Flexible Bronchoscopy in Resistant Pneumonia in PICU (FFP-RP PICU)

Outcome of Flexible Fiber Optic Bronchoscopy Usage in Children With Resistant Pneumonia in Pediatric Intensive Care Units (PICU )

Pneumonia is one of the most common and serious infections in children, especially those admitted to Pediatric Intensive Care Units (PICUs). Some children do not improve after at least five days of appropriate broad-spectrum antibiotic treatment. This condition is known as resistant or non-resolving pneumonia.

Flexible fiberoptic bronchoscopy (FFB) is a procedure that allows doctors to directly examine the airways and collect samples from the lungs for laboratory testing. This study aims to evaluate the role and usefulness of flexible bronchoscopy and bronchoalveolar lavage (BAL) in identifying the causes of resistant pneumonia in critically ill children.

The study will include children admitted to the PICU at Abu El-Reesh Children's Hospital, Cairo University, who show no clinical or radiological improvement after five days of first-line antibiotic therapy. The results of this study may help improve diagnosis, guide targeted treatment, and enhance outcomes in children with resistant pneumonia.

Study Overview

• Status: Active, not recruiting
• Conditions: Pneumonia; Resistant Pneumonia

• Study Type: Observational
• Enrollment (Estimated): 58

Contacts and Locations

Study Locations

• Egypt
  • Cairo Governorate
    • Cairo, Cairo Governorate, Egypt, 11562
      • faculty of medicine , Abu Elreesh children hospital
    • Cairo, Cairo Governorate, Egypt
      • faculty of medicine , Abu Elreesh children hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Pediatric patients admitted to the PICU at Abu El-Reesh Children's Hospital, Cairo University, diagnosed with resistant severe pneumonia and undergoing diagnostic flexible fiberoptic bronchoscopy

Description

Inclusion Criteria:

• - Children aged more than 3 months and less than 18 years.
• Admitted to Pediatric Intensive Care Unit (PICU).

• Severe pneumonia defined as cough or difficulty breathing with at least one of the following:

  • Oxygen saturation < 90% on pulse oximetry
  • Severe respiratory distress
  • General danger signs (inability to drink, lethargy, convulsions)
• No clinical or radiological improvement after at least five days of first-line broad-spectrum antibiotic therapy.
• Informed consent obtained from parent or legal guardian.

Exclusion Criteria:

• Age less than 3 months or more than 18 years.
• Absolute contraindication to flexible bronchoscopy (severe refractory hypoxemia, hemodynamic instability, uncorrected bleeding disorder).

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
resistant pneumonia patients; Children admitted to the Pediatric Intensive Care Unit (PICU) with severe pneumonia who show no clinical or radiological improvement after at least five days of first-line broad-spectrum antibiotic therapy and undergo flexible fiberoptic bronchoscopy for diagnostic evaluation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Diagnostic yield of flexible fiberoptic bronchoscopy (FFB) in resistant pneumonia	Proportion of patients in whom flexible fiberoptic bronchoscopy with bronchoalveolar lavage identifies a specific etiological pathogen (bacterial, viral, or fungal) responsible for resistant pneumonia	Within 7 days after bronchoscopy procedure

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Prevalence of resistant pneumonia in PICU	Percentage of pediatric intensive care unit patients diagnosed with resistant pneumonia among total admitted pneumonia cases during the study period.	Within 7 days after bronchoscopy procedure

Collaborators and Investigators

• Sponsor: Mansour Gomaa Mohammed Saleh

Study record dates

Study Major Dates

• Study Start (Actual): February 5, 2023
• Primary Completion (Estimated): April 1, 2026
• Study Completion (Estimated): April 1, 2026

Study Registration Dates

• First Submitted: February 12, 2026
• First Submitted That Met QC Criteria: February 12, 2026
• First Posted (Actual): February 19, 2026

Study Record Updates

• Last Update Posted (Actual): February 19, 2026
• Last Update Submitted That Met QC Criteria: February 12, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Respiratory Tract Infections; Infections; Respiratory Tract Diseases; Lung Diseases; Pneumonia
• Other Study ID Numbers: MD-207-2023

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No