Application of flexible fiberoptic bronchoscopy in critically ill children with continuous invasive respiratory support

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 support and undergone FFB in the pediatric intensive care unit(PICU) of our hospital.These patients were enrolled 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 significant 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 0.05). 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 support, 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 feasible intervention in PICU. Key words: Fiberoptic bronchoscopy; Critically ill; Uninterrupted; Invasive breathing support; Severe pneumonia