Measuring Pediatric Bronchoscopy Outcomes Using an Electronic Medical Record

DeBoer, Emily M.; Prager, Jeremy D.; Kerby, Gwendolyn S.; Stillwell, Paul C.

doi:10.1513/annalsats.201509-576oc

Cited by 24 publications

(41 citation statements)

References 27 publications

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“…In accordance with previous studies, we have demonstrated that children below 2 years of age are at a higher risk for severe complications . Similar findings related to other invasive procedures have also been reported in children in this age group .…”

Section: Discussionsupporting

confidence: 92%

“…Hence, comparison of overall numbers is difficult, since postprocedural complications accounted for most adverse events in our study. DeBoer et al developed and tested a method for analyzing flexible bronchoscopy outcomes by using an electronic medical recording system. A total of 1062 procedures were analyzed and complications were defined as events interrupting or terminating the bronchoscopy, differing considerably form the adverse events included in our analysis.…”

Section: Discussionsupporting

confidence: 92%

“…Existing reports on the incidence and the severity of complications related to bronchoscopy are extremely inconsistent, ranging from under 5% to over 30% . These inconsistencies are likely related to various factors including differences in the definitions of complications, patient populations and the types of procedures …”

Section: Discussionmentioning

confidence: 99%

“…The risk of relevant adverse events is dependent on several factors including the patients’ periprocedural condition, pre‐existing disease, and the type of intervention, which likely differ considerably even between large pediatric centers. Nevertheless data on the occurrence and the severity of complications related to bronchoscopy in children and adolescents are still scarce and sometimes contradictory . Furthermore, the comparability of existing studies is hindered by differences in study design and inconsistent definitions of complications.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, the comparability of existing studies is hindered by differences in study design and inconsistent definitions of complications. Only a few studies have focused on potential risk factors for complications in pediatric patients . The aim of this study was to evaluate frequency and severity of clearly defined complications of bronchoscopy that occur in children both during and after the procedure, and to identify potential risk factors for these complications.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Complications and risk factors in pediatric bronchoscopy in a tertiary pediatric respiratory center

Carlens

Fuge

Price

et al. 2018

Pediatric Pulmonology

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Complications and risk factors in pediatric bronchoscopy in a tertiary pediatric respiratory center

Carlens

Fuge

Price

et al. 2018

Pediatric Pulmonology

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Flexible and Rigid Bronchoscopy for Critically Ill Children on Extracorporeal Membrane Oxygenation

Young,

Patel,

Allen

et al. 2024

The Laryngoscope

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BackgroundWe aim to describe our experience with bronchoscopy to diagnose and relieve tracheobronchial obstruction in anticipation of decannulation in children on extracorporeal membrane oxygenation (ECMO) support.MethodsA retrospective cohort study of children on ECMO between 1/2018 and 12/2022.ResultsA total of 107 children required ECMO support during the study period for cardiac (n = 48, 45%), pulmonary (n = 38, 36%), or cardiopulmonary dysfunction (n = 21, 20%). Thirty‐seven (35%) patients underwent 99 bronchoscopies while on ECMO. Most (76%, n = 75) experienced no improvement or worsening of chest radiography 24 hours following bronchoscopy. Clinical improvement in tidal volumes 48 hours after the first bronchoscopy was noted in 13/25 patients with available data (p = 0.05). Adverse events were seen in 18 (49%) patients who underwent bronchoscopy, including pneumothorax (n = 8, 22%), pneumonia (n = 7, 19%), pulmonary hemorrhage (n = 6, 16%), and sepsis (n = 5, 14%). ECMO courses were longer (25.4 ± 37.2 vs 6.1 ± 8.8 days, p < 0.0001) and more likely to be complicated by pneumonia (p = 0.0004) and sepsis (p = 0.047) in patients who underwent bronchoscopy compared with those who did not. Adverse events following bronchoscopy were associated with the number of bronchoscopies (p = 0.0003) and the presence of obstructive materials but not with the type of bronchoscopy or indication for ECMO. Mortality rates were similar between patients who underwent bronchoscopy and those who did not.ConclusionChildren requiring bronchoscopy represent a subset of the sickest children on ECMO. Bronchoscopy may provide benefit in children with persistent cardiopulmonary failure who could not otherwise be decannulated. Adverse events are associated with the number of bronchoscopies and the presence of obstructive material.Level of Evidence4 Laryngoscope, 2024

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Evaluating the yield of gastrointestinal testing in pediatric patients in aerodigestive clinic

DeBoer

Kinder

Duggar

et al. 2018

Pediatric Pulmonology

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Objective To improve understanding of the interrelatedness of airway and esophageal diagnoses by evaluating the yield of procedural and radiographic testing of the gastrointestinal tract in children with airway conditions by their referring diagnoses in a pediatric aerodigestive clinic. Methods A retrospective chart review of all 325 patients seen in the aerodigestive program from 2010 to 2013 was performed in a single academic medical center. Demographics and results from esophagogastroduodenoscopies with biopsies (EGD), upper gastrointestinal fluoroscopy studies (UGI), and pH multichannel intraluminal impedance probe (pH‐MII) performed within 30 days of the clinic visit were evaluated according to presenting diagnoses. Results Mean patient age was 3.15 years (range 0.15‐24 years) and 41.2% were born premature. 189/325 (58.1%) were on acid suppression. A total of 295 EGD, 193 pH‐MII, and 54 UGI were performed. The most common diagnosis with an abnormal pH‐MII was asthma. The most common diagnoses with an abnormal EGD were feeding difficulty and tracheal esophageal fistula/ esophageal atresia (TEF/EA). EGDs were normal in 188/295 (63.7%), while 39/295 (13.2%) demonstrated esophagitis, and 22/295 (7.5%) had >15 esophageal eosinophils per high power field. The majority of pH‐MII (144/193 [74.6%]) and UGI (47/54 [87%]) were normal. Conclusions Children with feeding difficulty, TEF/EA, and asthma were the mostly likely to have a histologic abnormality on EGD or an abnormal pH‐MII. The majority of children were previously prescribed acid suppression medication and had a referring diagnosis of gastroesophageal reflux disease but were subsequently found to have normal evaluation. Prospective studies are needed to optimize care of this population.

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Measuring Pediatric Bronchoscopy Outcomes Using an Electronic Medical Record

Cited by 24 publications

References 27 publications

Complications and risk factors in pediatric bronchoscopy in a tertiary pediatric respiratory center

Complications and risk factors in pediatric bronchoscopy in a tertiary pediatric respiratory center

Flexible and Rigid Bronchoscopy for Critically Ill Children on Extracorporeal Membrane Oxygenation

Evaluating the yield of gastrointestinal testing in pediatric patients in aerodigestive clinic

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