Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Bronchoscopy”

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 865 records · Page 48Linked to original sources
PubMed2004

Double-lumen tube position should be confirmed by fiberoptic bronchoscopy.

PURPOSE OF REVIEW: This review is part of Pro and Contra use of fiberoptic bronchoscopy to confirm the position of a double lumen tube. The purpose of this review is to highlight the circumstances where fiberoptic bronchoscopy should be used in conjunction with lung separation, right sided double-lumen tube positioning, and to identify fine malposition for generally missed by clinical signs. RECENT FINDINGS: Until several years ago, confirmation of a double-lumen tube (DLT) position was limited to inspection and auscultation. Fiberoptic bronchoscopes were usually only available in the bronchoscope suite for the exclusive use of the pulmonary personnel. Today, in most institutions, fiberoptic bronchoscopes of different diameters are available in the operating room for use by the anesthesia personnel. SUMMARY: Advances in technology and improved quality of the endoscopes image make the technique easy to use with a relatively simple learning curve. In fact, fiberoptic workshops, thoracic workshops and difficult airway workshops are offered in nearly all important anesthesia meetings.

Journal Article↗
PubMed2004

Fiberoptic bronchoscopy need not be a routine part of double-lumen tube placement.

PURPOSE OF REVIEW: The debate continues as to whether a fiberoptic bronchoscope must be used to position a double-lumen tube. This review supports the argument that although bronchoscopy is extremely helpful, it is not always needed for the routine placement of left double-lumen tubes. RECENT FINDINGS: Several recent clinical reports have demonstrated that an experienced anesthesiologist can safely and consistently position double-lumen tubes without bronchoscopic assistance. In order to do so several important factors must be considered. These include the appropriate choice of tube (left or right), size of tube, and endpoint for the depth of insertion. SUMMARY: Although bronchoscopy is useful, no double-lumen tube positioning method is fail-safe. The choice of which approach to use, 'blind' versus fiberoptic bronchoscope-assisted, is influenced by many factors. Operator experience with any method increases the likelihood of success. A fiberoptic bronchoscope is not always needed for left double-lumen tube placement.

Journal Article↗
PubMed1982

Flexible fiberoptic bronchoscopy and laryngoscopy in children under 2 years of age: diagnostic and therapeutic applications of a new pediatric flexible fiberoptic bronchoscope.

The new flexible fiberoptic bronchoscope (Olympus BF Type 3C4, Tokyo, Japan) was employed for diagnostic and therapeutic purposes in 96 children below 2 yr of age. Sixty-two laryngoscopies and 34 bronchoscopies were performed without any mortality or significant morbidity. The bronchoscope was helpful in establishing diagnosis and also served as a tool for aspirating secretions and resolving atelectasis. It is concluded that flexible fiberoptic bronchoscopy and laryngoscopy in children 2 yr or younger is a safe procedure and may aid in the diagnosis and therapy of disorders of the respiratory tract in this age group.

Bronchoscopes↗
PubMedDate not supplied

A coaxial gas delivery system for laser bronchoscopy.

This paper discusses the development and implementation of a prototype coaxial gas delivery system for laser bronchoscopy. The design of the system is presented including a detailed description of the device's theory of operation and construction. The system's medical application in laser bronchoscopy is described.

Biomedical Engineering↗
PubMed1985

The use of fibreoptic bronchoscopy with sterile catheter in the diagnosis of pneumonia.

The use of fibreoptic bronchoscopy with sterile catheter sampling of pulmonary secretions was evaluated in 70 patients with a provisional diagnosis of pneumonia. In 37 patients quantitative analysis of the sterile catheter isolates was performed (colony forming units (CFU) per ml). Potential bacterial pathogens were isolated in 37 patients and in the quantitative analysis, 14 of 22 isolates were grown in counts greater than or equal to 10(3) CFU/ml. Sterile catheter increased the bacterial isolation rate as in only 19 patients blood (2) or sputum (18) cultures yielded the same organisms. Sputum cultures showed a 25% false-positive rate in patients with no growth from sterile catheter. Quantitative analysis did not yield any further information in patients receiving antibiotics. Atypical or fungal pneumonia was diagnosed in 22 patients, while ten patients had other pathology simulating pneumonia. Sterile catheter sampling of pulmonary secretions at fibreoptic bronchoscopy proved to be a valuable tool in the diagnosis of bacterial pneumonia.

Adolescent↗
PubMed1991

Ultrathin flexible bronchoscopy in neonatal intensive care units.

