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PubMed1978

[UV-fluorescence-bronchoscopy].

In UV fluorescence bronchoscopy the patient inhales 5 ml of a 5% aqueous solution of fluorescein by compressed air spray, together with a beta2-stimulator, 10-15 min before the bronchoscopy. After the dyestuff which has collected in the secretion has been coughed up or drawn off, only carcinomata, nonciliated metaplastic forms of the mucous membrane, macroscopically non-visible tumour infiltrations into the mucous membrane, and lymphangiosis carcinomatosa remain stained. Under UV illumination, these areas can be visualized for location of points to be examined by biopsy. Interested readers are called upon to form themselves into a study group.

Bronchial Diseases↗
PubMed1983

[Atelectasis - bronchoscopy and unilateral ventilation].

Atelectasis in the postsurgical patient or patients on artificial ventilation problems is a frequently occurring complication. Bronchoscopy, local secretion removal by suction, lavage and vigorous positive pressure ventilation in many cases fail to re-expand the collapsed lung. Intubation after bronchoscopy by a double lumen tube permits systematic overinflation of the collapsed lung whereas the other lung is open to atmospheric pressure. In this manner the opening pressure of the collapsed lung can be overcome without overdistension of the other lung. The result is a marked improvement of oxygenation by reducing the venous admixture in lung.

Adolescent↗
PubMed1984

[Ventilation using jet-ventilation during fiber-optic bronchoscopy in children under 5 years old. Apropos of 100 case reports].

The authors report an original procedure for respiratory assistance during flexible bronchoscopy in infants and toddlers. The injector is directly connected with the operating channel of the bronchoscope. Ventilation parameters are pre-regulated before introducing the fiberscope into the respiratory tree. Insufflation volumes are restricted to 5 ml/kg at the tip of the bronchoscope, on a basis of 40 to 60 cycles per minute, according to children's age. A venturi effect may occur as discrepancy between bronchi and the size of the fiberscope does exist. For evaluating this effect, gas flow is measured through tracheal tubes selected in accordance to the size of the respiratory tree of the infant. This evaluation demonstrates that tidal volumes are comprised within 5 and 10 ml/kg. The procedure of jet-ventilation was performed on 100 infants under general anaesthesia with curarization. Baro-traumatic accidents did not occur, despite poor physical conditions in many cases. The procedure was safe for the infants and convenient for the physicians. In this way, it could be recommended for flexible bronchoscopy in infants and toddlers with poor condition or when excessive duration of the examination could be required (diagnostic or therapeutic procedures associated).

Anesthesia, General↗
PubMed1978

Fiberoptic bronchoscopy in nonhospitalized patients.

Fiberoptic bronchoscopy is employed extensively in the examination of patients with pulmonary disease. As demonstrated in this large series, the procedure can be performed safely and efficiently on an outpatient basis, with the use of only topical anesthesia. Discomfort is minimal and readily accepted by most patients. Bronchial biopsies of suspected neoplastic lesions can be performed without difficulty. Outpatient bronchoscopy in an appropriate clinical setting can hasten the medical evaluation without compromising patient care.

Adolescent↗
PubMed1984

Bronchoscopy in the critically ill surgical patient.

Sixty-seven bronchoscopic examinations were performed in a busy surgical intensive care unit on 51 patients, and the techniques, morbidity, and outcome were prospectively analyzed to assess the efficacy and safety of the procedure in this particular patient population. General surgical trauma, cardiothoracic, and orthopedic patients were included. Fifty-three (79%) procedures were performed with the flexible instrument, while 14 patients (21%) underwent rigid endoscopy. Forty-six patients were being mechanically ventilated; 30 had endotracheal tubes, and 16 had tracheostomies. Suspected lobar collapse (60%), persistent pulmonary infiltrates (3%), suspected aspiration (21%), and suspicion of airway trauma (12%) were the primary clinical indications for bronchoscopy. No deaths occurred. Complications were seen in 16 per cent of the procedures and 17 per cent of the patients. There were arrhythmias (other than sinus tachycardia) in seven procedures (11%) and one episode each of hypertension, self-limited endobronchial bleeding, mediastinal emphysema, and increased intracranial pressure. Significant improvement was demonstrated for patients with lobar collapse but not for those with mild atelectasis or pulmonary infiltrates on radiographs taken within 24 hours. Overall, 39 patients (58%) improved radiographically, while 38 patients (42%) did not. Differences in arterial PO2 measured before and after bronchoscopy between groups ventilated with an FiO2 of 1.0, and those who were not did not achieve statistical significance (P less than 0.05).

