Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Bronchoscopes”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMed1985

Real-time analysis of the change in arterial oxygen tension during endotracheal suction with a fiberoptic bronchoscope.

An intra-arterial Clark-type polarographic oxygen electrode was used with a fiberoptic bronchoscope for real-time analysis of the PO2 change during 1 min of suction in patients spontaneously breathing oxygen. There was a strong correlation between values obtained from the intra-arterial electrode (PiO2) and those from blood samples (PaO2), before and at the end of suction; the PiO2/PaO2 ratio was close to one. Continuous PiO2 recordings during suction without supplemental oxygen showed little change in the early period of suction, followed by a steep drop continuing even after suction. This drop in PiO2 was partially attenuated by providing oxygen with high-frequency jet ventilation and was almost completely attenuated by the use of a suction adaptor. Changes in the inspired oxygen concentration indicated the importance of keeping this variable constant during suction to prevent hypoxemia.

Adult↗
PubMed2001

New bronchoscopic microsample probe to measure the biochemical constituents in epithelial lining fluid of patients with acute respiratory distress syndrome.

OBJECTIVE: A noninvasive bronchoscopic microsampling (BMS) probe was developed to sample biochemical constituents of the epithelial lining fluid in small airways. DESIGN: Observational, controlled study. SETTING: Intensive care unit of academic medical center. PATIENTS AND PROCEDURE: BMS was applied in a control group of seven patients who had hemoptysis or small solitary peripheral nodules but no hypoxemia or other signs of acute inflammation and in four patients with acute respiratory distress syndrome (ARDS), to test whether BMS can ascertain the presence of acute pulmonary inflammation without complications. MEASUREMENTS AND RESULTS: Complications, including a significant decrease in arterial oxygen saturation, were observed neither during nor after BMS. In the ARDS group, albumin, lactate dehydrogenase, interleukin-6, basic fibroblast growth factor, and neutrophil elastase concentrations in epithelial lining fluid were significantly higher (p <.0001, p =.012, p <.0001, p <.0001, and p <.0001, respectively) than in the control group. Serial BMS was safely performed in one patient with ARDS, allowing us to observe a correlation between changes in the concentration of inflammation-related biochemical markers and clinical course of the disease. CONCLUSIONS: These results suggest that BMS is safe and useful to monitor pulmonary biochemical events in ARDS.

Adult↗
PubMedDate not supplied

Tracheobronchial tree: three-dimensional spiral CT with bronchoscopic perspective.

The purpose of this report is to describe an original 3D technique that permits bronchoscopic perspective simulations of the tracheobronchial tree on an affordable workstation. Software based on surface shading was developed to permit navigation through the central airways using spiral CT data. Multiplanar reformations are displayed simultaneously with the virtual bronchoscopy simulations to give information about tissues surrounding the airways. Two clinical examples are reported to illustrate the value of this advanced computer technique.

Bronchography↗
PubMed1994

Management of postpneumonectomy syndrome with a bronchoscopically placed endobronchial stent.

Postpneumonectomy syndrome is a rare complication of right pneumonectomy characterized by marked shift and counterclockwise rotation of the heart and mediastinum into the evacuated hemithorax. Typically the left primary bronchus is draped over the aorta or spine and is markedly compressed. We describe one patient with postpneumonectomy syndrome successfully managed nonsurgically with a bronchoscopically placed Silastic endobronchial stent.

Adult↗
PubMed1998

In vivo spasmolytic effect of ketamine and adrenaline on histamine-induced airway constriction. Direct visualization method with a superfine fibreoptic bronchoscope.