Thirty seven flexible bronchoscopies were performed in 33 infants in a neonatal intensive care unit, using a 2.2 mm flexible ultrathin bronchoscope. Twenty eight procedures were performed via an endotracheal tube or tracheostomy and nine in spontaneously breathing infants. Indications for endoscopy included persistent atelectasis and/or emphysema (n = 21), unexplained acute respiratory distress (n = 10), stridor (n = 3), assessment of congenital abnormalities of the tracheobronchial tree (n = 2), and follow up of an endobronchial granuloma during the course of corticosteroid treatment (n = 1). Abnormal airway dynamics and/or abnormal structure were seen in 23 of 37 cases. In 54% of the procedures, the results of bronchoscopy had a direct effect on further management. The procedure was well tolerated and completed in less than two minutes. Our results suggest that the ultrathin flexible bronchoscope improves airway exploration and the understanding of respiratory disorders during the first months of life, particularly in ventilated infants.

Bronchi↗
PubMed1991

Comparison of the diagnostic yields of disposable and reusable cytology brushes in fibreoptic bronchoscopy.

Disposable rake and reusable bristle type cytology brushes have been compared in 50 patients undergoing fibreoptic bronchoscopy for suspected malignancy. Forty seven patients were eventually found to have carcinoma of the bronchus. A diagnosis of malignancy was made from the specimens taken with one or other brush in 34 patients, from the reusable brush in 28, and from the disposable brush in 31. The specimens taken with the two types of brush were of similar quality. The reusable brush is about five times less expensive per procedure but carries a risk of cross contamination and cross infection, and time is needed to clean the brush after each bronchoscopy. The diagnostic yield appears to be at least as good with the disposable brush.

Adult↗
PubMed1975

Ultrasonic nebulizer in local anesthesia for bronchoscopy.

A method of utilizing an ultrasonic nebulizer (De Vilbiss 35 A) in local anesthesia for bronchoscopy is described. 10 ml of 4% Licocaine without adrenaline was used as anesthetic agent. Blood levels of Lidocaine were determined on 12 patients. The maximum blood levels were reached 6-8 min after the end of anesthesia. Blood lelvels ranged from 0.37 to 3.28 mug/ml being so in the nontoxic dosage range. A satisfactory anesthesia was achieved in 95% of the 1,043 patients subjected to bronchoscopy, while 5% felt that laryngeal anesthesia was not complete. In no case was it necessary to use the conventional way to complete the anesthesia. Nebulizer anesthesia was preferred by 100 persons who had been anesthetized by both the conventional method and the ultrasonic technique.

Adult↗
PubMed1981

Flexible fiberoptic bronchoscopy for diagnosing pulmonary coccidioidomycosis.

To assess the diagnostic yield of flexible fiberoptic bronchoscopy (FFB), we reviewed records of 30 patients who had (1) cultural and/or histologic evidence of coccidioidomycosis, (2) abnormal chest roentgenograms, and (3) undergone FFB. Each patient underwent a complete examination including sputum collection for smears and culture. As additional diagnostic information was needed, FFB was performed in all patients, followed by percutaneous needle aspiration in 4 patients and thoracotomy in 10. Prebronchoscopy sputum cultures yielded Coccidioides immitis in 6 of 30 patients (20%). Bronchoscopy provided specimens diagnostic of coccidioidomycosis in 16 of 30 patients (53%), and in 10 of 30 (33%), FFB was the first procedure of the examination to produce a diagnostic specimen. The diagnosis was first obtained by needle aspiration in 1 of 30 (3%), by extrathoracic specimens in 3 of 30 (10%), and by thoracotomy in 10 of 30 (33%). All 8 patients with a solitary pulmonary nodule (SPN) had nondiagnostic FFB and comprised the majority of patients not diagnosed until thoracotomy was performed. When patients with a SPN were excluded, 20 of 29 (69%) FFB procedures documented coccidioidal infection. Seven of 22 (32%) prebronchoscopy sputum collections compared with 17 of 29 (59%) FFB procedures produced positive cultures for C. immitis. One of 22 (5%) prebronchoscopy sputum collections, compared with smears and biopsies from 8 of 29 (28%) FFB procedures, produced immediate microscopic evidence of coccidioidomycosis. Coexisting pulmonary pathologic findings in 4 patients were uncovered by FFB. Except in patients with a SPN, FFB is a valuable procedure for documenting pulmonary coccidioidomycosis when sputum specimens are nondiagnostic.

Biopsy, Needle↗
PubMed1982

A comparative evaluation of two fiberoptic bronchoscopy catheters: the plugged telescoping catheter versus the single sheathed nonplugged catheter.

