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FIBEROPTIC BRONCHOSCOPY
AAMIR HUSAIN
The Professional Medical Journal , 2009,
Abstract: Objectives: To demonstrate the usefulness of Bronchoscopy as a diagnostic tool in various pulmonary disorders. Design: Prospective study. Setting: Nawaz Medicare Hospital Faisalabad. Period: June 2004 to December 2007. Materials & Methods: This study was conducted on 52 patients, 37 were male & 15 were female. Their ages ranged from 26 to 85 years. These patients who under went Bronchoscopy were either suspected cases of bronchogenic carcinoma or had difficult to treat un-resolving pneumonias. Endobronchial biopsies and bronchial aspirates were obtained. Results: In the patients suspected of bronchogenic tumor 66.67% patients turned out to be positive on endobronchial biopsies. Bronchial aspirates were diagnostic in 73.32% cases of un-resolving pneumonias. The commonest symptoms in patients under going Bronchoscopy were haemoptysis and cough. Conclusion: Bronchoscopy is very useful in the diagnosis of suspected cases of bronchogenic carcinoma. Bronchial aspirates are helpful in the diagnosis of un-resolving pneumonias.
Dignostic Yield of Fiberoptic Bronchoscopy in a Teaching Hospital
Rajinder Singh,Harneet Kaur,Gurmeet Singh
JK Science : Journal of Medical Education & Research , 2008,
Abstract: Fiberoptic bronchoscopy is minimally invasive procedure which can be performed on outpatient basis.Thestudy is a reterospective review of the data at a tertiary center and compares the diganostic yield of thepatients (n=720), who underwent FB at our pulmonary unit with the data from international centers. Thediagnostic yield of the FB was high(70%) with good selection of the patients and growth was the mostcommon finding followed by infections.FB was normal in 218(30%) patients. Flexible fiberoptic bronchoscopyis a useful diagnostic tool with a low rate of complications. The diagnostic yield in our institution is alsmostsimilar to that reported in other series.
Extraction of Aspirated Headscarf Pins with Fiberoptic Bronchoscopy  [PDF]
Ahmed I. Al-Azzawi
World Journal of Cardiovascular Surgery (WJCS) , 2017, DOI: 10.4236/wjcs.2017.712016
Abstract: Background: Foreign body aspiration is a common yet preventable health problem. Headscarf pin aspiration is a unique example of aspirated foreign bodies in young Muslim women usually removed using the rigid bronchoscope. However, the flexible bronchoscope is increasingly used for this purpose. This prospective study was conducted in Sulaimaniyah Teaching Hospital, Sulaimaniyah, Iraq and aimed to evaluate the usefulness of fiberoptic bronchoscope for removal of aspirated headscarf pins in view of the relevant literature. Methodology: Fifty female patients with headscarf pin aspiration were managed by fiberoptic bronchoscopy over an 8-year period (January 2008 to December 2015). The procedure was performed under local anesthesia and conscious sedation through the mouth. Results: The age ranged from 10 to 45 years with a mean of 27.5. All patients had cough, five had unilateral wheeze (10%) while haemoptysis occurred twice (4%). Fiberoptic bronchoscopy succeeded in 45 cases (90%). Rigid bronchoscopy under general anesthesia was necessary in (n = 4, 8%) while one patient (2%) required thoracotomy. Conclusion: Fiberoptic bronchoscopy is safe and effective in removal of aspirated headscarf pins and should be tried first.
Indications and Efficacy of Fiberoptic Bronchoscopy in the ICU: Have They Changed Since Its Introduction in Clinical Practice?  [PDF]
Pablo álvarez-Maldonado,Carlos Nú?ez-Pérez Redondo,José D. Casillas-Enríquez,Francisco Navarro-Reynoso,Raúl Cicero-Sabido
ISRN Endoscopy , 2013, DOI: 10.5402/2013/217505
Abstract: Purpose. We describe characteristics, utility, and safety of fiberoptic bronchoscopy (FOB) in an intensive care unit (ICU). Methods. Prospective and descriptive cohort of patients admitted to a respiratory ICU from March 2010 to June 2012. Results. A total of 102 FOBs were performed in 84 patients among 580 patients that were admitted to the ICU. Mean age was years. FOB was useful in 65% of diagnostic procedures and 83% of therapeutic procedures, with an overall utility of 75%. Indications and utility according to indication were pneumonia in 31 cases, utility of 52%; percutaneous tracheostomy guidance in 26 cases, utility of 100%; atelectasis in 25 cases, utility of 76%; airway exploration in 16 cases, utility of 75%; hemoptysis in two cases, utility of 100%; and difficult airway intubation in two cases, utility of 100%. A decrease in oxygen saturation (SpO2) of >5% during FOB was present in 65% of cases, and other minor complications were present in 3.9% of cases. Conclusions. Reasons for performing FOB in the ICU have remained relatively stable over time with the exception of the addition of percutaneous tracheostomy guidance. Our series documents current indications and also the utility and safety of this procedure. 