PEDIATRICS Vol. 82 No. 6 December 1988, pp. 884-887
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Bronchoscopic Findings in Infants Treated With High-Frequency Jet Ventilation Versus Conventional Ventilation

Carolyn M. Kercsmar MD1, Richard J. Martin MB1, Robert L. Chatburn RRT1, and Waldemar A. Carlo MD1

1 From Case Western Reserve University and the Department of Pediatrics at Rainbow Babies and Children's Hospital, Cleveland

To identify tracheobronchial abnormalities associated with assisted ventilation, 40 infants with respiratory distress syndrome randomized to receive either short-term (48 hours) conventional or high-frequency jet ventilation were studied. Flexible fiberoptic bronchoscopy (n = 13) was performed and/or clinical and radiographic assessments were used to evaluate for laryngeal, tracheal, and bronchial lesions. There was no bronchoscopic evidence of necrotizing tracheobronchitis after either high-frequency jet ventilation (n = 8) or conventional ventilation (n = 5). Laryngotracheomalacia and nodular vocal cords were the most common abnormalities noted, and they occurred with equal frequency in both groups. Study infants who were not bronchoscoped had no clinical or radiographic evidence of tracheal or mainstem bronchial obstruction. One patient did have microscopic evidence of necrotizing tracheobronchitis at autopsy, however. It is concluded that short-term treatment of respiratory distress syndrome with high-frequency jet ventilation may be performed without undue risk of tracheobronchial injury.

Key Words: bronchoscopy • assisted ventilation • ecrotizing tracheobronchitis • high-frequency jet ventilation

Submitted on July 20, 1987
Accepted on December 10, 1987