We prospectively evaluated the ability of the plugged telescoping catheter (PTC) brush and the single sheathed nonplugged catheter brush to provide sterile lower respiratory tract samples during fiberoptic bronchoscopy in 19 noninfected patients with cancer. Both brushes were evaluated, in random order, in each of the 19 patients. The PTC brush and the single sheath brush were sterile in 12 and 5 patients, respectively, and in 7 patients, the PTC brush alone was sterile (p = 0.016, two-sided). Patients were anesthetized by lidocaine administered through the bronchoscope (6 patients), via an aerosol (3 patients), or by transtracheal injection (10 patients). The advantage of the PTC brush was evident only when aerosol or transtracheal anesthesia were used; the PTC brush was sterile in 9 of 13 patients, whereas the single sheathed brush was sterile in only 2 of these 13 (p = 0.016, two-sided). The plugged telescoping catheter brush is therefore more suitable than the single sheathed brush catheter for delivering sterile brushes to the lower respiratory tract during fiberoptic bronchoscopy.

Aerosols↗
PubMed1994

Use of fiberoptic bronchoscopy in the diagnosis of bronchogenic carcinoma. A study in patients with idiopathic pleural effusions.

We reviewed our experience with 115 patients with pleural effusion in whom bronchogenic carcinoma was suspected who underwent fiberoptic bronchoscopy (FOB) to identify those for whom the procedure was useful. In 6 of 12 patients with hemoptysis, 8 of 12 with a mass or infiltrate, and 8 of 18 with atelectasis with negative fluid cytology and 3 of 7 with cytology positive, FOB was useful in diagnosis. Sixty-six patients had an isolated cytology-negative effusion. Seven of 18 with massive effusion had FOB detecting cancer. Fiberoptic bronchoscopy usually was nondiagnostic in lesser-sized effusions (47 of 48). Using outcome for those with nondiagnostic FOB, we established operating characteristics for the procedure. We conclude that FOB is useful in diagnosing bronchogenic carcinoma in such patients when there is hemoptysis, accompanying lung mass or infiltrate, atelectasis, the effusion is massive, or in cytology-positive effusions without obvious primary tumor. Due to the low prevalence of bronchogenic carcinoma in patients with effusions of lesser size, we suggest that in this group FOB not be routinely performed.

Bronchoscopes↗
PubMed1977

Removal of foreign bodies (two teeth) by fiberoptic bronchoscopy.

In special situations the flexible fiberoptic bronchoscope, with its increased visual range and extended capabilities for extraction, may be utilized to augment rigid bronchoscopy. Recently developed tools for extraction (claw, basket, forceps, and balloon catheter) may be inserted through the channel of the fiberoptic bronchoscope to capture small, peripheral foreign objects. We present the case of a 76-year-old man in whom two aspirated teeth were removed from the right lower lobe (RB9a and RB9b) using the fiberoptic bronchoscope, a wire basket, and a Fogarty balloon catheter. Rigid tube bronchoscopy was contraindicated because the patient had just sustained a fractured skull and jaw in an automobile accident.

Aged↗
PubMed1979

Diagnostic accuracy in peripheral lung lesions. Factors predicting success with flexible fiberoptic bronchoscopy.

Ninety-seven consecutive peripheral lung lesions were evaluated by biplane fluoroscopically guided flexible fiberoptic bronchoscopy and analyzed to define features that predict diagnostic yield. The overall diagnostic accuracy was 56 percent (63 percent for malignant and 38 percent for benign lesions). The most important characteristic associated with a positive cyto- or histopathologic diagnosis was size of the lesion; the yield was 28 percent when the diameter was less than 2.0 cm compared to 64 percent if the diameter was greater than or equal to 2.0 cm (P = 0.0035). The diagnostic yield was similar for lesions located in the outer and middle third of the lung if the diameter was greater than 2.0 cm; inner one-third lesions were correctly diagnosed more frequently, related in part to the larger size of these lesions. There was no significant difference in diagnostic yield for the following: segmental location, greatest distance from carcina on either the posteroanterior or lateral radiograph, or radiographic characteristics of the lesion. We conclude that biplane fluoroscopically guided flexible fiberoptic bronchoscopy is a reasonable diagnostic procedure for peripheral lesions greater than or equal to 2.0 cm in diameter, but that alternative procedures should be used for lesions under 2.0 cm in diameter.

Adult↗
PubMedDate not supplied

Immunohistochemical detection of p53 protein in neoplastic, preneoplastic and normal bronchial mucosa specimens obtained during diagnostic bronchoscopy.

