Safety of endobronchial biopsy in 170 children with chronic respiratory symptoms

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Abstract
Background: There is a paucity of bronchial biopsy data in children. A major limitation is concern over the safety of the procedure. This paper reports the results of efforts to develop a method that is safe and provides adequate specimen for evaluation. Methods: 170 children aged 2.5 to 16 years with chronic respiratory symptoms were studied under general anaesthesia in an outpatient surgery setting. Bronchoalveolar lavage and biopsies were obtained using a 4.9 mm flexible bronchoscope through a laryngeal mask airway. At least three bioipsies were taken. Results: No patient required topical adrenaline to control bleeding, nor was there a change in the state of any of the patients. There were no episodes of pneumothorax, haemoptysis, pneumonia, or significant fever. All children less than four years old received a single dose of antibiotic intravenously after the procedure. The average length of time for the procedure was 12 minutes (range 6 to 27). Recovery time averaged 90 minutes. The limiting factor was the ability of the child’s airway to accomodate the bronchoscope. Conclusions: This report should encourage clinicians to incorporate endobronchial biopsy into the evaluation of children with difficult respiratory problems.