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Flexible fiberoptic bronchoscopy in children on extracorporeal membrane oxygenation
Author(s) -
Karlson Karl H.,
Pickert Curtis B.,
Schexnayder Stephen M.,
Heulitt Mark J.
Publication year - 1993
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950160402
Subject(s) - medicine , extracorporeal membrane oxygenation , atelectasis , surgery , complication , bronchoscopy , bronchoalveolar lavage , membrane oxygenator , anesthesia , flexible bronchoscopy , extracorporeal , lung
Bleeding is one of the most feared complications of veno‐arterial (V‐A) extracorporeal membrane oxygenation (ECMO), and is also a potential complication of flexible fiberoptic bronchoscopy (FFB). We retrospectively reviewed 14 patients who underwent FFB procedures with bronchial washings (BW) and bronchoalveolar lavage (BAL) to evaluate the safety of this procedure in children on ECMO. Standard FFB with BAUBW technique was used after stabilization on ECMO. Three patients underwent two procedures each, and one patient underwent three, for a total of 19 procedures. No significant complications, such as bleeding have occurred. Three patients required additional ECMO support shortly after FFB. After the 16 procedures done for atelectasis, seven patients improved radiographically, three had increased opacifications, and six were unchanged. The remaining three patients had suspected pulmonary infections, and in each, therapeutic decisions were guided by the BAL results. Lung compliance was unchanged or improved after 11 of 13 procedures. We conclude that FFB with BAUBW in children on ECMO is safe and may benefit certain patients. Pediatr Pulmonol. 1993; 16:215–218. © 1993 Wiley‐Liss, Inc.