A Prospective Study of Fever and Bacteremia After Flexible Fiberoptic Bronchoscopy in Children

Picard, Elie; Schwartz, Shepard; Goldberg, Shmuel; Glick, Tzipporah; Villa, Yael; Kerem, Eitan

doi:10.1378/chest.117.2.573

Cited by 62 publications

(67 citation statements)

References 21 publications

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“…A peak fever (body temperature w38.5uC) occurred 6-8 h after the procedure in 18.8% of cases. This frequency is similar to that observed by SCHELLHASE et al [17] (17%), but is lower than that published by PICARD et al [18] (48%). In their study, fever was correlated with positive bacterial culture (w10 4 cfu?mL -1 ), age v2 yrs and abnormal bronchoscopy findings.…”

Section: Discussionsupporting

confidence: 89%

Complications of flexible bronchoscopy in children: prospective study of 1,328 procedures

Blic¹,

Marchac²,

Scheinmann³

2002

Eur Respir J

190

121

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Complications of flexible bronchoscopy (FB) were prospectively evaluated during 1,328 diagnostic procedures in children, not in intensive care units. A total 92.8% of the procedures were performed in conscious patients under sedation and 7.2% under deep sedation. Supplementary oxygen was provided in y80% of cases via endoscopic face mask (n=783) or nasal prongs (n=290).At least one complication was recorded in 91 cases (6.9%). Minor complications (n=69; 5.2%) included moderate and transient episodes of desaturation (n=15), isolated excessive coughing (n=22), excessive nausea reflex with coughing (n=20), transient laryngospasm (n=6) and epistaxis (n=6). Major complications (n=22; 1.7%) included oxygen desaturation to v90%, either isolated (n=10) or associated with laryngospasm (n=6), coughing (n=4), bronchospasm (n=1), and pneumothorax (n=1).Major complications involving oxygen desaturation were associated with age v2 yrs (13 of 529 versus 8 of 778) and laryngotracheal abnormalities (7 of 85 versus 14 of 1,222). The overall frequency of complications was similar in conscious (6.7%) but sedated patients and patients under deep (7.3%) sedation. However, the frequency of transient desaturation was significantly higher in children undergoing FB under deep sedation. Transient fever after bronchoalveolar lavage was observed in 52 of 277 cases (18.8%).Flexible bronchoscopy is a safe procedure with v2% major complications. Careful analysis of indications and clinical status for each patient, and proper anaesthesia and monitoring during the examination ensure that the procedure is successful, with a minimum of complications.

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Section: Discussionsupporting

confidence: 89%

Complications of flexible bronchoscopy in children: prospective study of 1,328 procedures

Blic¹,

Marchac²,

Scheinmann³

2002

Eur Respir J

190

121

View full text Add to dashboard Cite

show abstract

“…Fever was observed remotely after a BAL in 52 cases out of 277 (18.8%). Another prospective study of 91 pediatric FB recorded a significant association between fever within 24 hours post-FB and positive BAL culture 21 .…”

mentioning

confidence: 98%

Flexible bronchoscopy contribution in the approach of diagnosis and treatment of children’s respiratory diseases: the experience of a unique pediatric unit in Tunisia

et al. 2016

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Objective: Our study aimed at assessing the role of flexible bronchoscopy (FB) in improving diagnosis and management of children's respiratory conditions in the pediatric unit of FB, newly created and unique in Tunisia. Methods: Retrospective study including all the FB achieved in our pediatric unit from 2009 to 2014. Results: We performed 365 FB in 333 patients aged 46 months on average (1 month -15 years), often under conscious anesthesia (81.6%). FB was performed for diagnostic purposes in 341 cases and for therapeutic purposes in 24 cases. Eight anatomical abnormalities were revealed in 22 patients. An intraluminal bronchial obstruction was found in 71 FB, mainly due to a foreign body (n=36). A vascular anomaly was responsible for nine cases out of 17 extraluminal obstructions. Airways malacia was observed in 60 FB. Bronchoalveolar lavage was performed in 196 cases. It was determinant in 43.9% of the cases. FB was of great diagnostic value in 74.8% of the cases. It influenced the management of the patients in 58% of the cases. The FB for therapeutic purposes was beneficial in all cases. Few complications occurred (5.5%). Conclusion: FB is a safe tool providing precious diagnostic and/or therapeutic help for the clinician. Tunisia. Afri Health Sci. 2016;16(1): 51-60. http://dx.doi.org/10.4314/ahs.v16i1.7 Introduction Pediatric pulmonology has experienced significant progress in recent decades in the understanding and management of respiratory diseases of children, becoming a specialty in itself. The development of diagnostic tools, including flexible bronchoscopy (FB), has contributed much to the development of this specialty.

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“…Whereas the frequency of postbronchoscopy fever following EBUS-TBNA was still unknown, our study showed firstly that 9.0% of patients had fever after EBUS-TBNA. Previous reports showed that the cause of postbronchoscopy fever may be because of the rise of inflammatory cytokines associated with tissue destruction and/or bacteremia [23]. The elevation of serum levels of inflammatory cytokines such as interleukin (IL)-1β, IL-6, and tumor necrosis factor alpha (TNF-α) have also been reported in patients who developed a fever above 38°C after bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Antibiotic Prophylaxis after Endobronchial Ultrasound-guided Transbronchial Needle Aspiration: A Preliminary Prospective Study

Takagi¹,

Nagaoka²,

Ando³

et al. 2017

J Pulm Respir Med

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A Prospective Study of Fever and Bacteremia After Flexible Fiberoptic Bronchoscopy in Children

Cited by 62 publications

References 21 publications

Complications of flexible bronchoscopy in children: prospective study of 1,328 procedures

Complications of flexible bronchoscopy in children: prospective study of 1,328 procedures

Flexible bronchoscopy contribution in the approach of diagnosis and treatment of children’s respiratory diseases: the experience of a unique pediatric unit in Tunisia

Efficacy of Antibiotic Prophylaxis after Endobronchial Ultrasound-guided Transbronchial Needle Aspiration: A Preliminary Prospective Study

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