The expression of p53 protein was evaluated immunochemically in cancer tissue, preneoplastic lesions and normal bronchial mucosa obtained during diagnostic bronchoscopy from 53 patients with lung cancer and 12 patients with benign lung diseases. In lung cancer patients, positive p53 staining was detected in 26/53 (49%) of the tumour specimens. In preneoplastic lesions p53 positive staining was found in 8 of 24 (33.3%) squamous metaplasia, 1 of 4 hyperplasia and 1 of 3 dysplasia lesions. In the same group of patients, 12 cases were found with positive p53 cells in normal bronchial mucosa. In patients with benign diseases, positive p53 staining was found in 1 of 4 cases with squamous metaplasia and in one normal mucosa. Our results provide evidence that somatic genetic alterations may occur in early stages of lung tumorigenesis, raising the possibility that molecular analyses is useful in the early diagnosis of precancerous lesions of the bronchial mucosa, and results indicate that p53 expression can be studied in small tissue specimens obtained during bronchoscopy.

Adenocarcinoma↗
PubMed1990

[Rigid tube bronchoscopy in tuberculous children. Apropos of 24 cases].

We report the preliminary results of a study in children with tuberculosis. Rigid tube bronchoscopy provided diagnostic information in 79% of cases and allowed a few therapeutic procedures including aspiration of secretions and removal of inflammatory granulomas. We found that the most common lesion is bronchial compression. Rigid tube bronchoscopy is acceptably comfortable under general anesthesia and provides valuable results.

Bronchoscopes↗
PubMed1979

[Bronchoscopy with a rigid tube, an obsolete method?].

Of the two methods of bronchoscopy, the rigid bronchoscope and the flexible instrument, it is clear that one cannot be used to the complete exclusion of the other. Both methods have their advantages and disadvantages. The rigid tube has many diagnostic and especially therapeutic advantages in the main bronchi, while the flexible instrument displays its strong points in the peripheral areas. The two methods complement one another. Bronchofiberscopy alone cannot be recommended, but if it is carried out nevertheless it is merely a general bronchoscopy and the limitations must be taken into consideration. It must be possible to deal with any complications which may arise.

Anesthesia, Local↗
PubMed1989

Changing spectrum of hemoptysis. Underlying causes in 148 patients undergoing diagnostic flexible fiberoptic bronchoscopy.

A retrospective study to examine the underlying causes of hemoptysis in patients undergoing diagnostic bronchoscopy was conducted. We found hemoptysis to be caused by bronchitis in 55 (37%) of 148, bronchogenic carcinoma in 28 (19%) of 148, tuberculosis in 10 (7%) of 148, and bronchiectasis in 1 (1%) of 148 patients. Compared with previous studies, it appears that hemoptysis is less likely to be caused by bronchiectasis or tuberculosis while hemoptysis caused by bronchitis has increased proportionately. The rate of occurrence of hemoptysis caused by bronchogenic carcinoma has not changed significantly. All patients with underlying bronchogenic carcinoma had a positive smoking history and abnormal chest roentgenogram. The rate of hemoptysis was not a good indicator of the underlying disease.

Adult↗
PubMed1996

Pediatric flexible fiberoptic bronchoscopy through the laryngeal mask airway.

OBJECTIVE: To determine the usefulness and safety of the laryngeal mask airway (LMA) as an adjunct to pediatric flexible fiberoptic bronchoscopy (FOB). DESIGN: A case-series retrospective study. SETTING: Pediatric otolaryngology tertiary referral center, outpatient and inpatient operating suites. PATIENTS: Retrospective review of charts of children who had FOB performed with the use of LMA by the pediatric otolaryngology service. The patients were ages 3 months to 18 years with respiratory symptoms requiring FOB for diagnosis. INTERVENTIONS: Use of LMA to support airway during FOB with spontaneous ventilation with the patients under general anesthesia. MAIN OUTCOME MEASURES: Ability to perform airway evaluation with FOB and LMA; number and type of complications. RESULTS: Seventeen patients, ages 3 months to 18 years (median age, 39 months) underwent FOB with use of LMA. In 2 patients use of LMA failed-1 from airway obstruction with LMA in place, which required intubation, and another who could not have LMA appropriately placed. Fifteen patients underwent uncomplicated FOB through the LMA. None of these 15 patients required unplanned endotracheal intubation. Two patients with mandibular hypoplasia required LMA use for airway evaluation when the glottis could not be visualized at direct laryngoscopy. CONCLUSIONS: The LMA is a safe and effective adjunct to pediatric FOB. Laryngeal mask airway use for FOB allows evaluation of the airway during spontaneous ventilation without an endotracheal tube or a face mask. Larger fiberoptic scopes can be used through the LMA compared with pediatric FOB performed through the nose or through an endotracheal tube.

Adolescent↗