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 1,045 records · Page 58Linked to original sources
PubMedDate not supplied

Virtual bronchoscopy for three--dimensional pulmonary image assessment: state of the art and future needs.

Virtual bronchoscopy is emerging as a useful approach for assessment of three-dimensional (3D) computed tomographic (CT) pulmonary images. A protocol for virtual bronchoscopic assessment of a 3D CT pulmonary image would have two main stages: (a) preprocessing of image data, which involves extracting objects of interest, defining paths through major airways, and preparing the extracted objects for 3D rendering; and (b) interactive image assessment, which involves use of graphics-based software tools such as surface-rendered views, projection images, virtual endoscopic views, tube views, oblique section images, measurement data, global two-dimensional section images, and cross-sectional views. Although a virtual bronchoscope offers a unique opportunity for exploration and quantitation, it cannot replace a real bronchoscope. Limitations of current virtual endoscopy systems include high cost, lack of visual aids beyond simulated endoscopic views, difficulty in performing interactive anatomic exploration, lack of quantitative information, use of surface rendering instead of volume rendering, and need for substantial off-line display computation. Future needs include development of fully integrated user-friendly virtual bronchoscopes, development of optimal CT protocols for generating artifact-free data sets, and improvements in automated preprocessing of 3D CT images.

Bronchoscopy↗
PubMed1995

Airways and lung: correlation of CT with fiberoptic bronchoscopy.

Recent advances in computed tomography (CT) and fiberoptic bronchoscopy (FOB) have led to confusion concerning the optimal use of these modalities, especially with regard to each other. The present review summarizes the current understanding of the role of CT in relation to FOB. Emphasis is placed on optimization of CT technique and basic principles of interpretation of the images. In addition, an in-depth evaluation is presented of the advantages and limitations of CT and FOB in the analysis of both focal and diffuse diseases of the airways and lung parenchyma.

Bronchoscopy↗
PubMed1996

Virtual bronchoscopy: segmentation method for real-time display.

Computed tomography (CT) data sets obtained in 14 patients were used in a segmentation method for virtual bronchoscopy (VB). The method constrained the distance of propagation of a region-growing algorithm. The resulting three-dimensional bronchial model was a faithful representation of the source CT data and could be manipulated in real time at frame rates of one to two frames per second. Preliminary data showed that 90% of bronchi (up to third order) measureable on multiplanar CT reformations were also measurable at VB. The bronchial diameters measured at VB were within 1 mm of those measured on multi-planar reconstructions of the CT data.

Adult↗
PubMed1998

CT bronchoscopy: optimization of imaging parameters.

The authors evaluated the relative importance of the following scanning parameters at computed tomographic bronchoscopy in an anesthetized adult sheep's thorax: section thickness (2, 4, 8 mm), pitch (1.0, 1.5, 2.0), milliampere setting (100, 175, 250 mA), and overlap of reconstructed sections (0%, 25%, 50%, 75%). Five blinded readers ranked the images twice in comparison with photographs of the mounted specimen. Differences in image quality were significant (P < .001) with section thickness of 2 mm and a pitch of 1.0. The milliampere setting had only a minor effect on image quality, and a 50% overlap of reconstructed sections was best.

Animals↗
PubMed2005

[Flexible bronchoscopy techniques: bronchoalveolar lavage, bronchial biopsy and transbronchial biopsy].

This article completes previous recommendations of the Techniques Group of the Spanish Society of Pediatric Pulmonologists on the practice of flexible bronchoscopy in children. We review the most frequently performed diagnostic and therapeutic procedures applied through the flexible bronchoscope: bronchoalveolar lavage, bronchial biopsy and transbronchial biopsy. Recommendations are also provided on the practice of nonbronchoscopic bronchoalveolar lavage. We review the indications and contraindications of these techniques, the equipment required, and the preparation and monitoring of the patient before, during and after the procedure. The complications of these techniques are also discussed. These recommendations may be adopted, modified or rejected according to clinical needs and constraints.

Biopsy↗
PubMed2000

Serum concentrations of lignocaine before, during and after fiberoptic bronchoscopy.

