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Bronchoscopy in neonates with severe bronchopulmonary dysplasia in the NICU

Journal of Perinatology volume 39, pages 263–268 (2019)Cite this article

Subjects

Abstract

Objectives

To describe the findings, resulting changes in management, and safety profile of flexible bronchoscopy in the neonates with severe bronchopulmonary dysplasia.

Study design

This was a retrospective case series of twenty-seven neonates with severe bronchopulmonary dysplasia who underwent flexible bronchoscopy in the neonatal intensive care unit.

Results

Flexible bronchoscopy revealed airway pathology in 20/27 (74%) patients. Tracheomalacia 13/27 (48%), bronchomalacia 11/27 (40.7%), and airway edema 13/27 (48%) were the most common findings. Bronchoalveolar lavage (BAL) was performed in 17 patients. BAL culture revealed a microorganism in 12/17 (70.5%) cases. Findings from bronchoscopy resulted in change in clinical management in 17/27 (63%) patients. Common interventions included initiation of antibiotics (37%) and treatment of tracheobronchomalacia with bethanechol (22.2%), atrovent (18.5%), and PEEP titration (18.5%). Bronchoscopy was performed without significant complication in 26/27 (97%) patients.

Conclusion

Flexible bronchoscopy can be a safe and useful tool for the management of neonates with severe bronchopulmonary dysplasia.

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Authors and Affiliations

  1. Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Erik Hysinger

  2. Department of Pediatrics, Madigan Army Medical Center, Tacoma, WA, USA

    Nicholas Friedman

  3. Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Erik Jensen & Huayan Zhang

  4. Division of Pulmonary Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Joseph Piccione

Authors
  1. Erik Hysinger
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  2. Nicholas Friedman
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  3. Erik Jensen
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  4. Huayan Zhang
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  5. Joseph Piccione
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Corresponding author

Correspondence to Erik Jensen.

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The authors declare that they have no conflict of interest.

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Hysinger, E., Friedman, N., Jensen, E. et al. Bronchoscopy in neonates with severe bronchopulmonary dysplasia in the NICU. J Perinatol 39, 263–268 (2019). https://doi.org/10.1038/s41372-018-0280-y

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