| Fiberoptic bronchoscopy during nasal non-invasive ventilation in acute respiratory failure. | |
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MedLine Citation:
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PMID: 20424426 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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E Chiner; J N Sancho-Chust; M Llombart; C Senent; A Camarasa; J Signes-Costa |
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Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2010-04-27 |
Journal Detail:
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Title: Respiration; international review of thoracic diseases Volume: 80 ISSN: 1423-0356 ISO Abbreviation: Respiration Publication Date: 2010 |
Date Detail:
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Created Date: 2010-09-17 Completed Date: 2011-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0137356 Medline TA: Respiration Country: Switzerland |
Other Details:
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Languages: eng Pagination: 321-6 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 S. Karger AG, Basel. |
Affiliation:
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Pulmonology Section, University Hospital of Sant Joan d'Alacant, Sant Joan d'Alacant, Spain. chiner_eus @ gva.es |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Bronchoscopy / instrumentation* Female Fiber Optic Technology Humans Male Middle Aged Prospective Studies Respiratory Distress Syndrome, Adult / diagnosis* |
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