<0. 005). Conclusion FFB can play an important role in the collection of pathogenic microbes. It also achieves better results in the treatment of severe pneumonia for children in PICU. Therefore,it is worthwhile to be recommended as a safe and feasi-ble intervention in PICU.
