Finding Of Flexible Bronchoscopy In 212 Infants With Recurrent Wheezing

Objectives To investigate the common causes of recurrent wheezing in infants, and to observe the efficay and the safety of flexible bronchoscopy (FB) in infants with persistent and recurrent wheezing.Methods Between Jan 2008 and Dec 2010,212 patients with recurrent wheezing more than 3 times were included to this study. Clinical data and findings of FB and bronchoalveolar lavage fluid (BALF) were retrospective analysized .For purposes of data analysis,patients were divided into～1 yr and～3 yr age groups,and also divided into <1month, <3month ,≥3month groups ,based on the duration of symptom.Results Definitive diagnosis was made by flexible bronchoscopy in 81.1% of the patients (n=172). The most common cause was tracheobronchomalacia (n=88,41.5%), and tented to be more common in the～1 yr group. Then followed by asthma (n=30), airway stenosis (n=27), pneumonia (n=26), tracheobronchomalacia and airway stenosis (n=19), abnormal branching of the bronchial tree (n=11), vascular rings (n=6), laryngomalacia (n=2),foreign body(n=1), aplasia of the right lung (n=1), idiopathicpulmonary hemosiderosis(n=1). BAL revealed positive bacterial growth in 99 out of 177(55.9%) patients.Minor complications were seen in 15.1% of the patients ,the most frequently were fever(n=18) and transient hypoxemia (n=6).Conclusions In additional to asthma,congenital abnormalities of the lower airways such as tracheobronchomalacia and airway stenosis are also the common causes in infants with recurrent wheezing. FB can be regarded as a golden criteria for diagnosis of these congenitals abnormalities, and also is an important tool for the differential diagnosis of asthma. For these children with recurrent wheezing and poor response to the conventional treatment, early FB evaluation can provided accurate diagnosis and symptomatic therapy.