BACKGROUND: Lignocaine is commonly used for local anesthesia during fiberoptic bronchoscopy (FOB). Several studies have reported the peak serum concentration of lignocaine in relation to time, but most of them did not specify the administered dose of lignocaine gel and its possible correlation with peak serum concentration. OBJECTIVE: The aim of our study was to record the plasma concentrations of lignocaine before, during and after FOB and to evaluate whether the doses for nasal and tracheobronchial anesthesia have any correlation with the peak serum concentrations of the drug. METHODS: Twelve patients with no comorbid conditions undergoing FOB were studied. Lignocaine was administered as a 2% solution using a larynx syringe, 2% gel (mean dose 182.5 +/- 15 mg) and finally 2% solution through the bronchoscope (mean dose 339 +/- 12 mg). Total dose was 622 +/- 20 mg. Venous blood samples were taken before the beginning of local anesthesia and then at 5, 10, 20, 60, 90 and 120 min thereafter. RESULTS: Our results showed that peak plasma concentrations of lignocaine were observed in 8 patients 20 min after the beginning of local anesthesia, in 3 patients 30 min afterwards and in 1 patient 60 min afterwards (2.15 +/- 0.4 microg/ml, 1.9 +/- 0.3 microg/ml, 1. 81 microg/ml, respectively). None of our patients exceeded the critical level of toxicity (5 microg/ml). Both the total and tracheobronchial doses of lignocaine were significantly correlated with peak serum concentration (r = 0.63, p = 0.05 and r = 0.64, p = 0.02, respectively). No correlation was found between the dose for nasal anesthesia and peak serum concentration. No adverse reactions were observed. CONCLUSIONS: In conclusion our data show that although the amount of lignocaine used in this study exceeded the recommended highest dose (400 mg) in all patients, no toxic levels were observed. Peak plasma concentrations were found within 20-30 min from the beginning of local anesthesia. The dose for the anesthesia of nasal mucosa represented a significant percentage of the total dose, but did not correlate with the peak serum concentration of the drug.

Anesthetics, Local↗
PubMed2002

Hypoglossal nerve palsy as complication of oral intubation, bronchoscopy and use of the laryngeal mask airway.

Hypoglossal nerve injury is a recognized but rare complication of oropharyngeal manipulation during intubation, bronchoscopy and use of a laryngeal mask airway. We present 2 new cases of temporary hypoglossal nerve palsy after orotracheal intubation for general anesthesia. The relevant literature is reviewed and different hypotheses concerning the pathophysiological mechanisms of nerve damage are discussed.

Adult↗
PubMedDate not supplied

Bronchoscopy with the Vision Sciences BF100 disposable-sheath device: French experience after 328 procedures.

BACKGROUND: In spite of adhesion to recommended disinfection procedures, the transmission of infections by bronchoscopes is a permanent problem. OBJECTIVE: The new device may prevent nosocomial infections because it consists of two parts: a specific bronchoscope Vision Sciences BF100 and a single-use protective sheath for each procedure. The aim of this paper is to report our practice and the difficulties encountered when using this system. METHODS: We report our experience from 1997 to 2002 after 328 elective and emergency endoscopic procedures with the BF100 device. In a retrospective study, we describe the population and the incidents during procedure. We discuss the impact of the use of BF100 on the cost of bronchoscopies. RESULTS: The major constraint is the care required in assembling the optical device and disposable sheath. The intrinsic qualities of the optics are confirmed; any sample may be taken although image quality and suction capacity are inferior to videoscopes. Maneuverability is inferior to videoscopes, but improves with a short experience. In addition, this device is expensive. CONCLUSIONS: The technical performances of the BF100 device are inferior to those of videoscopes but the concept of sterile single-use sheaths is able to prevent the nosocomial infections related to bronchoscopes. Because of the cost, examination with the BF100 should be reserved to patients with proved or suspected infection (multiresistant bacteria, tuberculosis, hepatitis C and B virus, HIV, prions) and immunosuppression (hematologic diseases).

Asepsis↗
PubMedDate not supplied

Contraindications and safety of transbronchial lung biopsy via flexible bronchoscopy. A survey of pulmonologists and review of the literature.

BACKGROUND: Transbronchial lung biopsy (TBLB) via flexible bronchoscopy is a common procedure performed by pulmonologists. Limited scientific data exist concerning the risk of this procedure in patients with conditions that may adversely affect the rate of procedural complications. OBJECTIVES: To evaluate the current practice pattern and attitude of pulmonologists toward the performance of TBLB in the presence of high-risk conditions. METHODS: A survey was constructed and distributed at the American College of Chest Physicians annual meeting, held in Philadelphia, USA, in November of 2001. RESULTS: A total of 227 surveys were distributed with a return of 158 (69.6%). Anticoagulation medications are temporarily held prior to TBLB by the majority of our survey respondents (98.7% for intravenous heparin, 90.5% for warfarin, and 87.3% for low-molecular-weight heparin). Medications with effect on platelet function are held by fewer pulmonologists. There is a wide variation in the pulmonologists' perception of the risk of performing TBLB when certain medical conditions coexist: pulmonary hypertension [absolute contraindication (AC), 28.7%; relative contraindication (RC) 58.6%], superior vena cava syndrome (AC 19.6%, RC 51%), mechanical ventilation (AC 17.8%, RC 58.6%) and lung cavity/abscess (AC 7%, RC 44.9%). A significant percentage of pulmonologists (55%) do not regard an elevated serum creatinine at any level as AC to TBLB. Thirty-eight percent of the survey participants administer desmopressin prior to TBLB in uremic patients to prevent excessive bleeding. CONCLUSIONS: Prior to performing bronchoscopic TBLB, the majority of pulmonologists temporarily holds anticoagulation medications. However, there is a lack of agreement in relation to perceived contraindications and safety of TBLB.

