Document Detail


Efficacy of selective intrabronchial air insufflation in acute lobar collapse.
MedLine Citation:
PMID:  1443377     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Flexible fiberoptic bronchoscopy (FFB) to remove mucous plugs followed by selective intrabronchial air insufflation (SII) to expand the atelectatic lung was used in 17 surgical intensive care unit (SICU) patients with pulmonary lobar collapse. Thirteen patients were admitted for acute trauma, and the remainder were elderly postoperative patients. Lobar collapses occurred on SICU days 1 to 18 (mean +/- SEM: 5 +/- 1 days), and duration ranged from 4 to 258 hours (mean: 77 +/- 18 hours). Indications for FFB with SII included critical hypoxemia in 5 patients, worsening collapse in 2, and failure to respond to aggressive respiratory care in 10 (59%). FFB with SII was effective in 14 (82%) patients: 10 achieved full lung re-expansion, and 4 partial lung re-expansion. When lobar collapse was of less than 72 hours' duration, 92% (12 of 13) of patients had lungs re-expanded compared with 50% (2 of 4) whose collapse existed for more than 72 hours. The mean PaO2/FIO2 (fraction inspired oxygen) ratio was 135 +/- 18 prior to FFB with SII and increased to 205 +/- 21 after FFB with SII. Complications were minor and clinically insignificant. In conclusion, SII appears to be a simple, safe, effective adjunct to FFB in the treatment of SICU patients with pulmonary lobar collapse.
Authors:
J B Haenel; F A Moore; E E Moore; R A Read
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  164     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1992-12-14     Completed Date:  1992-12-14     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  501-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Denver General Hospital, University of Colorado Health Science Center 80204-4507.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Bronchi
Bronchoscopy
Child
Clinical Protocols
Expectorants / therapeutic use
Female
Fiber Optic Technology
Humans
Insufflation* / methods
Intensive Care
Intubation, Intratracheal
Irrigation
Male
Middle Aged
Oxygen / administration & dosage,  therapeutic use*
Prospective Studies
Pulmonary Atelectasis / drug therapy,  therapy*
Suction
Chemical
Reg. No./Substance:
0/Expectorants; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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