Bronchoscopic Treatment of Atelectasis

Pulmonary atelectasis in children was often found to have cleared soon after diagnostic bronchoscopy. Re-ventilation occurred even in children in whom the collapse had resisted the usual methods of treatment during preceding weeks or months. It was, therefore, decided to bronchoscope every child with pulmonary collapse provided the collapse was known to have existed for more than five weeks. In a few children the examination was carried out sooner than five weeks after the existence of the collapse was known, either because the indications were urgent or because the collapse could reasonably be assumed to have existed for a considerable time. Bronchoscopy was carried out on 50 consecutive children admitted with atelectasis, unselected apart from the exclusion of cases due to foreign body, and irrespective of the presumed aetiology of the collapse. Sixty-seven collapsed lobes were present in these 50 children, whose ages ranged from 17 days to 12 years, the average age being 3 years 11 months. The lobes involved were: right upper, 14; right middle, 17; right lower, 21; left upper (including lingula), 7; left lower, 8. In 15 cases several lobes were collapsed. The collapse was known to have existed from three days to two years four months, the average being 15j weeks. Antero-posterior and lateral radiographs were taken 10 days after the examination. The effect of bronchoscopic aspiration was considered good if the lung had re-expanded after 10 days, fair if it had cleared one month after bronchoscopy and poor if the collapse persisted.