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At least 667 records · Page 37Linked to original sources
PubMed1994

An assessment of prilocaine as a topical anaesthetic agent for fibreoptic bronchoscopy in comparison with lidocaine.

We have evaluated prilocaine as a topical anaesthetic agent for fibreoptic bronchoscopy in comparison with lidocaine in terms of efficacy and safety. Forty patients were included in a randomised double-blind parallel-group study. Efficacy was assessed using visual analogue scales, a patient ranking scale and the number of doses of local anaesthetic and intravenous sedative required. Measures of toxicity included peak plasma concentration of local anaesthetic, whether supplementary oxygen was needed and change in methaemoglobin concentration. For most of the outcome variables, the medians and quartiles were similar for the two local anaesthetics. However, the median peak plasma concentration of prilocaine (0.5 micrograms.ml-1) was less than one-third that of lidocaine (1.76 micrograms.ml-1). The merits and hazards of using multiple-regression modelling to improve the precision of the analysis of the results are considered. We conclude that prilocaine can be used successfully as a topical anaesthetic agent for fibreoptic bronchoscopy and is associated with a lower risk of toxicity.

Adult↗
PubMed1995

The laryngeal mask airway for fibreoptic bronchoscopy in children.

A size 2 laryngeal mask airway (ID 7 mm) was used for general anaesthesia during fibreoptic bronchoscopy in a six-year-old child. The mask permitted the use of an adult bronchoscope with an external diameter of 5 mm. Throughout bronchoscopy, adequate controlled ventilation could be achieved easily without excessive air leak or airway resistance; the Spo2 was always > 97%, and the end-tidal Pco2 ranged between 3.9-4.5 kPa (30-35 mmHg).

Airway Resistance↗
PubMed1996

Flexible fibre-optic bronchoscopy in the management of lung complications in cystic fibrosis.

Flexible fibre-optic bronchoscopy was performed under sedation in 24 children with cystic fibrosis. In eight cases bronchoscopy was carried out as a therapeutic procedure. Most children were subjectively improved, but objective evidence of change was minimal. Useful information was obtained in 9/16 children who underwent the procedure for diagnostic purposes. Information included sensitive identification of organisms responsible for lower respiratory symptoms in non-expectorating cases and identification of unsuspected gastro-oesophageal reflux.

Adolescent↗
PubMed1992

[Study on the bacteriological examination of sputum and bronchoscopy specimens from 31 cases with pneumonia due to Chlamydia psittaci].

We carried out the bacteriological examination of sputum and bronchoscopy specimens from 31 cases with pneumonia due to C. psittaci. The results obtained were as follows: 1. The positive culture of sputum and bronchoscopy specimens were 38.7% (12/31). 2. The organisms detected from them were 13 strains of gram-negative bacilli, 2 of gram-positive cocci and one gram-positive bacillus. 3. Significant differences were observed in the white blood cell count between the cases of positive culture and those of normal upper respiratory tract flora (p less than 0.05). From the results we conclude that it would be better that we add the proper antimicrobial drugs to chlamydial antibiotics in the treatment of patients with leukocytosis.

Adolescent↗
PubMed1999

[Usefulness of bronchoscopy for the diagnosis of atypical pulmonary mycobacteriosis].

