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At least 379 records · Page 21Linked to original sources
PubMed1996

[Difficulties in bronchoscopic diagnosis of the foreign bodies located in lower respiratory tract in children].

Diagnostic difficulties and causes of incorrect interpretation of bronchoscopic examination in the cases of foreign body (f.b.) aspiration in children are presented. In 16 out of 280 children (5.7%) treated in our Institute due to f.b. aspiration in the years 1979-1993, f.b. were not diagnosed (incorrectly excluded or not confirmed) although bronchoscopic examination have been performed. Recurrent or persistent symptoms of bronchitis or bronchopneumonia were indications for performing diagnostic bronchoscopy in our hospital. The causes of diagnostic difficulties during the first bronchoscopy were as follow: 5-most likely inflammation, 2-peripheral deposition of foreign body, 2-only tracheoscopy was performed. In 7 cases the lack of necessary technical competence for performing bronchoscopy was probably the cause. Foreign bodies were deposited in 2 cases in the trachea, in 4 cases in the right bronchial tree and in 10 cases in the left bronchial tree. One child with diagnostic problems is describe in details. We have found that: -for exclusion of f.b. aspiration detailed examination of segmental or even subsegmental bronchi is necessary, -diagnosis and treatment of f.b. aspiration requires good bronchological knowledge and experience, -persistent symptoms of bronchial patency disturbances should be the indication to the control bronchoscopy.

Adolescent↗
PubMed1996

[Costs and time savings by dilatation tracheotomy with bronchoscopic control].

Forty-seven patients underwent dilatational tracheostomy with bronchoscopic support. Bronchoscopic support during the procedure prevents perforation of the dorsal wall of the trachea and reveals any bleeding into the trachea. Complications intra- and postoperatively have not been seen as yet (follow-up up to 1 year). Duration of the procedure was 8 min versus 30 min for the conventional tracheostomy (mean values).

Bronchoscopy↗
PubMed1997

[Removal of bronchial foreign bodies by suction with a bronchoscope].

We report two cases in which intrabronchial foreign bodies were removed with a fiberoptic bronchoscope. In both cases the foreign body was a seed of a small Japanese apricot. Atelectasis or obstructive pneumonia was seen on chest roentgenograms. The foreign bodies were associated with slight inflammation and polyps on the bronchial epithelium. The foreign bodies were removed by applying suction with a fiberoptic bronchoscope. This method may also be useful for removing other large, hard, uneven, and ball-like foreign bodies.

Aged↗
PubMed1997

[Use of a bronchoscope for thoracoscopic observation and diagnosis of pleural plaques].

A 62-year-old man was admitted to our hospital for evaluation of bilateral tumor-like shadows along the ribs. He had been a diamond-grinder for twenty years. Thoracoscopic examination with a flexible bronchoscope revealed many well-circumscribed tumors with shiny, smooth, convex surfaces on the parietal pleura. The biopsy specimen had hyaline collagen with no cellular components. Based on these findings the tumors were diagnosed as pleural plaques. Cases of pleural plaques are usually followed up with chest radiography only, but the clinical course may be complicated by malignant mesothelioma and other malignant disease. To differentiate these conditions we performed biopsy during intrathoracic observation. The flexible bronchoscope can be useful in such procedures because it is relatively easy to operate and the procedure is relatively non invasive.

Asbestosis↗
PubMed1976

Prognostic implications of bronchogenic carcinoma proven by bronchoscopic biopsy.

A total of 104 cases of bronchoscopically biopsy proven bronchogenic carcinoma are reviewed. Twenty-seven of 39 patients with operable lesions underwent pulmonary resection. There are seven patients with squamous cell tumors who are long-term, cancer-free survivors. The operative mortality was low at 2.3 per cent. A positive bronchoscopic biopsy should not be considered a contraindication for exploration, and an aggressive approach for squamous cell lesions seems justified.

Adenocarcinoma↗
PubMed1991

Diagnostic sensitivity of different techniques in the diagnosis of lung tumors with the flexible fiberoptic bronchoscope. Comparison of brush biopsy, imprint cytology of forceps biopsy, and histology of forceps biopsy.