Bronchoscopes↗
PubMed1984

Use of fiberoptic bronchoscopy in experimental production of bovine respiratory tract disease.

Fourteen 6-month-old calves were infected with Pasteurella haemolytica or infectious bovine rhinotracheitis (IBR) virus. Four calves were inoculated sequentially with IBR virus followed by P haemolytica at a 5-day interval. Calves were inoculated by allowing them to inhale an aerosol of the organism or by placing an inoculum in the right lung, using fiberoptic bronchoscopy. Clinical signs of infection were recorded, and the calves, if they survived, were killed and necropsied 3 days after inoculation with P haemolytica (or 8 days after inoculation with IBR virus). The extent of pulmonary lesions was determined, and the lower respiratory tract (lungs and lower trachea) was examined for both organisms. Inoculation of the calves by aerosolization with IBR virus alone resulted in mild respiratory tract disease. Mild-to-moderately severe respiratory tract disease developed as a result of sequential inoculations by aerosolization with IBR virus and P haemolytica. However, respiratory tract disease did not develop in calves exposed by aerosol to P haemolytica alone. Large numbers of these organisms were recovered from the lower respiratory tract of the dually inoculated calves, only indicating delayed pulmonary clearance. Mild clinical signs of disease but substantial, though localized, pneumonic lesions developed in calves inoculated with P haemolytica by fiberoptic bronchoscopy. Calves inoculated with IBR virus by the latter procedure developed moderately severe respiratory tract disease involving 25% to 30% of the total lung volume. Lesions occurred mainly in the right lung, but the left lung also had marked lesions in these calves.(ABSTRACT TRUNCATED AT 250 WORDS)

Aerosols↗
PubMed1983

Status Asthmaticus: use of acetylcysteine during bronchoscopy and lavage to remove mucous plugs.

Three patients suffering from severe, chronic, bronchial asthma underwent bronchoscopy and lavage, using in the irrigant fluid acetylcysteine, isoetharine and Solu-Medrol. All patients had a large amount of thick mucus in the tracheobronchial tree which was removed during the lavage. Following the lavage, all three patients were easily treated with conventional allergic measures and were able to lead normal lives, which they could not do before. A discussion of the precautions to be taken by the medical-surgical team in charge of a patient undergoing bronchoscopy and lavage is made. These conclusions were based on the results of two previous reports by the authors in addition to the present communication.

Acetylcysteine↗
PubMed1978

The role of bronchoscopy and needle aspiration in the diagnosis of peripheral lung masses.

Sixty patients underwent flexible fiberoptic bronchoscopy and percutaneous needle aspiration of peripheral lung lesions with fluoroscopic monitoring. A single general anesthetic was used. We found that percutaneous needle aspiration was the more accurate of the two procedures in establishing a diagnosis but that flexible fiberoptic bronchoscopy proved complementary in some instances. The incidence of pneumothorax was 27% but aspiration was needed in only 8%. There were no other complications. In 84% of patients with primary carcinoma of the lung presenting as a peripheral lesion, the diagnosis was established by these procedures. The accuracy was less in metastatic lesions and considerably less in benign lesions.

Biopsy, Needle↗
PubMed1982

[Complications of bronchoscopy].

1500 bronchoscopies performed in the Department of Pneumology, University of Basle, were analyzed for frequency and severity of complications. 500 patients were investigated by rigid tube in local anesthesia, 500 patients by rigid tube in neuroleptanalgesia and 500 patients by flexible fiberbronchoscope. The rate of complication for all patients was 4.1%, which agrees well with the previously reported complication frequency of 1-11%. The complications were minor in 3.5% of patients, moderate in 0.5% and major in 0.1%. There were no deaths. The incidence of severe complications and deaths was thus lower than in other studies. There was a higher incidence of complications (p less than 0.001) in the group examined with the rigid tube in neuroleptanalgesia, due to the more frequently observed minor complications. The incidence of complications can be reduced by a careful indication for bronchoscopy, adequate yet sparing use of anesthesia, and choice of the right instrument.

