Airway exploration in children
Abstract Introduction and objective: The management of the airways represents a constant challenge in pediatric practice. In the last years, bronchoscopy has become an essential technique in the diagnosis and treatment of various abnormalities of the child's respiratory system. The special characteristics of the pediatric airway and the differentiated pathology it presents give pediatric bronchoscopy its own entity. Pediatric bronchoscopy is a safe technique with many applications, both diagnostic and therapeutic. The use of both types of bronchoscopes (flexible and rigid) allows to take advantage of each one of them. Flexible bronchoscopy in pediatrics is a relatively simple and low-risk procedure that provides anatomical and dynamic information on the airways, as well as cytological and microbiological studies. The simplicity and low risk of this technique, in addition to not requiring general anesthesia, allows it to be performed even at the head of the patient, which has led to an increasingly extensive field of indications. The purpose of this article is to provide a review on the timeliness of the pediatric bronchoscopy procedure, especially about its indications. Method: Narrative review. Conclusion: The endoscopic examination of the airway is a cost-effective technique in pediatrics, with little complications and can offer very valuable diagnostic information, as well as perform certain therapeutic procedures. It is recommended that all professionals involved in the management of patients with airway pathology should know their indications, contraindications, complications, as well as their therapeutic applications.
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Pérez Frías FJ, Pérez Ruiz E, Caro Aguilera P. Broncoscopia pediátrica y técnicas asociadas. 1ª ed. Ergon. 2014. ISBN 978-84-15950-97-4
Pérez Frías J, Caro Aguilera P, Pérez Ruiz E, Moreno Requena L. Tratamiento del cuerpo extra-o intrabronquial. Broncoscopia combinada en neumologíaa infantil. An PEdiatr. 2010;72:67-71. https://doi.org/10.1016/j.anpedi.2009.08.014 PMid:19815471
Pérez Frías J, Moreno Galdó A, Pérez Ruiz E, Barrio Gómez de Agüero MI, Escribano Montaner A, Caro Aguilera P,. Normativa SEPAR. Normativa de broncoscopia pediátrica. Arch Bronconeumol. 2011; 47:350-60 https://doi.org/10.1016/j.arbres.2011.04.003 PMid:21600686
Weinberger M, Abu-Hasan M. Pseudo-asthma: when cough, wheezing and dypsnea are not asthma. Pediatrics. 2007;120:855-64. https://doi.org/10.1542/peds.2007-0078 PMid:17908773
Wood RE, FinkR. Applications of flexible fiberoptic bronchoscopes in infants and children. Chest. 1978;73: 737.
https://doi.org/10.1378/chest.73.5.737 https://doi.org/10.1378/chest.73.5_Supplement.737
Wood RE, Postma D. Endoscopy of the airway in infants and children. L Pediatr 1988;112:1-6. https://doi.org/10.1016/S0022-3476(88)80109-4
Wood RE. Evaluation of the upper airway in children. Curr Opin Pediatr.2008;20:266-71. https://doi.org/10.1097/MOP.0b013e3282ff631e PMid:18475094
Wood RE. The emerging role of flexible bronchoscopy in pediatrics. Clin Chest Med 2001; 22:311-7 https://doi.org/10.1016/S0272-5231(05)70045-9
Zafra Anta MA, Luna Paredes MC. Endoscopia de la vía aérea. Pediatr Integral 2016; XX(2): 128e1-128.e8.
