Retrospective analysis of 29 cases of neonatal atelectasis treated by ultrasound-assisted fiberoptic bronchoscopy and bronchoalveolar lavage

Objective To evaluate the efficacy and safety of bronchoalveolar lavage(BAL) in the treatment of neonatal atelectasis with fiberoptic bronchoscopy under ultrasound monitoring. Methods From June 2018 to December 2018, 29 children were diagnosed as atelectasis by lung ultrasound.After conventional mechanical vibration and sputum ineffective, BAL was treated with fiberoptic bronchoscopy.All patients before operation were monitored by ultrasound to find the lung segment where the atelectasis was located.0.9% NaCl solution was injected by fibrobronchoscope(1~2 ml/kg), and then sucked to ensure the recovery rate of the lavage fluid was more than 50%.After each lavage, ultrasound was immediately used to monitor the recovery of atelectasis to determine whether or not to continue the lavage.One course of treatment could be continuously performed BAL 1 to 3 times a day, 1 course per day, and up to 3 courses of lavage.We analyzed the efficacy, adverse reactions and complications of BAL in the treatment of neonatal atelectasis under ultrasound monitoring. Results Twenty-nine patients underwent BAL treatment with fiberoptic bronchoscopy, 25 cases (86.2%) were cured, 3 cases (10.3%) were effective, and 1 case (3.4%) was ineffective.All children had stable vital signs during treatment.Among them, 11 cases (37.9%) had transient hypoxemia, 3 cases (10.3%) had tracheal mucosal injury, and 2 cases (6.9%) had hoarseness.There were no serious complications such as pulmonary hemorrhage, pneumothorax, and cardiac arrest. Conclusion BAL treatment of atelectasis under lung ultrasound monitoring has obvious effect, easy to operate, no radiation, no obvious adverse reactions and complications, which is worthy of clinical application. Key words: Lung ultrasound; Fiberoptic bronchoscopy; Bronchoalveolar lavage; Neonate; Atelectasis