Adolescent↗
PubMed1981

Haemoptysis with no radiological evidence of tumour - the value of early bronchoscopy.

Thirty-two patients who presented with haemoptysis and in whom a chest radiograph showed no suggestion of a tumour are reviewed. Six had bronchogenic carcinoma diagnosed by bronchoscopy and 1 had an adenoid cystic tumour of the trachea. Flexible fibre-optic bronchoscopy is a safe and easy method of excluding a tumour of the tracheobronchial tree as the cause of haemoptysis and should be performed early in patients who present with this symptom, regardless of the findings on chest radiography.

Adult↗
PubMed1981

Flexible fiberoptic bronchoscopy in the diagnosis of pulmonary complication of lymphoma.

Patients with known lymphoma frequently present with pulmonary abnormalities that require prompt diagnosis. The usual chest radiograph and bacteriologic studies often fail to be of diagnostic value. Since February 1973, we have performed flexible fiberoptic bronchoscopies on 76 patients with Hodgkin and non-Hodgkin lymphoma who presented with pulmonary abnormalities. Biopsy specimens revealed lymphoma in 21 of these 76 patients, pneumocystic carinii infection in six, aspergillus infection in three, and cryptococcus, herpes simplex, and squamous cell carcinoma, respectively, in the remaining three. In all, specific diagnosis was obtained in 33 patients (43%). One death from bleeding occurred in a patient with marked thrombocytopenia and respiratory failure. Flexible bronchoscopy is recommended as a valuable, relatively risk-free procedure in the diagnosis of the pulmonary manifestations, or complications, of lymphoma.

Bronchoscopy↗
PubMed1980

[Studies on the influence of the short-time narcosis during bronchoscopy on the cellular immunity (author's transl)].

The investigations were carried out on 30 patients with different pulmological diseases before a bronchoscopy with Brevinarkon and one, four and seven days after the bronchoscopy. There were evaluated the absolute lymphocytes in the blood smear and the transformation rate in the phytohemagglutinin-induced lymphocyte transformation test. On the first day after narcosis the results showed a decrease of lymphocytes and on the following days there was to be found a suppression in the lymphocyte function.

Anesthetics↗
PubMedDate not supplied

Pediatric flexible bronchoscopy: a three-year experience.

One hundred and forty-one flexible fiberoptic bronchoscopies were performed in 124 pediatric patients in Chang Gung Children's Hospital between October 1991 and September 1994. Eleven of these patients were younger than 1 month old; 52 patients were younger than 1 year old; 94 patients were younger than 6 years old. The bronchoscope used was Olympus BF 3C20; with a 3.5 mm outer diameter, it also has a build-in 1.2 mm working channel. Most of the procedures were done in the pediatric intensive care unit. Oral chloral hydrate and parenteral benadryl were given as pre-sedation medication 30 minutes before the procedures; for most cases intravenous midazolam and meperidine hydrochloride were given immediately before the examination. The most common diagnoses were laryngomalacia, airway foreign bodies, subglottic stenosis or tracheal stenosis. Six episodes of transient hypoxemia and one brief episode of apnea were encountered. It was concluded that flexible fiberoptic bronchoscopy, very useful and safe in pediatric patients, has been underused in Taiwan.

Adolescent↗
PubMed1994

[Use of fiberoptic bronchoscopy for removal of foreign bodies from the lower respiratory tract].

One of the initial indications for therapeutic bronchoscopy was removal of an aspirated foreign body. The aim of this study was to evaluate the role of bronchofiberoscopy in removal of aspirated foreign bodies. Thirty patients were included in the study (age range 4-81 years). Endoscopy was performed under local anesthesia in two sessions. During the first a complete evaluation of the tracheobronchial tree was carried out, while during the second the actual removal was performed. In the majority of the patients (23) the foreign body was aspirated into the right lung. In the majority of the patients (13) various fragments of bones were recovered. Only in one patient a major complication was observed (hemorrhage) which compelled to change from bronchofiberoscopy to rigid endoscopy. All complaints from patients subsided during 2-4 days after removal of the foreign body. Foreign bodies were removed using a bronchofiberoscope in 21 out of the 28 patients. In two patients a calcified lymph node could not be removed during bronchoscopy and the patients were referred to the Surgical Department for thoracotomy.