In 14 subjects whose chest radiographs showed abnormal shadows during the two years from January 1995 until December 1996, no definite diagnosis could be obtained because sputum, smears and cultures all gave negative results for mycobacteria. Bronchoscopy was therefore performed, revealing atypical mycobacteria in cultures of the bronchial washing fluid for mycobacteria, and the significance of bronchoscopic examinations in cases diagnosed an atypical pulmonary mycobacteriosis was investigated. Most of the subjects (9) were women. Nine subjects had been informed that they had abnormal chest shadows; five had subjective symptoms; bloody sputum, 3 and cough, 2. The characteristics of the shadows were as follows: in the plain radiographs, the main shadows had a mottled or granular appearance in the majority of the patients (9) and there were infiltrative shadows in 3 patients and nodular shadows in another 3. In computed tomograms, the shadows in the vicinity of the pleura appeared as micronodular conglomerates in 12 patients, in 11 of whom bronchiectasis was also present near the shadows. Alveolar infiltrative shadows were present in four cases, and a cavity was seen in only one. Smears of the bronchial washing fluid for mycobacteria were positive in 7 patients, and cultures of this fluid yielded at least 100 colonies in 8 of the 14 subjects for whom the results were positive. By culture, Mycobacterium avium complex (MAC) was identified in 13 patients, but eleven of these in whom the bronchial washing fluid was concurrently tested for MAC by the polymerase chain reaction, only four were MAC-positive. Transbronchial lung biopsies were performed in 11 cases, in which the histological findings of mycobacterial infections showed granuloma in four, and caseation in three. Bronchoscopy is making possible initial-stage diagnosis, which are normally difficult, among the recently growing number of cases of the bronchial form of atypical pulmonary mycobacteriosis and is also useful for reaching definite diagnosis in the early stage.

Adult↗
PubMed2006

Bronchoscopy following diagnosis with cystic fibrosis.

We recently changed our practice to perform bronchoscopy following diagnosis with cystic fibrosis. On a retrospective review of 25 children, Pseudomonas aeruginosa was detected in bronchoalveolar lavage for the first time in five children (20%) and Staphylococcus aureus in four (16%). Lavage culture was positive in eight of 18 children without respiratory symptoms. This highlights the potential of bronchoscopy following diagnosis, even in asymptomatic children.

Bronchoscopy↗
PubMed1992

Bronchoscopy in lipoid pneumonia.

Forcible administration of rendered animal fat to infants is a tradition in south western Saudi Arabia. Accidental inhalation may result in a resistant form of lipoid pneumonia. A series of 24 cases of lipoid pneumonia, 22 of which were diagnosed by bronchoscopy with bronchial lavage and microscopic examination of the aspirate, are reported. The technique is described briefly and the results analysed. A high index of suspicion together with bronchoscopy and bronchial lavage of all cases of resistant or recurrent pneumonia is essential in areas such as ours for diagnosis of this condition.

Bronchoscopy↗
PubMed2002

Foreign body aspiration: clinical utility of flexible bronchoscopy.

Foreign body aspiration is a worldwide health problem which often results in life threatening complications. More than two thirds of foreign body aspirations occur among children younger than 3 years. Organic materials such as nuts, seeds, and bones are most commonly aspirated. There is a wide range of clinical presentation, and often there is not a reliable witness to supply the clinical history, especially in children. Maintaining a high index of suspicion is therefore necessary for the diagnosis. None of the imaging methods employed in such cases are diagnostic, and bronchoscopy is frequently necessary for the diagnosis as well as the treatment. In adults, removal of the foreign body can be attempted during diagnostic examination with a fibreoptic bronchoscope under local anaesthesia, which may help to avoid any further invasive procedures with more complications. When diagnosis is delayed, complications of a retained foreign body such as unresolving pneumonia, lung abscess, recurrent haemoptysis, and bronchiectasis may necessitate a surgical resection. However, some of the late complications may resolve completely after the retrieval of the foreign body, therefore, a preoperative flexible bronchoscopy should always be considered in suitable cases.

Adolescent↗
PubMed1977

Diagnostic fibreoptic bronchoscopy in the immunocompromised host with pulmonary infiltrates.

Nineteen immunocompromised patients with pulmonary infiltrates underwent diagnostic fibreoptic bronchoscopy with transbronchial forceps and brush biopsy. A specific diagnosis was obtained in 21/25 procedures (10/11 focal lesions and 11/14 diffuse legions). The most common diagnosis was infection, and organisms isolated included bacteria, fungi, Pneumocystis carinii, and herpes simplex. A pneumothroax requiring tube drainage occurred in two cases and mild lung parenchymal bleeding was noted in two others. It is concluded that fibreoptic bronchoscopy with forceps and brush biopsy can be performed safely with an excellent diagnostic yield in immunocompromised hosts with lung lesions. Supplemental oxygen should be administered during fibreoptic procedures in these patients and platelet transfusions should be given when thrombocytopenia is present.