BACKGROUND: Ketamine (K) has been reported to produce bronchodilation in patients suffering from asthma. Although most researchers have used indirect measurements to study the effect of K in vivo, the reliability of these indirect methods are controversial. We have developed a new technique to measure the bronchial cross-sectional area (BCA) in vivo with a superfine fibreoptic bronchoscope (SFB). Employing this method, we evaluated in vivo spasmolytic effect of K and adrenaline (A). METHODS: Twenty-one mongrel dogs were anaesthetized with pentobarbitone (30 mg.kg-1) and paralyzed with pancuronium (200 micrograms.kg-1.h-1). The trachea was intubated with an endotracheal tube that has a second lumen for insertion of a SFB (OD: 2.2 mm) to measure the BCA continuously. The tip of the SFB was placed between the 2nd and 3rd bronchial bifurcation of the right lung. A videoprinter printed the BCA, which was then measured with NIH Image. Bronchoconstriction was produced with histamine (H: 10 micrograms.kg-1 + 500 micrograms.kg-1.h-1) which was administered until the end of the experiment. The BCA was assessed before and 30 min after the start of H infusion. The dogs were randomly allocated to 3 groups of 7 dogs each. In group K, K (0-10 mg.kg-1) was given i.v., and the BCA was measured 5 min after each K dose. In group A, A (0-0.4 microgram.kg-1) was given i.v., and the BCA was measured 1 min after each A dose. In group A + K, K (1 mg.kg-1 i.v. + 1 mg.kg-1.h-1 i.v.) was given followed, 30 min after, by A i.v. in the same doses as in group A. The BCA was assessed 30 min after the start of K and again 1 min after each A dose. RESULTS: K 10 mg.kg-1 reversed H-induced bronchoconstriction. A subthreshold dose of K significantly potentiated the effect of A, reversing the decrease in BCA by H. CONCLUSION: We have found that K could reverse the H-induced bronchoconstriction and potentiate the A-induced bronchial relaxation.

Animals↗
PubMed1989

Bronchoscopic appearance of acute tracheobronchial compression by an endo-oesophageal tube.

The bronchoscopic appearance of a patient who developed acute respiratory distress following the insertion of a pulsion endo-oesophageal tube is described. Intubation of the lower thoracic oesophagus causes cardio-oesophageal incompetence, which is considered important in causing aspiration pneumonia. The selection of a suitably sized tube is important as a possible means of preventing tracheobronchial compression.

Acute Disease↗
PubMed1995

Pneumocystis carinii pneumonia in preterm infants: report of two cases successfully diagnosed by non-bronchoscopic bronchoalveolar lavage.

We present two cases of Pneumocystis carinii pneumonia in apparently immunocompetent preterm infants presenting with unexplained respiratory distress associated with a predominantly interstitial process on the chest radiograph. Definite diagnosis was promptly established on the detection of cyst forms in the lung fluid obtained by non-bronchoscopic bronchoalveolar lavage, and a favourable outcome was achieved.

Bronchoalveolar Lavage↗
PubMed1987

Should patients with haemoptysis and a normal chest X-ray be bronchoscoped?

A review of bronchoscopic records over a 5 year period identified 41 patients who had undergone fibreoptic bronchoscopy after presenting with haemoptysis and a normal chest X-ray. Carcinoma of the bronchus was found in 4 patients (9.7%) and the procedure yielded a diagnosis in 8 of the 20 patients in whom a specific cause of their bleeding could be identified. The diagnostic yield is sufficiently high and the morbidity of the procedure sufficiently low to justify the investigation in patients presenting with haemoptysis and a normal chest X-ray.

Aged↗
PubMed1996

Community-based respiratory viral infections in HIV positive patients with lower respiratory tract disease: a prospective bronchoscopic study.

OBJECTIVES: To evaluate the contribution of community-based respiratory virus infections to lower respiratory tract disease in HIV-1 infected individuals. DESIGN: Prospective clinical cohort study. SETTING: Specialist in-patient unit for HIV and AIDS, University College London Hospitals, London. SUBJECTS: 44 consecutive HIV-1 antibody positive patients who underwent 47 diagnostic bronchoscopies for evaluation of the symptoms and signs of lower respiratory tract disease. TIME: Winter months of 1994/95. MAIN OUTCOME MEASURES: Detection, in bronchoscopic alveolar lavage fluid, of infection with influenza A and B, respiratory syncytial virus (RSV), parainfluenza 1, 2 and 3 (by immunofluorescence and cell culture) and adenovirus and enteroviruses (by cell culture). RESULTS: No evidence of influenza, RSV, parainfluenza, adenovirus, or enterovirus infection was detected. CONCLUSIONS: Despite a marked increase in RSV and influenza B infection in the general population over the winter of 1994-95, respiratory virus infections were not detected in this cohort of HIV infected patients. As the organisms causing lower respiratory tract disease were related to immunosuppression, this study questions the value of routine identification of community-based respiratory viruses in this patient group.

AIDS-Related Opportunistic Infections↗
PubMed1998

Association of Kaposi's sarcoma associated herpesvirus (KSHV) DNA in bronchoalveolar lavage fluid of HIV infected individuals with bronchoscopically diagnosed tracheobronchial Kaposi's sarcoma.

