In Reply.—We appreciate Dr Schellhase's comments. Our lack of problems with oxygen desaturation may indeed be related to the narrower diameter of the bronchoscope (1.3 or 2 mm). In addition, we routinely limit each pass of the bronchoscope to 30 seconds to prevent prolonged airway obstruction.
We did not routinely measure blood pressure continuously throughout the procedure. Measurements before and after the procedure and a few cases in which monitoring was performed did not reveal significant changes. This may also be related to the minimal period of airway obstruction.
We are, at present, continuing to study the applicability and safety of fiberoptic bronchoscopy in intubated neonates and agree that, until further data are available, this procedure cannot as yet be considered routine.