Cakir E, Ersu RH, Uyan ZS, et al. Flexible bronchoscopy as a valuable tool of persistent wheezing in children. Int J Pediatric Otorhinol.2009;73:1666-8. https://doi.org/10.1016/j.ijporl.2009.08.016 PMid:19733921
De Blic J, Telion C. Sedation and anasthesia for bronchsocopy. En : Priftis KN, Anthracopoulos MB, Eber E, Koumbourlis AC, Wood RE, eds. PAediatric bronchoscopy. Basel: Karger; 2010.p.22-9. https://doi.org/10.1159/000314381
Díaz-Agero P, Canseco F, Gil JL. Indicaciones y técnica de la broncoscopia rígida. Broncoscopia diagnóstica y terapéutica. Madrid; Ergon; 2007.p 53-70
Dickison AE. The normal and abnormal pediatric upper airway. Recognition and managementof obstruction. Clin Chest Med 1987;583-596. PMid:3322644
Escribano MontanerA, Moreno Galdo A. Grupo de técnicas de la Sociedad Espa-ola de Neumología Pediátrica. Técnicas fibrobroncoscópicas especiales: lavado broncoalveolar, biopsia bronquial y biopsia transbronquial. An Pediatr ( Barc). 2005;62:352-66 https://doi.org/10.1157/13073249
Fiadjoe J, Stricker P. Peddiatric difficult airway Management: current devices and thecniques. Anesthesiology Clin. 2009;5:191-5.
FiguerolaMulet J, Osona Rodriguez de Torres B, Llull FerretjansM, Román Pi-ana JM. Contribución de la fibrobroncoscopia al diagnóstico de las enfermedades de la vía aérea superior. An Pediatr.2005;63:137-42. https://doi.org/10.1157/13077456
Garrido Galindo C, Flores Hernández SS, Nu-ez-Pérez Redondo C. Diferencias anatomofuncionales y endoscópicas entre la vía aérea del ni-o y la del adulto. Rev Inst Nal Enf Resp Mex. 2007; 20(2): 142-148
Islam S, Mathur PN, Finlay G. Flexible bronchoscopy in adults:preparation, procedure technique, and complications. UpToDate 2016
Midulla F, De Blic J, Barbato a, Bush A, çeber E, et al. Flexible endoscopy of paediatric airways. Eur Respir J.2003;22:698-708. https://doi.org/10.1183/09031936.02.00113202 PMid:14582925
Pérez Frías FJ, Pérez Ruiz E, Caro Aguilera P. Broncoscopia pediátrica y técnicas asociadas. 1ª ed. Ergon. 2014. ISBN 978-84-15950-97-4
Pérez Frías J, Caro Aguilera P, Pérez Ruiz E, Moreno Requena L. Tratamiento del cuerpo extra-o intrabronquial. Broncoscopia combinada en neumologíaa infantil. An PEdiatr. 2010;72:67-71. https://doi.org/10.1016/j.anpedi.2009.08.014 PMid:19815471
Pérez Frías J, Moreno Galdó A, Pérez Ruiz E, Barrio Gómez de Agüero MI, Escribano Montaner A, Caro Aguilera P,. Normativa SEPAR. Normativa de broncoscopia pediátrica. Arch Bronconeumol. 2011; 47:350-60 https://doi.org/10.1016/j.arbres.2011.04.003 PMid:21600686
Weinberger M, Abu-Hasan M. Pseudo-asthma: when cough, wheezing and dypsnea are not asthma. Pediatrics. 2007;120:855-64. https://doi.org/10.1542/peds.2007-0078 PMid:17908773
Wood RE, FinkR. Applications of flexible fiberoptic bronchoscopes in infants and children. Chest. 1978;73: 737.
https://doi.org/10.1378/chest.73.5.737 https://doi.org/10.1378/chest.73.5_Supplement.737
Wood RE, Postma D. Endoscopy of the airway in infants and children. L Pediatr 1988;112:1-6. https://doi.org/10.1016/S0022-3476(88)80109-4
Wood RE. Evaluation of the upper airway in children. Curr Opin Pediatr.2008;20:266-71. https://doi.org/10.1097/MOP.0b013e3282ff631e PMid:18475094
Wood RE. The emerging role of flexible bronchoscopy in pediatrics. Clin Chest Med 2001; 22:311-7 https://doi.org/10.1016/S0272-5231(05)70045-9
Zafra Anta MA, Luna Paredes MC. Endoscopia de la vía aérea. Pediatr Integral 2016; XX(2): 128e1-128.e8.
Gómez-Sáez, F., Navazo-Eguía, A. I., Vega-Val, C., Gómez-Sánchez, E., Mirás-Veiga, A., & Valencia-Ramos, J. (2018). Airway exploration in children. Revista ORL, 9(1), 49–61. https://doi.org/10.14201/orl.15900
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