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2006, Number 1

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Acta Pediatr Mex 2006; 27 (1)

Bronchoscopy in children with persistent atelectasis. Endoscopic findings and results of selective aspiration (1994-2003)

Cuevas-Schacht F, Garrido-Galindo C, Sosa-de-Martínez MC, Pérez-Fernández LF

Language: Spanish
References: 22
Page: 10-18
PDF size: 71.47 Kb.


ABSTRACT

Objective: To determine antecedents and clinical characteristics of persistent atelectasis in patients who underwent a bronchoscopic study, in terms of their radiological evolution 24 h later.
Design: Retrospective, longitudinal, descriptive and observational.
Place and date: Endoscopy Service of the National Institute of Pediatrics, between January 1st, 1994 and August 31st, 2003.
Material and methods: All clinical-radiological files of patients with persistent atelectasis who underwent a bronchoscopical examination were studied. The following information was retrieved: age, gender, the following antecedents: prematurity, pneumopathy due to aspiration, previous surgery, respiratory infection, mechanical ventilation, evolution (in days), and previous treatment; regarding the atelectasis: endoscopic location, procedure, clinical and radiological evolution 24 h after the procedure. Information was described graphically and numerically. As explanatory variable, radiological evolution 24 h after the bronchoscopy was used. When the response variable was categorical, Chi-square test was performed; when continuos, the Kruskal-Wallis test. All tests were two-tailed with α=0.05.
Results: One hundred and seventeen patients fulfilled the selection criteria. In 29 patients no radiological improvement was observed; in 56, partial improvement; in 32, the problem was solved. No significant differences were detected in terms of gender, nor the rest of the antecedents. In the three groups, during the endoscopic procedure the most frequent findings were: some degree of mucous endobronchitis; in the lumen, mucous hypersecretion; in the wall, dyscinesia. When the radiological and the clinical evolution were correlated by means of a weighted kappa test, a fairly good association (κ=0.73) was observed, which was highly significant (p‹=.0001).
Discussion: When we compared the present study with the one we performed between 1990-1992, highly significant differences (p ‹0.01) were detected, since in this study we obtained 27% of cures versus 7% in the previous study, possibly due to the experience acquired in the management of these patients, as well as the improved techniques performed in this study.


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