Document Detail

Fiberoptic bronchoscopy during nasal non-invasive ventilation in acute respiratory failure.
MedLine Citation:
PMID:  20424426     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Various methods have been described for safely performing fiberoptic bronchoscopy (FB) while applying non-invasive positive pressure ventilation (NIPPV) in patients with acute respiratory failure (ARF).
OBJECTIVES: To evaluate the safety of a new method to perform FB in patients with ARF.
METHODS: Patients with ARF in whom FB was indicated were studied. The primary end-point was a mean drop in oxygen saturation (S(a)O(2)) after the procedure. During nasal NIPPV, FB was performed via the mouth using a bite block sealed with an elastic glove finger allowing bronchoscope insertion.
RESULTS: Thirty-five patients were included in the final study (63 ± 17 years, 74% men, P(a)O(2)/F(i)O(2) ratio 168 ± 63). A total of 35 bronchoaspirates, 21 protected brushings, 11 bronchoalveolar lavages and 8 bronchial biopsies were done. The cardiorespiratory variables at the start and end of FB were: S(a)O(2) 93 ± 3 to 94 ± 5%, heart rate 95 ± 17 to 99 ± 22 b.p.m. and respiratory rate 24 ± 11 to 25 ± 11 respirations/min. The lowest S(a)O(2) value reached during the procedure was 86 ± 3% and the maximal ETCO(2) rise was 41 ± 4 mm Hg. Leakage was <50 ml/s in 32 patients. The clinical course was favorable in 66%. Invasive ventilation was necessary in 11%, 5 ± 4 days after FB. Twelve patients (33%) died 3 ± 2 days after FB as a result of their underlying disease.
CONCLUSIONS: The system allowed to perform FB safely in patients with ARF. Although there is a relatively high rate of intubation and invasive mechanical ventilation due to illness severity, there was no worsening of oxygenation or complications attributable to the procedure.
E Chiner; J N Sancho-Chust; M Llombart; C Senent; A Camarasa; J Signes-Costa
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-04-27
Journal Detail:
Title:  Respiration; international review of thoracic diseases     Volume:  80     ISSN:  1423-0356     ISO Abbreviation:  Respiration     Publication Date:  2010  
Date Detail:
Created Date:  2010-09-17     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0137356     Medline TA:  Respiration     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  321-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 S. Karger AG, Basel.
Pulmonology Section, University Hospital of Sant Joan d'Alacant, Sant Joan d'Alacant, Spain. chiner_eus @
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MeSH Terms
Aged, 80 and over
Bronchoscopy / instrumentation*
Fiber Optic Technology
Middle Aged
Prospective Studies
Respiratory Distress Syndrome, Adult / diagnosis*

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