Impact of fiberoptic bronchoscopy on systemic inflammatory markers and outcomes in neonatal patients with respiratory conditions.

Abstract

Background: Fiberoptic bronchoscopy is an essential tool in neonatal respiratory medicine, facilitating both diagnosis and management of complex respiratory disorders. Despite its widespread use, the procedure's impact on systemic health parameters, including inflammation, remains under-evaluated. This study investigates the effects of fiberoptic bronchoscopy on respiratory function and systemic inflammatory markers, such as the systemic immune-inflammation index (SII), in neonatal patients.

Methods: A retrospective analysis was conducted on 38 neonatal patients at Anhui Provincial Children's Hospital who underwent fiberoptic bronchoscopy between January 2019 and December 2022. Clinical characteristics, respiratory outcomes, including partial pressure of oxygen (PO₂) and oxygen saturation (SO₂), and systemic inflammatory responses were assessed. Key parameters like blood gas values, SII, and other inflammatory markers were evaluated pre- and post-bronchoscopy. Multivariate linear regression and receiver operating characteristic (ROC) curve analysis were deployed to explore the relationships between inflammatory markers and neonatal hyperbilirubinemia risk.

Results: Significant improvements were noted in blood gas parameters post-treatment, with increased PO₂ and SO₂ levels indicative of enhanced respiratory function. Inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), and notably SII, showed significant reductions post-bronchoscopy, suggesting decreased systemic inflammation. SII emerged as a strong predictor for neonatal hyperbilirubinemia with an area under the curve (AUC) of 0.9091, highlighting its potential clinical utility. The study also identified correlations between bilirubin levels and SII, underscoring a novel link between systemic inflammation and bilirubin metabolism in neonates.

Conclusions: Fiberoptic bronchoscopy offers significant therapeutic benefits in neonatal respiratory care beyond airway management. The identified reduction in systemic inflammation and the novel association between SII and neonatal hyperbilirubinemia offer important insights for optimizing clinical practices and patient outcomes in neonatal respiratory medicine. Further research is warranted to validate these findings and explore their implications for individualized patient care.