Diagnostic Flexible Bronchoscopy
- Pediatric Pulmonary Overview
- Apnea of Prematurity
- Chronic Cough in Children
- Lung Disorders in Children
- Acute Bronchitis in Children
- Diagnostic Flexible Bronchoscopy
- Pediatric Asthma
- Exercise Induced Asthma
- Pneumonia in Children
- Pediatric Pulmonary Care
Diagnostic Flexible Bronchoscopy Explained
The Bronchoscopy procedure allows the practitioner to see the inside of the air passages. This allows for more accurate diagnoses and therapeutic recommendations when it comes to pulmonary disorders.
The bronchoscope construction ranges from a flexible fiber optic bronchoscope with modern video equipment to a rigid metal instrument with attached lighting devices. Now, the flexible bronchoscopy has replaced the rigid bronchoscopy for almost all diagnostic and most therapeutic uses.
Diagnostic Flexible Bronchoscopy Uses
The bronchoscope gets inserted into the airways via the nose or mouth. The examiner can then easily see if foreign bodies, tumors, inflammations, or abnormal bleeding exist. The process has many diagnostic uses including:
- Direct airway visualization down to and including bronchi
- Obtaining samples of respiratory secretions and cells
- Biopsy of endobronchial, parenchymal and mediastinal structures
- Persistent unexplained coughing
- Airway evaluation in burn victims
- Evaluation of chest trauma for bronchial disruption
- Unexpected hoarseness or vocal cord trauma
- Abnormal chest radiograph
- Evaluation for rejection in lung transplant recipient
- Lung staging
Therapeutic flexible bronchoscopy uses include:
- Laser tumor resection
- Placement of airway stent
- Removal of foreign body
- Aspiration of retained secretions
- Photodynamic therapy
- Placement of endotracheal tube in difficult patient
Diagnostic Flexible Bronchoscopy Procedure
A pulmonologist or trained surgeon would perform a bronchoscopy in a bronchoscopy suite, ICU or an operating room.
Patients should eat nothing by mouth for at least 4 hours before the procedure. They need to have IC access, intermittent blood pressure and cardiac monitoring. Supplemental oxygen also needs to be available.
The vocal cords and pharynx receive anesthesia with nebulized or aerosolized lidocaine. The bronchoscope itself gets lubricated with lidocaine jelly. It passes through the nostril or mouth using an oral airway or bite block.
The clinician eventually passes the bronchoscope through the vocal cords into the trachea and finally into the bronchi.
Complications from a Diagnostic Flexible Bronchoscopy Procedure
Severe complications are uncommon. Ten to fifteen percent of the patients experience minor bleeding from a biopsy or have a fever. If it occurs, the fever begins 6 to 12 hours after the procedure. It requires only symptomatic treatment.
The bronchoscopy itself can sometimes cause hoarseness.
All patients are observed for 2 to 4 hours after the procedure or until the gag reflex returns.
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