Adult↗
PubMed1982

Rigid bronchoscopy under intravenous general anaesthesia with oxygen Venturi ventilation.

In a study of 100 patients undergoing rigid bronchoscopy under intravenous general anaesthesia with oxygen Venturi ventilation no major complications were observed. Minor complications included one adverse reaction to alphaxalone-alphadolone acetate (Althesin), one prolonged episode of laryngeal spasm after removal of the bronchoscope, and subsequent muscle pain attributed to suxamethonium in 36 patients. The last complication occurred significantly less frequently (p less than 0 . 025) in those patients who were pretreated with a small dose of a non-depolarising neuromuscular blocking agent. Serial arterial blood gas sampling in 10 patients showed adequate ventilation during bronchoscopy, but carbon dioxide retention developed in nine cases immediately after the bronchoscope was withdrawn. With adequate precautions, however, the procedure is safe and well tolerated, even in patients with severe impairment of respiratory function.

Adult↗
PubMed1989

Topical nasal anaesthesia for fibreoptic bronchoscopy: patients' preference for lignocaine gel.

Two techniques for anaesthetising the nose before fibreoptic bronchoscopy have been compared. Fourteen of 16 patients given lignocaine spray found it unpleasant, compared with three of 20 patients given lignocaine gel. The two forms of local anaesthetic were found to be equally effective. Lignocaine gel is therefore recommended for topical nasal anaesthesia before fibreoptic bronchoscopy.

Anesthesia, Local↗
PubMed1990

Effect of fibreoptic bronchoscopy on pulmonary function.

Several studies have shown that after fibreoptic bronchoscopy there may be a deterioration in lung function but it is not known whether this is due to the premedication, the topical anaesthetic, or the obstruction produced by the bronchoscope. The effects of each part of the procedure on spirometric measurements were studied in patients with lung disease and in normal non-smokers. Measurements were made after premedication (papaveretum and atropine) in seven patients and after topical anaesthesia of the bronchial tree (340 mg lignocaine) with and without the bronchoscope in the trachea in 21 patients and 10 control subjects. Premedication had no effect. In the normal subjects lignocaine produced significant falls in FEV1, forced vital capacity (FVC), peak expiratory flow (PEF), and peak inspiratory flow (PIF), and insertion of the bronchoscope caused further falls that were also significant. In the patients, however, although anaesthesia produced significant falls in FEV1, FVC, PEF, and PIF of similar magnitude to those found in the normal subjects, there was no further important decrease when the bronchoscope was inserted. It is concluded that the major effect of bronchoscopy on lung function is due to topical lignocaine in the airways, and in patients with lung disease (excluding asthma or a central obstructing carcinoma) the insertion of the bronchoscope causes little additional obstruction.

Administration, Topical↗
PubMed1990

Value of washings and brushings at fibreoptic bronchoscopy in the diagnosis of lung cancer.

A retrospective study was performed to evaluate the diagnostic yield for lung cancer from histological biopsy specimens and from washings and brushings for cytological examination taken at fibreoptic bronchoscopy. The records of 680 bronchoscopies were analysed. Of 300 patients eventually diagnosed as having a malignant lesion, 188 had had biopsy, washing, and brushing. Of these, 125 had endoscopically visible tumour (group A) and 63 had no abnormal findings or abnormal findings that were not diagnostic of malignancy (group B). In group A biopsy specimens gave a positive result in 76% of cases, washings in 49.6%, and brushings in 52%; biopsy material gave the only positive result in 22.4% of cases, washings in 2.2%, and brushings in 4.8%. In group B biopsy specimens were positive in 36.5%, washings in 38.1%, and brushings in 28.6%; biopsy gave the only positive result in 11.1% of cases, washing in 9.5%, and brushing in 3.2%. Washing had a higher diagnostic yield than brushing in group B. Biopsy and cytological examination of either washings or brushings were found to give over 95% of all positive results in group A, but in group B the combination of biopsy and washing was more often successful (94.3%) than biopsy and brushing (82.8%). It is concluded that for the maximum diagnostic yield in the diagnosis of lung cancer biopsy should be combined with cytology using both washings and brushings.

