ABSTRACT
Bronchoscopy in the newborn is an important diagnostic and therapeutic tool. Diagnosis of congenital laryngotracheal malformations and management of airway complications secondary to prolonged intubation are the two commonest indications for pediatric bronchoscopy. Rigid bronchoscopy is the diagnostic procedure of choice in the management of airway obstruction. Most neonates with stridor will have laryngomalacia and can be diagnosed with fiber-optic laryngoscopy in an outpatient setting. Rigid laryngobronchoscopy requires general anesthesia. Flexible bronchoscopy may be performed for diagnostic reasons in the neonate with mild stridor, unexplained wheezing, hemoptysis, chronic cough, persistent atelectasis, and persistent pulmonary infiltrates. It is also increasingly performed in the neonatal intensive care unit (NICU). The technique of bronchoalveolar lavage (BAL) has helped determine the diagnosis in a number of respiratory conditions including persistent/recurrent lower respiratory tract infections, interstitial pulmonary infiltrates, severe refractory lower respiratory tract infections in the setting of the intensive care unit (ICU), and pulmonary infiltrates in immunocompromised children.