Brush and forceps biopsies were done consecutively in 186 cases of pulmonary neoplasia with a flexible fiberoptic bronchoscope guided by x-ray television fluoroscopy. Imprint and histologic sections were prepared from all forceps biopsy specimens. The three techniques were compared for their diagnostic sensitivity. As a result 84.9% of all imprints, 80.6% of brush biopsy specimens, and 62.9% of histologic sections were positive for malignancy. The sensitivity of brush biopsy specimens was independent of the location and morphology of the tumors, but the sensitivity of forceps biopsy specimens was lower in neoplasms unidentified by bronchoscopy. The sensitivity of the diagnostic accuracy when all three methods were used jointly was 97.3%, and the specificity was 100%. Agreement in the final morphologic tumor type was found in 130 of 150 cases (86.7%) by positive brush biopsy specimens, in 136 of 158 cases (86.1%) by positive imprint cytology, and in 104 of 117 cases (88.9%) by positive histology from forceps biopsy specimens. For routine bronchoscopy, all three methods should be used in combination to obtain the highest diagnostic yield.

Biopsy↗
PubMed1979

A newly designed flexible fiberoptic bronchoscope for use in intensive care units.

A newly designed flexible fibroptic bronchoscope has been manufactured for use in intensive care units (ICU). It has an inside channel of large caliber, diameter 2.5 mm, through which pulmonary secretions can be aspirated directly via the suction tube. Furthermore, prompt bedside use is possible since handle type batteries can easily be attached to the bronchofibroscope. This new instrument is now employed in our ICU for: 1. The diagnosis and treatment of atelectasis. 2. Suction of retained secretions. 3. Detection of tracheal obstruction. 4. Evaluation of endotracheal and tracheostomy tubes whilst in position. 5. Observation of tracheal and bronchial changes. 6. Help in endotracheal intubation. It was used most frequently for the diagnosis and treatment of atelectasis and suction of retained secretions.

Bronchoscopes↗
PubMed1993

Outpatient pediatric oesophagoscopy using a flexible fibreoptic bronchoscope. Design of an insufflation-aspiration adaptor.

The design of an adaptor for use with fibre-optic flexible endoscopes with a single instrument channel is described that enables them to be used for oesophagoscopy. The adaptor enables both aspiration of secretions as well as gas insufflation to expand the oesophagus distal to the tip of the endoscope down the single channel. When the adaptor is used on a pediatric bronchoscope it is possible to perform oesophagoscopy in an outpatient setting on the awake child. This application is particularly useful for the assessment of children who have ingested corrosive agents and enables rational management decisions to be based on precise knowledge of the extent of the mucosal injury.

Ambulatory Care↗
PubMedDate not supplied

Verification of endotracheal tube placement by prehospital providers: is a portable fiberoptic bronchoscope of value?

INTRODUCTION: This study was designed to examine whether a handheld, battery-operated fiberoptic bronchoscope (FOB) used to verify endotracheal tube (ETT) placement would be as sensitive and specific as other modes and whether a combination of multiple modes would further enhance the sensitivity and specificity of ETT placement verification. SETTING: An academic hospital-based air medical program. METHODS: This was a prospective, randomized study examining surgical patients undergoing general endotracheal anesthesia. Eighteen critical care transport (CCT) nurses, previously unfamiliar with FOB, were asked to identify intratracheal and intraesophageal ETTs by using misting, end-tidal carbon dioxide concentration (ETCO(2)), and FOB alone or with a combination of all three modes. The sensitivity and specificity of single and multimode verification were calculated and compared. RESULTS: Comparison of ETT verification by single mode alone revealed a rank order of sensitivity with ETCO(2) (0.97) > FOB (0.87) > misting (0.84), whereas all three modes had similar specificities (0.93-0.94). However, the use of the three-mode combination revealed a sensitivity and specificity of 1.0. CONCLUSIONS: As a single mode for ETT verification, use of a handheld, battery-operated FOB device allowed for direct visualization and had an 87% sensitivity and 93% specificity. When combined with misting and ETCO(2), FOB allowed 100% successful verification of ETT placement.

Air Ambulances↗
PubMed2005

Intratumoral administration of cisplatin through a bronchoscope followed by irradiation for treatment of inoperable non-small cell obstructive lung cancer.

