Use of the paediatric bronchoscope, flexible and rigid, in 51 European centres

We have undertaken a survey to establish current practices and differences in the use of bronchoscopes in children in European centres, A questionnaire was sent to all 220 members of the Paediatric Assembly of the European Respiratory Society (ERS), The questions concerned the following points: indications for bronchoscopy; site of bronchoscopy; type of sedation; any oxygen supplementation during the procedure; number of procedures performed in the previous 12 months; number of procedures performed in the neonatal intensive care unit; number of bronchoalveolar lavages (BALs); side-effects during and after the procedures; and diagnostic yield, Fifty one European centres (40.8% of the European centres contacted) took part in the study, A total of 7,446 bronchoscopies had been performed in the last 12 months: 4,587 using the flexible bronchoscope and 2,859 using the rigid broncho scope, At centres using only the fibreoptic bronchoscope, the most frequent indication was ''recurrent/persistent pneumonia'' (17%); at centres using only the rigid bronchoscope, it was ''foreign body inhalation'' (36.7%); at centres using both methods, the most frequent indication was ''other indications'' (23.9%), In 12 months, 2,231 BALs were performed: 1,419 in immunocompetent children and 812 in immunocompromised patients, In centres using only the fibreoptic bronchoscope, the highest yield was for ''stridor'' (81%); in centres using only the rigid bronchoscope, the highest yield was for ''persistent atelectasis'' (68%); and in centres using both instruments, it was for ''foreign body inhalation'' (93%), The results of the study suggest that bronchoscopy in children is now a well-established procedure at several European centres, while others are just beginning to use this technique.