Flexible Bronchoscopy for the Pediatric Intensivist: A New Tool in the Handbag?

Foreign body aspiration (FBA) is a common cause of unintentional-injury mortality. Modern bronchoscopy techniques have reduced mortality in children with FBA. We describe a case of a 16-month-old child with refractory hypoxia where flexible bronchoscopy performed by the intensivist led to prompt etiology recognition and proper treatment. Patients presenting with respiratory distress with persistent hypoxia should be evaluated for FBA, considering initial chest X-ray can be normal in at least 30% of the cases. Intensivists trained in flexible bronchoscopy techniques possess a valuable tool to obtain diagnostic information avoiding delays in diagnosis and initiation of unnecessary therapies, such as extracorporeal membrane oxygenation.