A Retrospective Study of Rigid Bronchoscopy in 58 Paediatric Cases with Acute Respiratory Distress

Context: Rigid bronchoscopy has been time tested modality for management of acute respiratory distress, especially in paediatric cases of foreign body in bronchus. However, there still persists dilemma regarding its application in conditions other than foreign body bronchus. Aims: To explore extended indications of rigid bronchoscopy in paediatric cases with acute respiratory distress . Settings and Design: Retrospective study of rigid bronchoscopy performed in paediatric cases with acute respiratory distress from January 2006 to July 2011 at tertiary care centre in India. Methods and Material: All 58 paediatric cases who underwent emergency or elective rigid bronchoscopy for acute respiratory distress between January 2006 to July 2011 were included in the study. Results: Out of the total 58 cases included in our study, 35 (60%) patients had foreign body aspiration history and 23(40%) had no history of foreign body bronchus. However, while doing rigid bronchoscopy in the latter cases, foreign body was found in 5 patients whereas 18 had secretions and mucus plugs. All 23 patients had swift clinical recovery after the procedure. Conclusions: All paediatric cases presenting with acute onset of respiratory distress without history suggestive of foreign body aspiration should also be assessed by a diagnostic rigid bronchoscopy if they do not improve within 48 hours of medical treatment. Early diagnosis and intervention is the key to successful management.