PURPOSE: Patients presenting with inoperable non-small cell carcinoma of the lung associated with severe bronchial obstruction are at a high risk for developing post-obstructive pneumonia or respiratory failure. This often leads to death in weeks to months. Several studies suggest that initial use of debulking of obstructed airways by Nd-YAG laser photo resection or by cryotherapy lessens morbidity by reducing infections and respiratory insufficiencies. This can shorten hospitalization, improve the quality of life, and prolong survival. It has also been demonstrated that patients first treated for debulking and then by irradiation have better survival than similar patients treated with irradiation alone. Intratumoral (IT) injection of cytotoxic drugs (IT chemotherapy) has also been successfully used to debulk airways. The aim of the present work was to study the effectiveness, safety, and feasibility of initial debulking by IT chemotherapy with cisplatin combined with irradiation with a curative intent in the treatment of obstructive inoperable non-small cell lung cancer. PATIENTS AND METHODS: Twenty three patients were treated first by bronchoscopic IT injection of up to 40 mg cisplatin solution (4 mg/ml), administered weekly four times (on days: 1, 8, 15, 22) and then by irradiation. RESULTS: At the end of a 3-week period of IT treatment, 11 of 23 patients showed an increase in airway lumen diameter of more than 50% (good response), 8 patients showed an improvement of 25-50% (partial response) and 4 patients showed an increase of less than 25% (small response). Overall, debulking by IT chemotherapy was considered clinically effective in 19 of 23 patients and only marginally effective in 4 patients. Statistical analysis indicated a statistically significant improvement in lumen diameter (P < 0.001) for all patients. The combination of IT chemotherapy and irradiation resulted in prolonged survival in the patients with good response (median survival 636 days) compared to patients with partial response (median survival 342 days). The four patients with only a small response had a median survival of 202 days. CONCLUSIONS: Debulking by intratumoral injection of cisplatin was shown to be a safe, simple, and cost effective procedure. There were no severe side effects and complications. Initial debulking of obstructed airways by IT administration of cisplatin, followed by irradiation requires further studies in order to determine its effect on survival.

Adult↗
PubMed2003

Contributions of bronchoscopic microsampling in the supplemental diagnosis of small peripheral lung carcinoma.

BACKGROUND: Making a preoperative pathologic diagnosis in patients with small lung nodules remains challenging. We have developed a new, noninvasive bronchoscopic microsampling probe to examine biochemical substances in epithelial lining fluid. We used this probe to measure tumor markers in fluid from tissues surrounding lung nodules less than 30 mm in diameter to test its adjunctive diagnostic utility in lung cancer. METHODS: In 12 patients, epithelial lining fluid was collected in triplicate or duplicate from tissue within 2 cm of small peripheral lung nodules and from the contralateral lung. The diagnosis of adenocarcinoma was surgically confirmed in all patients. Fifteen patients without lung cancer served as controls. Concentrations of carcinoembryonic antigen, cytokeratin fragment 19, and sialyl SSEA-1 were measured in the fluid. RESULTS: Carcinoembryonic antigen and cytokeratin fragment 19 concentrations were significantly higher in fluid near the nodules (median, 8.7 and 87.2 ng/mg, respectively) than on the contralateral sides (median, 1.5 and 3.7 ng/mg, respectively) or in fluid collected from the controls (median, 2.0 and 2.8 ng/mg, respectively). CONCLUSIONS: Measurements of carcinoembryonic antigen and cytokeratin fragment 19 collected by our microsampling probe may be a useful diagnostic adjunct in patients with small peripheral lung nodules.

Adenocarcinoma↗
PubMed1984

Bronchoscopic phototherapy using hematoporphyrin derivative.

Phototherapy in the presence of hematoporphyrin (HPD) produces cytotoxicity through both energy- and power-dependent mechanisms. The resulting cellular death demonstrates the promise of HPD in the therapy of small cancers. This article reports our clinical experience and follow-up results of treating 19 patients with cancer of the tracheobronchial tree, who have completed at least one course of HPD administered via the flexible fiberoptic bronchoscope.