Adolescent↗
PubMed1994

[Anesthesia for bronchoscopy: application of laryngeal mask airway and "minidose midazolam anesthesia"].

Bronchoscopy distresses most of the patients. Therefore, we combines a small dose of midazolam (ca. 2 mg) with laryngeal mask airway. This method of anesthesia has the following features: (1) mild discomfort, (2) day care, (3) putting bronchoscope in or out easily, (4) mild effect on respiration and circulation, and (5) easy respiratory care. But improper cases for this method include non-fasting patients, those at high risk for regurgitation, and those with low pulmonary compliance. This is a very usefull anesthetic method for bronchoscopy.

Adult↗
PubMed1994

Value of CT-guided fine needle aspiration in solitary pulmonary nodules with negative fiberoptic bronchoscopy.

The usefulness of fine needle aspiration (FNA) with CT-guidance was evaluated in the diagnosis of solitary pulmonary nodules (SPN) following negative fiberoptic bronchoscopy in 84 patients. The records were analyzed for all patients with SPN who had undergone chest FNA in the years 1988 to 1990, showing previous nondiagnostic fiberoptic bronchoscopy. A final diagnosis was made by biopsy (transbronchial, thoracotomy or necropsy), response to therapy or follow-up of the lesions. The patients had medium-sized lesions, 2.87 +/- 1.11 cm, adherent to the pleura in 62%. In the diagnosis of malignancy FNA showed 76% sensitivity, 100% specificity, 100% positive predictive value, 52% negative predictive value and 81% accuracy. These results were correlated with histology in 84% of the cases. One pulmonary hemorrhage, which resolved spontaneously, and 12 cases of pneumothorax, requiring a thoracic tube in 4 patients, were noted.

Biopsy, Needle↗
PubMed1994

Clinical application of bronchoscopy and bronchoalveolar lavage in the immunocompromised host.

Pulmonary complications are the most frequent cause of morbidity and mortality in immunocompromised patients. The speed of clinical assessment and the initiation of appropriate therapy is critically related to survival. Fibreoptic bronchoscopy and bronchoalveolar lavage (BAL) had proved useful in making the diagnosis of pulmonary complications in a high proportion of immunocompromised patients, where less invasive techniques, such as blood cultures or sputum induction, have failed to establish a diagnosis. Bronchoscopy and BAL cause little discomfort and low morbidity, and should be performed as early in the disease course as possible, preferably before the onset of respiratory failure.

Bronchoalveolar Lavage Fluid↗
PubMedDate not supplied

Effect of routine fiberoptic bronchoscopy and bronchoalveolar lavage on arterial blood gases.

Effect of conventional fiberoptic bronchoscopy (FOB) procedure (Group A, n = 10) and bronchoalveolar lavage (BAL) (Group B, n = 11) on arterial blood gases was studied in 21 patients. A significant fall in arterial oxygen tension (PaO2) with widening of alveolar arterial oxygen gradient D(A-a)O2 was observed during FOB (p < 0.001) and 30 minutes following the procedure (p < 0.001). Bronchoalveolar lavage was also associated with significant fall (p < 0.001) in PaO2 with increased D(A-a)O2 and this fall in PaO2 persisted for 30 minutes after the procedure (p < 0.01). None of the patients received oxygen during the procedures. None of the patients in either group developed bronchospasm. No change in arterial carbon dioxide (PaCO2) was observed in either group. Hypoxaemic encephalopathy developed in one patient in group A, hypotension and cyanosis developed in one patient each in group B. No mortality was encountered in the study. All the three patients with complications were excluded from final analysis. It was concluded from this study that both conventional bronchoscopy and BAL procedures were associated with significant hypoxaemia and supplemental oxygen should be given to all patients during the procedure and should be continued for at least 30 min. afterwards.

Adolescent↗