Bronchoscopic treatment of pediatric atelectasis: A modified segmental insufflation-surfactant instillation technique

Pediatr Pulmonol. 2024 Mar;59(3):625-631. doi: 10.1002/ppul.26792. Epub 2023 Nov 29.

Abstract

Background: Atelectasis is a condition characterized by the collapse and nonaeration of lung regions and is considered a manifestation of an underlying disease process. The goal of atelectasis treatment is the restoration of volume loss. In the range of different treatment options, chest physiotherapy is often used as a first-line approach, and some cases require bronchoscopic interventions.

Methods: In this case series, we describe a modified bronchoscopic treatment procedure using pressure-controlled bronchoscopic segmental insufflation with surfactant application.

Results: The proposed approach resulted in significant improvement of lung volume across a range of patients including massive lobar, atypical rounded atelectasis in previously healthy patients, and in a particularly challenging case involving an infant suffering from spinal muscular atrophy type I.

Conclusion: The modified segmental insufflation-surfactant instillation technique offers a safe and promising easily implementable treatment of persistent atelectasis caused by different underlying disease processes with positive long-term outcomes.

Keywords: atelectasis; bronchoscopy; pneumonia; spinal muscular atrophy.

MeSH terms

  • Bronchoscopy / methods
  • Child
  • Humans
  • Infant
  • Insufflation* / adverse effects
  • Pulmonary Atelectasis* / etiology
  • Pulmonary Atelectasis* / therapy
  • Pulmonary Surfactants* / therapeutic use
  • Surface-Active Agents

Substances

  • Surface-Active Agents
  • Pulmonary Surfactants

Grants and funding