Clinical application of flexible bronchoscopy in neonatal respiratory diseases

Abstract Background: Respiratory diseases are an important component of neonatal diseases, and flexible bronchoscopy is increasingly used in neonates. This study aimed to investigate the value of bronchoscopy in neonatal respiratory abnormalities and to evaluate the safety of bronchoscopy application. Methods: Clinical data and outcomes of 56 children who underwent flexible bronchoscopy were retrospectively analyzed. Correlations among indications for bronchoscopy, findings, and clinical diseases were analyzed. Results: A total of 56 children had a minimum body weight of 1200 g at the time of bronchoscopy, and the minimum gestational age at birth was 26+1 weeks. A total of 22 cases (39.3%) had two or more clinical indications; the five most common indications were dyspnea in 24 cases (42.9%), laryngeal tinnitus in 22 cases (39.3%), pulmonary atelectasis in 10 cases (17.6%), feeding difficulty in 10 cases (17.6%), and difficulty in extubation in 6 cases (10.7%). A total of 16 types of structural and functional abnormalities were detected in the respiratory tract. The most common symptoms were laryngomalacia in 29 cases (59.2%), tracheobronchial tenderness in 8 cases (16.3%), and vocal cord paralysis in 6 cases (12.2%). Bronchoalveolar lavage was performed in 39 cases. Eight children were diagnosed by bronchoscopy and then underwent thoracic or pentacameral surgery; all of them were cured and discharged from the hospital after surgery. No serious complications, such as pneumothorax or shock, occurred in any of the children, and none died. Conclusions: Flexible bronchoscopy plays an important role in diagnosing and identifying respiratory disorders in neonates and can be safely used in neonates with few serious complications.