1. Introduction Fiberoptic bronchoscopy (FOB) was first introduced in clinical practice in 1967 [1]. Since then, it is considered one of the most important techniques in pulmonary medicine. New advances emerge in the field over the years [2] and its potential is being recognized around the world as a contributor to the management of every pulmonary condition [3]. A wide range of indications exists for FOB in the intensive care unit (ICU) [4]. Most correspond to basic bronchoscopy with exploration, lavage, brushing, and forceps sampling as the primary used techniques [5–7]. It is recommended that intensive care units account for the facility to perform urgent and timely FOB for a range of therapeutic and diagnostic purposes [8]. Critical care settings demand that respiratory system problems be resolved and clinical decisions be made in a timely manner. Here we describe the impact in decision-making and problem solving of FOB in an ICU along with indications, complications and results of the procedure. 2. Materials and Methods 2.1. Study Design This is a prospective and descriptive cohort. 2.2. Setting The seven-bed respiratory intensive care unit (RICU) of the Department of Pneumology and Thoracic Surgery is one of the eight ICUs of the Hospital General de México O.D., a 901-bed teaching hospital. The RICU works as a closed unit with
Subcutaneous Dissociative Conscious Sedation (sDCS) an Alternative Method of Anesthesia for Fiberoptic Bronchoscopy  [PDF]
Mihan J. Javid, Zoha Alinejad, Asghar Hajipour, Zahra Khazaeipour
Open Journal of Anesthesiology (OJAnes) , 2015, DOI: 10.4236/ojanes.2015.57027
Abstract: Objective: Current randomized clinical trial was conducted to compare the efficacy and side effects of dissociative conscious sedation and conscious sedation in patients under bronchoscopy. Methods: In this randomized clinical trial, 110 patients scheduled for Fiberoptic Bronchoscopy in a training hospital in 2012 were enrolled and randomly assigned to receive either SC ketamine plus IV fentanyl (dissociative conscious sedation) or placebo plus IV fentanyl (conscious sedation) and the efficacy and side effects were assessed and compared. Results: There was significant difference between systolic and diastolic blood pressure and heart rate in two groups and more stability was shown in dissociative conscious sedation group (P < 0.05). Also the incidence of cough, the need to extra dose of fentanyl and recall showed less frequency in dissociative conscious sedation group (P < 0.05). Conclusions: Totally, according to the obtained results, it may be concluded that Subcutaneous Dissociative Conscious Sedation (sDCS) in comparison to Conscious Sedation is significantly more efficient accompanied by less side effects in fiberoptic bronchoscopy and using this method is recommended. Implication of the Manuscript: The study was designed in order to evaluate the efficacy of subcutaneous Dissociative Conscious Sedation (sDCS) Method in fiberoptic bronchoscopy.
Laser resection of endobronchial hamartoma via fiberoptic bronchoscopy  [cached]
Rai Satya,Patil Ashok,Saxena Puneet,Kaur Amulyajit
Lung India , 2010,
Abstract: Endobronchial hamartoma is a rare benign tumor of lung that may present with symptoms of airway obstruction with wheezing, stridor, recurrent pneumonia or atelectasis. We report a case of a patient with endobronchial hamartoma, recurrent pneumonia, who presented to us with sputum smear and culture positive pulmonary tuberculosis. He was treated with antitubercular treatment and endobronchial hamartoma was resected completely by diode laser through fiberoptic bronchoscope.
Giant endobronchial hamartoma resected by fiberoptic bronchoscopy electrosurgical snaring
Baldassare Mondello, Salvatore Lentini, Carmelo Buda, Francesco Monaco, Dario Familiari, Michele Sibilio, Annunziata La Rocca, Pietro Barresi, Vittorio Cavallari, Maurizio Monaco, Mario Barone
Journal of Cardiothoracic Surgery , 2011, DOI: 10.1186/1749-8090-6-97
Abstract: Clinical manifestation of an endobronchial hamartoma (EH) results from tracheobronchial obstruction or bleeding. Usually, EH localizes in large diameter bronchus. Endoscopic removal is usually recommended. Bronchotomy or parenchimal resection through thoracotomy should be reserved only for cases where the hamatoma cannot be approached through endoscopy, or when irreversible lung functional impairment occurred after prolonged airflow obstruction. Generally, when endoscopic approach is used, this is through rigid bronchoscopy, laser photocoagulation or mechanical resection. Here we present a giant EH occasionally diagnosed and treated by fiberoptic bronchoscopy electrosurgical snaring.Most tumors of the tracheobronchial tree are malignant [1,2]. Benign lung tumors represent less than 1%, and among these, hamartomas, with an incidence between 0.025% and 0.32%, are the most common [3]. In relation to the localization, hamartomas are divided into intraparenchymal, generally asymptomatic and with a radiological coin lesion appearance [4], and endobronchial, clinically manifesting as a result of tracheobronchial obstruction [5].From a previous paper reviewing a total of 215 cases of hamartoma reported in the literature, the endobronchial location was found in only 1.4% of cases [6]. In contrast, other studies found an incidence of endobronchial location in 10 and 20% of all pulmonary hamartomas [7,8]. The endobronchial hamartomas (EH) usually localize in large diameter bronchus [2]. Since these tumors are benign, endoscopic removal is usually recommended, reserving lung resection to cases of longstanding bronchial obstruction with infection and irreversible lung injury [9].We report the case of a giant hamartoma of the left main bronchus, diagnosed and removed by fiberoptic bronchoscopy electrosurgical snaring.An asymptomatic 65 year old man, previously treated by rectum resection for adenocarcinoma, during follow-up examination for his neoplastic disease underwent chest C