OBJECTIVES: To determine the frequency of detection of Kaposi's sarcoma associated herpesvirus (KSHV), also known as human herpesvirus (HHV) type 8, DNA in bronchoalveolar lavage (BAL) fluid from HIV infected individuals with and without KS and to compare this with the detection rate in peripheral blood. Also to identify whether KSHV was associated with specific cell types in lavage fluid. METHODS: Nested PCR was used to detect KSHV DNA in BAL fluid from 41 consecutive individuals with Kaposi's sarcoma (KS) and in 41 controls with similar CD4 lymphocyte counts. Semiquantification of viral DNA was by end point titration. A positive cell sorting selection procedure was used to isolate specific BAL fluid cell types. RESULTS: KSHV DNA was detected in BAL fluid from 24 of 29 (83%) individuals with a bronchoscopic diagnosis of tracheobronchial KS. None was detected in 12 individuals with only cutaneous KS, or in 41 matched controls without KS. In five, KSHV DNA was detected in the cell depleted and cellular fractions of BAL fluid and in 1/5 in the CD14 (macrophage) fractions. None was detected in the CD19 (B lymphocyte) or CD4/CD8 (T lymphocyte) fractions. CONCLUSIONS: There was a clear association between the diagnosis of tracheobronchial KS and detection of KSHV DNA in BAL fluid. The cell type supporting KSHV in the respiratory tract is not CD 19 positive and has yet to be conclusively identified.

Bronchial Neoplasms↗
PubMed2001

Repeatability of cellular constituents and cytokine concentration in fluid obtained by non-bronchoscopic bronchoalveolar lavage of infants receiving extracorporeal oxygenation.

BACKGROUND: Since few studies have assessed the repeatability of non-bronchoscopic bronchoalveolar lavage (NB-BAL), we compared cellular counts and cytokine concentrations in fluid obtained by standardised NB-BAL from each side of 20 intubated infants receiving extracorporeal membrane oxygenation (ECMO). METHODS: Total cell counts were obtained from 95 paired lavages and 77 pairs were suitable for differential counts and measurement of cytokine concentrations. RESULTS: Moderate correlation was noted between the two sides for most cell types including total cell counts and percentages of neutrophils and macrophages (R=0.70-0.84) and for cytokine concentrations (IL-8 R=0.78, IL-6 R=0.75, TNF-alpha R=0.64, all p< or =0.001). Using Bland-Altman analysis the mean difference between the two sides approached zero for cellular constituents (total cell counts mean difference 1.7, limits of agreement -187.5 to +190.9 x 10(4)/ml; percentage neutrophils -3.9%, -41.5% to +33.6%; percentage macrophages 3.9%, -33.8% to +41.6%) but tended to be greater on the right for logarithmically transformed cytokine measurements (IL-8: left/right ratio 0.74, limits of agreement 0.12 to 5.45, IL-6: 0.93, 0.09 to 5.87, and TNF-alpha: 0.93, 0.27 to 3.16). Using linear regression with random effects to assess the variability, only the infant's age appeared to influence the cellular results but, for cytokines, only the volume retrieved affected the variability. The magnitude of the measurements, the underlying disease, the operator's experience, days on ECMO, or survival did not affect the variability. CONCLUSION: Measurements obtained by NB-BAL need to be interpreted with caution and strongly suggest that normalisation for the dilutional effects of saline is essential.

Age Factors↗
PubMed1981

Bronchoscopic management of tracheal lesions using the neodynium yttrium aluminium garnet laser.

We report our first clinical trials with the NdYAG laser in the treatment of tracheal and bronchial tumours and stenoses. The beam is carried through a flexible fibre delivering a power of 50 to 90 watts. It can be introduced through the biopsy channel of a standard bronchoscope, or through a fibrescope. Anaesthesia must avoid inflammable gases. In most cases, general anaesthesia was used, and ventilation achieved with a mixture of 50% nitrogen and oxygen, using a modification of the Sanders injector. One hundred and sixty-four cases have been treated in 317 sessions (from one to five sessions per patient). They comprised: 72 cancers, 24 of which had just been diagnosed and had acute respiratory obstruction. In 16, one single session restored the patency of the airway. Forty-eight other cases were recurrent carcinomas after either surgery or radiotherapy, nine of which were caused by cancers of other origin invading the trachea; 21 benign or moderately malignant tumours; 44 iatrogenic stenoses, including 31 narrow ones. Of those 31 cases, 17 had an immediate satisfactory result, but eight recurred; 24 granulomas on bronchial suture lines. There were two deaths not directly related to surgery or anaesthesia. Bleeding was never more than moderate. The main difficulty lies in the critical respiratory condition of the patients, sometimes seen in acute asphyxia, referred to us as a last resort, especially those with carcinomas involving the trachea or main bronchi.

