Over the past thirty years, neonatal care and treatment options have changed due to advancements in intensive care. In advanced respiratory care, direct viewing of the respiratory tract using bronchoscopy is a valuable diagnostic and therapeutic method. 

While otorhinolaryngologists and pulmonologists have historically done bronchoscopies, neonatologists are mastering this task. Their efforts in neonatal bronchoscopy using flexible bronchoscopes are particularly useful. While it was previously unfeasible, the use of bronchoscopes on newborns is now possible because of the smaller devices that are currently used.  

What is Neonatal Bronchoscopy? 

Respiratory diseases are a problem that many newborns suffer from, and most newborns in intensive care units (ICUs) have this issue. The intricate link between lung immaturity, lung damage due to ventilator use, and infection in ventilated patients is difficult to understand, and the clinical treatment of this is challenging. 

A crucial technique for the identification and management of a range of neonatal respiratory conditions is flexible bronchoscopy. With the advancement of bronchoscopy technology and equipment, flexible bronchoscopy use has increased, and they especially help in the identification and treatment of aberrant airways. 

A neonatal bronchoscopy is advised by a medical professional to determine the root of any potential lung issues in a newborn. The most typical reason for a bronchoscopy is to identify pulmonary conditions or other reasons for symptoms such as persistent coughing, blood in the cough, or dyspnea. It also helps to identify the reasons behind lung irritation or infection, and to collect tissue or mucous samples that get sent to a lab for examination.  

What is the Process of Bronchoscopy?

A bronchoscope is a little tube with a camera and light attached to it, and it can support a doctor in the diagnosis, assessment, and occasionally the treatment of disorders affecting the throat, trachea, or lungs. Using a bronchoscope, a healthcare professional can see into the lungs and airways during a minimally invasive bronchoscopy examination, and this is mainly done if the patient is suffering from chronic respiratory disease. 

There are two types of bronchoscopes, called flexible and rigid. A bendable tube is called a flexible bronchoscope, and it is easier for doctors to maneuver down the airway with a flexible bronchoscope. A hard tube is called a rigid bronchoscope, and it's used by healthcare professionals when anything gets lodged in the airway or when stent placement, tumor treatment, or hemorrhage control is needed. 

Insights into the Bronchoscopy Procedure

Censors are placed on the patient’s body to monitor the heart rate, blood pressure, and oxygen saturation, and doctors use numbing medication on the lips and may also spray numbing gel into the nose. The bronchoscope is inserted into the mouth or nostril during a bronchoscopy, and at the tip of the bronchoscope is a tiny camera and light that the doctor can use to project the video onto a monitor.

The bronchoscope is gently moved into the throat, past the vocal cords, and into the airways. The physician uses the bronchoscope to take tissue or fluid samples if needed. In most cases, the process takes 30 to 45 minutes, but for newborns, it may take longer.

When anything alien becomes stuck in the throat or airways of a newborn, a rigid bronchoscope can be employed because the large head of the rigid scope facilitates therapeutic procedures and the removal of foreign items. A rigid bronchoscopy necessitates total unconsciousness under general anesthesia, and that is why it is rarely used for newborns. Rigid bronchoscopy is usually not something a doctor will undertake unless the newborn also requires another surgery.

Neonatal Bronchoscopy Outcomes 

Pulmonologists and respiratory therapists depend on bronchoscopy to confidently identify and treat neonatal lung disease. The following are the most common bronchoscopy outcomes: 

1. Early Identification of Lung Disease 

Early detection of lung disorders, including TB and pneumonia, is a significant advantage of bronchoscopy, as well as higher odds of recovery and better treatment results from early identification. It doesn't need lengthy recuperation periods or huge incisions as surgery does, and usually, either local anesthesia or light sedation get used during the process. Being less intrusive than surgery is one of the main benefits of bronchoscopy because newborns are not good candidates for invasive operations.  

2. Reliable Diagnosis Helps with Treatment 

Although bronchoscopy is performed for several purposes, diagnostic purposes account for the majority of its usage. For instance, in order to look into respiratory conditions like strep throat, shortness of breath, persistent cough, or abnormal chest X-rays, doctors may perform a bronchoscopy, and the process can also determine the origin of bleeding, tumors, or lung infections. 

Furthermore, a bronchoscopy real-time imaging makes it possible to obtain samples for further examination, and it is also a secure and efficient method for correctly identifying the best course of action for the newborn’s treatment plan.  

3. Therapeutic Uses

The ability of bronchoscopy to remove foreign items from the airway is the therapeutic use of this process. By obtaining tissue samples for additional analysis and therapy planning, it may also be used to detect and treat respiratory diseases, and it has been shown that therapeutic bronchoscopy can alleviate respiratory symptoms such as wheezing, coughing, and dyspnea, especially in older children and adults. With its focused treatment choices, this minimally invasive process can greatly enhance the quality of life of newborns suffering from respiratory problems. 

Final remarks

All things considered, neonatal bronchoscopy is a useful technique for the diagnosis and treatment of respiratory disorders in newborns and can save lives as well as help treat respiratory issues.