Bronchoalveolar Lavage Fluid↗
PubMed1990

Local anaesthesia for fibreoptic bronchoscopy: transcricoid injection or the "spray as you go" technique?

Local anaesthesia for fibreoptic bronchoscopy should be given by a safe technique that is not unpleasant to the patient and should provide acceptable conditions for the bronchoscopist. Single injection transcricoid local anaesthesia was compared with the "spray as you go" technique in patients having day case fibreoptic bronchoscopy. Patients were randomised to receive either 100 mg lignocaine by a single cricothyroid puncture or 240 mg lignocaine instilled through the bronchoscope under direct vision. Further doses were given by the operator to both groups as required. The 30 patients receiving transcricoid lignocaine coughed less (3.56 (SD 3.1) coughs/min) than the 32 patients receiving lignocaine through the bronchoscope (5.89 (4.8)/min) despite receiving a lower total dose of lignocaine (322 (25.9) v 451 (20.9) mg). Cricothyroid puncture was not associated with any complications and was not unpleasant for the patients.

Administration, Topical↗
PubMed2001

Transbronchial biopsy with virtual CT bronchoscopy and nodal highlighting.

Transbronchial biopsy to sample lymph nodes and tumors that are not visible at endoscopy has a poor (<50%) success rate. These nodes can be highlighted easily at virtual computed tomographic (CT) bronchoscopy to provide a guide. This study was performed to evaluate if the addition of this information to the bronchoscopist improved the success rate of transbronchial biopsy of subcarinal and aortopulmonary lymph nodes. The addition of virtual CT bronchoscopy with lymph node highlighting significantly (P < .5) increased biopsy success rates for pretracheal, hilar, and high pretracheal adenopathy.

Adult↗
PubMed1998

Bronchial anastomotic complications in lung transplant recipients: virtual bronchoscopy for noninvasive assessment.

PURPOSE: To compare the accuracy of virtual bronchoscopy (VB) with that of axial computed tomography (CT) in the assessment of bronchial anastomotic complications in lung transplant recipients. MATERIALS AND METHODS: Twenty-seven bronchial anastomoses in 17 patients were evaluated with helical CT. Axial CT and VB images were evaluated for surface irregularity and the presence, length, and severity of stenosis. Findings were correlated with the results of fiberoptic bronchoscopy (FOB). RESULTS: There were 12 anastomotic stenoses at FOB. Pooled accuracy (among all four readers) of VB and axial CT for diagnosis of clinically relevant stenosis was 97% and 80%, respectively, at the right bronchial anastomoses and 92% and 75%, respectively, at the left bronchial anastomoses. Pooled accuracy of VB and Axial CT for stenosis length was 72% and 62%, respectively, at the right anastomoses and 81% and 69%, respectively, at the left anastomoses. These differences were not statistically significant. Both the VB and axial CT images showed surface irregularities when anastomotic infection (n = 2) or dehiscence (n = 1) was present but resulted in an overdiagnosis of mucosal abnormalities when anastomoses were normal. CONCLUSION: VB was slightly more accurate than axial CT for diagnosis of clinically relevant stenoses at bronchial anastomoses in lung transplant recipients. However, because VB is not 100% accurate and has no role in the diagnosis of infection or dehiscence, it probably will not replace FOB for assessment of bronchial anastomotic complications in this population.

Anastomosis, Surgical↗
PubMedDate not supplied

Flexible bronchoscopy in the management of congenital lobar emphysema in the neonate.

This paper describes the case of a 3 kg neonate who had congenital lobar emphysema of the left upper lobe (LUL). He was in severe respiratory distress with a fraction of inspired oxygen of 0.8. Chest x-ray showed hyperlucent expanded left hemithorax and marked mediastinal shift. Following flexible bronchoscopy and introduction of ultrathin bronchoscope into the LUL bronchus, symptoms and chest x-ray improved markedly. Flexible bronchoscopy resulted in emergency relief of his initial respiratory distress, and left upper lobe lobectomy was performed electively three days later.

Bronchoscopy↗