Adult↗
PubMed1986

Postal survey of bronchoscopic practice by physicians in the United Kingdom.

In 1983 a postal survey of the bronchoscopic practice of chest physicians in the United Kingdom produced a 90% response rate. Two hundred and thirty one physicians were carrying out bronchoscopy; they had performed about 40 000 bronchoscopies in the preceding year, 87% of these being fibreoptic procedures with topical anaesthesia. The mortality rate of fibreoptic bronchoscopy was 0.04%, with a 0.12% incidence of major complications. Transbronchial biopsy carried both an appreciably higher mortality rate of 0.12% and a major complication rate of 2.7%. There is wide variation in the use and choice of sedative drugs for fibreoptic bronchoscopy. Many of the drug combinations could be criticised on pharmacological grounds. The mean dose of lignocaine was 342 mg, most operators exceeding the usual maximum recommended dose; but adverse reactions were rare. Routine supplemental oxygen was given by only 18% of bronchoscopists. Basic resuscitation equipment was often inadequate. Radiological screening was used for transbronchial lung biopsy by 53% of respondents and significantly reduced the incidence of pneumothorax from 2.9% to 1.8%. Both the number of bronchoscopies performed and the complication rate were higher than previous estimates. Bronchoscopists should re-examine their policy on drugs and safety precautions to minimise the risks of the procedure.

Anesthesia↗
PubMed1990

Bronchoscopic and bronchographic findings in 12 patients with sarcoidosis and severe or progressive airways obstruction.

Twelve patients (8 men), aged 33-67 (mean 49) years, with histologically proved sarcoidosis underwent bronchoscopy. All had symptoms, signs (wheeze in 11, high pitched inspiratory "squeaks" in six, stridor in three), and physiological abnormalities characteristic of severe or worsening airways obstruction. Eleven patients also underwent bronchography. At the time of bronchoscopy four patients had stage II, one stage III, and seven stage IV sarcoidosis. All patients had a peak expiratory flow (PEF) of 70% predicted or less and a maximum expiratory flow at 50% (MEF50) and 25% (MEF25) of vital capacity below 35% predicted. The ratio of their forced expiratory volume in one second to forced vital capacity (FEV1/FVC) ranged from 37% to 65%. Fibreoptic bronchoscopy showed single or multiple areas of segmental bronchial stenoses in 10 patients, two of whom had stenotic webs. Bronchography showed that the sites and severity of stenoses were more widespread than suspected from the bronchoscopic findings. Five of the 11 patients undergoing bronchography had bronchiectasis, which was restricted to the upper lobes in three and a lower lobe in one and affected both upper and lower lobes in one patient. The bronchiectasis had not been suspected or diagnosed from the chest radiography or the bronchoscopy.

Adult↗
PubMed1993

Bronchoscopic diathermy resection and stent insertion: a cost effective treatment for tracheobronchial obstruction.

BACKGROUND: Major airways obstruction is a distressing cause of morbidity and mortality. For disease that is extensive and recurrent, there is a need for a safe and cost effective technique for palliation. METHODS: The results of 29 patients with tracheobronchial obstruction (24 malignant and five benign) treated by diathermy resection alone or in combination with endobronchial stenting have been reviewed. RESULTS: The major site of obstruction was the trachea in 14, main carina in seven, right main bronchus in six, and left main bronchus in two patients. Fifteen had received other forms of treatment beforehand including external radiotherapy, endoscopic dilatation, and laser resection (Nd:YAG). Five patients required two or more treatment sessions for symptom recurrence. Ten patients also received additional treatment with a stent (nine) or insertion of gold grains (one). There were no intraoperative deaths or complications and the average length of stay was five days (range 2-14). Twenty eight patients reported immediate symptomatic relief, and objective improvement in the results of lung function tests was seen in eight patients whose condition was less acute and where preoperative lung function tests could be undertaken (average improvement in FEV1 of 53.1% and in FVC of 20.6%). CONCLUSIONS: Bronchoscopic diathermy resection is an effective and safe method for relieving the symptoms of tracheobronchial obstruction at appreciably less cost than laser resection.

Adult↗