Pediatric Bronchoscopy and LUS

Atelectasis and Lung USG Scores in Pediatric Patients Undergoing Bronchoscopy

Rigid bronchoscopy is commonly used for diagnosing and treating lung and airway diseases, including foreign body removal. Patients often experience atelectasis post-procedure, which lung ultrasound (LUS) can effectively detect. LUS is a rapid, noninvasive imaging technique that provides real-time evaluation without the need for patient transportation. In this observational study, researchers will assess the incidence and severity of atelectasis in patients undergoing elective rigid bronchoscopy, comparing those who were intubated and awakened post-procedure with those who were not intubated. The study aims to determine whether intubation influences the development of atelectasis after bronchoscopy.

Study Overview

• Status: Completed
• Conditions: Atelectasis; Atelectasis, Postoperative Pulmonary

Detailed Description

Rigid bronchoscopy has been used for many years in the diagnosis and treatment of various primary diseases of the lungs and airways, removal of tracheobronchial foreign bodies and therapeutic procedures for central airway pathologies. Most patients have atelectasis after the procedure. Lung ultrasound (LUS) has begun to take its place in clinical use as a new tool for the detection of both acute and chronical pathologies in the perioperative period and intensive care follow-up of patients. Its use is rapid, noninvasive, point-of-care, without radiation and no need patient transportation. The imaging pattern of atelectasis is similar to that of lung consolidation, and the B line image and loss of lung shear are considered typical findings. Atelectasis after a bronchoscopy procedure can be recognized with LUS. As standard procedure, after bronchoscopy, patients are given drugs (neostigmine or sugammadex) to reverse the effect of muscle relaxants and are allowed to wake up. During this time, patients are sometimes intubated until their respiratory function is fully restored and the patient wakes up. Which patient is intubated depends on factors such as the patient's comorbidities, lung capacity, the procedure performed and the clinician's preference. Intubation may reduce the development of atelectasis due to positive airway pressure. In this observational study, we aim to determine the frequency and degree of atelectasis in patients undergoing elective rigid bronchoscopy using lung ultrasound. Specifically, we will compare the frequency and degree of atelectasis in patients who were intubated and awakened after bronchoscopy and those who were awakened without intubation.

• Study Type: Observational
• Enrollment (Actual): 30

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey, 34899
    • Marmara University Pendik Training and Research Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

1-17 year old pediatric patients who will undergo elective rigid bronchoscopy under general anesthesia by the pediatric surgery department at Marmara University Training and Research Hospital.

Description

Inclusion Criteria:

• Elective rigid bronchoscopy
• American Society of Anaesthesiologists (ASA) physical status I or II

Exclusion Criteria:

• Emergent rigid bronchoscopy
• ASA III or above
• Patients left intubated after the procedure

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Group C; Patients not intubated at the end of the bronchoscopy during the neuromuscular block reversal and weaning course.
Group I; Patients intubated at the end of the bronchoscopy during the neuromuscular block reversal and weaning course.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Atelectasis	Lung ultrasound score (LUS) will be used for the detection of atelectasis. Each lung will be evaluated separately and scores will be recorded. Scores will be obtained from 6 regions for each lung (anterior superior/inferior, middle superior/inferior, posterior superior/inferior) for a total of 12 regions for each patient. Scoring will be based on the 'B lines' pattern seen on LUS (B0, B1, B2, B3, indicating progressive atelectasis). A score of 0 to 3 points will be given for each lung field measured, for a total LUS of 0-36.	From the preinduction period in the operating theater to the postoperative recovery of the patient again in the operating theater.

Collaborators and Investigators

• Sponsor: Marmara University
• Investigators: Principal Investigator: Ruslan Abdullayev, Marmara University Department of Anesthesiology and Reanimation

Study record dates

Study Major Dates

• Study Start (Actual): October 25, 2024
• Primary Completion (Actual): May 1, 2025
• Study Completion (Actual): May 1, 2025

Study Registration Dates

• First Submitted: October 24, 2024
• First Submitted That Met QC Criteria: October 24, 2024
• First Posted (Actual): October 26, 2024

Study Record Updates

• Last Update Posted (Actual): June 10, 2025
• Last Update Submitted That Met QC Criteria: June 9, 2025
• Last Verified: October 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Lung Diseases; Pulmonary Atelectasis
• Other Study ID Numbers: 09.2024.870

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No