Fiberoptic bronchoscopy of the intubated patient with life-threatening hemoptysis
H-J Düpree, J-C Lewejohann, J Gleiβ, E Muhl, H-P Bruch
Critical Care , 2000, DOI: 10.1186/cc378
Abstract: We show the bronchoscopic management of endobronchial bleeding in intubated patients at our ICU. During the period 7/97–112/97 seven consecutive patients with acute endobronchial bleeding were treated with fiberoptic bronchoscopy. All patients received an endobronchial instillation of epinephrine and physiological saline solution (1:10 000–100 000).Control of bleeding was achieved with 1 to 20 (m ± SEM:5.86 ± 0.93) bronchoscopic interventions. Hemostasis was accomplished in a period of 0.5 h and 10 days. Cardiocirculatory instability was observed in five patients. One patient died because of persistent bleeding caused by severe aspergillosis. Six patients survived without further interventions.Endobronchial instillation of epinephrine and physiological saline solution represents an effective method in case of lifethreatening hemoptysis in intubated and mechanical ventilated patients.
Incidence of Fever and Bacteriemia Following Flexible Fiberoptic Bronchoscopy: A Prospective Study
Babak Sharif-Kashani,Payman Shahabi,, Neda Behzadnia,Zohreh Mohammad-Taheri
Acta Medica Iranica , 2010,
Abstract: "nThe latest American Heart Association (AHA) statement for preventing infectious endocarditis, has not recommended prophylactic antibiotic therapy prior to fiberoptic bronchoscopy (FB) except for patients with preexisting predisposing cardiac conditions. Our aim was to determine the incidence of bacteriemia and fever following FB in our experience and compare with those which have been mentioned in AHA guideline as well as other studies. Venous blood of 85 consecutive patients was evaluated for both aerobic and anaerobic cultures before (for detecting possible previous bacteriemia) and after FB. None of the patients were treated with antibiotics prior to the procedure. All the patients were examined during the first 24 hours after FB for detecting fever defined as temperature more than 38 °C. Positive hemocultures were noted in 7 (8.2 %) patients after FB examination. Coagulase negative Staphylococcus, coagulase positive Staphylococcus, beta haemolytic Streptococcus, Citrobacter freundii and Streptococcus viridans were found in 4, 1, 1 and 1 cultures of patients, respectively. By excluding 6 contaminated samples, the rate of bacteriemia reduced to 1 (1.1%) patient in whom the identical pathogen (Streptococcus viridans) was found both in bronchial lavage and venous blood culture. We also found fever in 9 (10.5 %) cases in the first 24 hours following the bronchoscopy. Our results were in consistent with AHA recommendations regarding prevention of infectious endocarditis as a practical gridline in patients who schedule for FB. Besides, transient fever following bronchoscopy is a common self-limited event which does not need medical intervention.
Infant who Developed Noncardiac Pulmonary Edema after Flexible Fiberoptic Bronchoscopy
Hasan Yüksel,?smet Top?u,Hasan Tarkan ?kizo?lu,?zge Y?lmaz
Turk Toraks Dergisi , 2009,
Abstract: Pulmonary edema may be secondary to cardiac or noncardiac etiologies. Noncardiac pulmonary edema develops as a result of increased vasopermeability, leading to water and protein leak into the interstitium. Negative pressure at the level of the alveoli during flexible fiberoptic bronchoscopy (FFB) may lead to the development of pulmonary edema. This is a rare complication in infants undergoing FFB. Dignostic FFB was performed on a four month old female patient with hypoxic ischemic encephalopathy due to persistent upper respiratory findings. Additional respiratory tract anomalies were not observed in this case who was diagnosed as having laryngomalacia. She developed bronchospastic findings following FFB which improved with nebulized salbutamol treatment. Although her bronchospasm regressed two hours after the procedure, oxygen requirement continued and fine rales became prominent on pulmonary auscultation. Findings of pulmonary edema were observed in the chest X-ray. Mannitol at a dose of 0.5 mg/kg was administered with the diagnosis of pulmonary edema. Physical findings and vital signs normalized with treatment and oxygen requirement ceased. This case was discussed because pulmonary edema after FFB is a rare complication and this is the first experience with mannitol in the treatment.
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