Bronchial Neoplasms↗
PubMed2002

Retrieval of bronchial foreign body with central lumen using a flexible bronchoscope.

A 5 year-old boy aspirated a metal spring accidentally. The right bronchial foreign body was removed by threading the alligator of a biopsy forceps through the lumen of the spring while opening its jaws distally. This case illustrates that a foreign body with a central lumen in a child can be successfully removed using a flexible bronchoscope, thus obviating the need for general anesthesia and rigid bronchoscopy.

Bronchi↗
PubMed1997

Pseudoepidemic of Legionella pneumophila serogroup 6 associated with contaminated bronchoscopes.

An investigation of a pseudoepidemic of Legionella pneumophila serogroup 6 contaminating bronchoalveolar lavage specimens traced the source to contaminated tap water used to rinse disinfected bronchoscopes. The problem recurred despite plumbing changes and the installation of filters in the endoscopy unit water system because of inadequate maintenance of the filters.

Bronchoalveolar Lavage Fluid↗
PubMed1977

The fiberoptic bronchoscope.

The fibertopic bronchoscope was used in 14 cases in the emergency department between September 1974 and September 1976 at Lock Haven Hospital, Lock Haven, Pennsylvania and St. Charles Hospital, Toledo, Ohio. It was used successfully to remove foreign bodies from the trachea and esophagus; in difficult or hazardous endotracheal intubation; intubation in a victim of cardiac arrest with a cervical deformity; evaluation of laryngeal and tracheal injury; localization of bleeding from the posterior nose; evaluation of hemoptysis, and evaluation of thermal injuries from smoke inhalation.

Adolescent↗
PubMed2001

A comparison of the Bullard laryngoscope versus the flexible fiberoptic bronchoscope during intubation in patients afforded inline stabilization.

STUDY OBJECTIVE: To compare the Bullard laryngoscope (BL) with the flexible fiberoptic bronchoscope (FFB) in a cervical spine injury model, using inline stabilization. DESIGN: Randomized clinical trial. SETTING: Main operating room of a tertiary care hospital. PATIENTS: 50 adult, ASA physical status I, II, and III patients undergoing an elective general anesthetic. INTERVENTIONS: Each patient's trachea was intubated with both techniques. Cricoid pressure was applied to half of the study patients. MEASUREMENTS: The time for laryngoscopic view and the time to intubation were recorded for each technique. The effects of cricoid pressure on laryngoscopic view and intubation time were determined. MAIN RESULTS: The times for laryngoscopy and intubation were longer in the FFB group than in the BL group (p < 0.004). There was a significantly lower success rate of laryngoscopy view in the FFB group in the presence of cricoid pressure (15 of 25 patients, or 60%) than either of the BL groups or the FFB no-cricoid pressure group. CONCLUSIONS: The BL is more reliable, quicker, and more resistant to the effects of cricoid pressure than is the FFB.

Adult↗
PubMedDate not supplied

Prehospital and emergency department verification of endotracheal tube position using a portable, non-directable, fiberoptic bronchoscope.

Verification of endotracheal tube (ETT) location in prehospital setting and the emergency department (ED) is a challenging task. Unrecognized esophageal intubations with potentially dangerous consequences may occur more frequently in these environments than in less hectic settings. To evaluate the capabilities of a portable, non-directable, fiberoptic bronchoscope (Visicath; Saratoga Medical, Saratoga, Calif., USA) to detect appropriate ETT placement, a prospective series of 22 intubated prehospital, air-medical, or ED patients underwent fiberoptic verification (FOV) of a newly placed ETT. Each patient was intubated under urgent circumstances. The time required for FOV, ETT location, the relative difficulty of intubation, and the changes in management as a result of FOV were recorded. A total of 24 FOVs were performed, twenty-one tracheal (88%), and two esophageal (8%) intubations were identified. Position could not be identified in one case (4%). FOV confirmed placement in 23 intubations (96%) in less than 25 seconds. Seven intubations (29%) were judged to be "difficult." FOV resulted in five minor changes in management (22%) and was the sole confirmation method for five intubations. We conclude that fiberoptic verification is a promising method of ETT position in air-medical and ED intubations.

Bronchoscopes↗