Role of flexible bronchoscopy in the re-expansion of persistent atelectasis in children

OBJECTIVE: To evaluate the efficacy of flexible bronchoscopy plus bronchoalveolar lavage for the reexpansion of persistent atelectasis (course longer than 3 weeks) in children. PATIENTS AND METHODS: Retrospective review of the records of 83 children who underwent flexible fiberoptic bronchoscopy plus bronchoalveolar lavage for persistent atelectasis. Three categories of evolution were established for radiologic assessment: a) full re-expansion (full improvement over the initial image); b) partial re-expansion (decreased atelectasis of between 50% and 100%); and c) no change (if the decrease was less than 50% of the initial image). RESULTS: Endoscopy revealed mucus plugs in 54 patients (65%); bronchial malformations in 16 (19%); bronchial stenosis in 5 (6%); normal airways in 5 (6%) and other findings in 3 (4%). Radiologic changes after bronchoscopy showed full expansion for 34 patients (41%), partial re-expansion for 28 (34%) and no changes for 21 (25%). CONCLUSION: Flexible bronchoscopy plus bronchoalveolar lavage for the re-expansion of persistent atelectasis is useful in a high percentage of children.