Bronchoscopy↗
PubMed2005

Susceptibility to oxygen desaturation during bronchoscopy in elderly patients with pulmonary fibrosis.

BACKGROUND: Fiber-optic flexible bronchoscopy (FFB) is a frequently performed procedure for the diagnosis and treatment of pulmonary disorders. However, hypoxemia occasionally occurs during FFB. OBJECTIVES: We attempted to examine the causes of arterial oxygen desaturation during FFB. METHODS: We studied 336 patients who underwent FFB without intervention between June 1, 2001 and September 30, 2002. Arterial oxygen saturation (SpO2) was continuously monitored using oximetry with a recording system. We analyzed the relationship between a reduction in SpO2 during FFB and various clinical parameters or background lung diseases. RESULTS: Of the 336 patients, 73 (22%) had an episode of oxygen desaturation (SpO2 <90% over 10 s). Of patients over 80 years old, 55% had an episode of oxygen desaturation, which was significantly higher than 27% observed in the patients of 80 and less than 80 years old (p < 0.05). Patients with pulmonary fibrosis had a higher risk of desaturation (55%) compared to patients with other complications or patients without any complication (p < 0.05). Multivariable analysis revealed that both age and pulmonary fibrosis were independent predictors of oxygen desaturation. However, the majority of the patients (94%) did not require routine oxygen supplementation. CONCLUSION: Although FFB is safe and does not require oxygen supplementation in most cases, age over 80 years and pulmonary fibrosis are high risk factors for significant oxygen desaturation during FFB.

Adult↗
PubMed2006

Evaluation of the spatial diffusion of methylene blue injected in vivo by bronchoscopy into non-small cell lung carcinoma.

BACKGROUND: Due to smoking prevalence and the poor efficiency of current therapy, lung cancer is the leading cause of cancer death in developed countries, and its worldwide incidence is steadily increasing. Gene therapy by direct intratumoral injection of different types of gene constructs through a fiberscope has been suggested and evaluated in a few patients. OBJECTIVE: It was the aim of this study to observe the actual volume of diffusion within a lung tumor using a color marker. METHODS: Using bronchoscopy, just after anesthesia, methylene blue was injected into patient tumors. These patients subsequently underwent surgery for treatment of a non-small cell lung cancer. RESULTS: We observed a diffusion of methylene blue in resected lung tumors with a mean infiltrated versus noninfiltrated tumor volume ratio of 29 +/- 15%. Interestingly, some large tumor areas were not stained. At the cellular level, a preferential diffusion of the dye was observed in the tumor stroma compartment versus the tumor cellular compartment, where basal cells were more frequently and strongly labeled than the other tumor cells. CONCLUSIONS: Since a cancer is cured when most, if not all, cancer cells are killed, the preliminary evaluation of the spatial diffusion of any injected gene construct should be carried out as a first step in any cancer type.

Adolescent↗
PubMed1987

Fiberoptic bronchoscopy in the diagnosis of pulmonary lymphomas.

Fiberoptic bronchoscopy was useful for the diagnosis of 7 of 9 pulmonary lymphomas (5 primary lung lymphomas, 4 lung involvement in systemic disease). Radiologic and endoscopic findings were variable. The importance of immunohistochemical markers for successful diagnosis is emphasized.

Adult↗
PubMed1988

Bronchoalveolar lavage during fiberoptic bronchoscopy: what has it brought to pulmonary medicine?

In the last 13 years, bronchoalveolar lavage has been widely used to study the mechanisms involved in the defense of the lower respiratory tract and in the pathogenesis of a variety of lung disorders. This technique, which is a relatively safe and simple extension of fiberoptic bronchoscopy, has been proved to be a powerful investigative tool with enormous potential since it has enhanced our knowledge on a variety of disorders, including interstitial lung diseases, lung destruction associated to cigarette smoking and, recently, bronchial asthma. In addition, bronchoalveolar lavage has also been utilized as an interesting test to help in the diagnostic procedures and in the management of patients with a variety of pulmonary diseases. Its actual importance in clinical respiratory medicine, however, is still under debate and the value of some suggested applications remains to be established.

Asthma↗
PubMed1992

Transbronchial needle aspiration in routine fiberoptic bronchoscopy.

The objective of this study was to evaluate the yield of transbronchial needle aspiration (TBNA) in a clinical routine setting of a teaching hospital for the diagnosis and staging of bronchogenic carcinoma in comparison to the results of controlled clinical studies. We reviewed our results with Wang retractable needle catheters during a 9-month period. The needle catheters were used in 72 patients. 43 patients had a final diagnosis of bronchogenic carcinoma. Classical bronchial washes, brushings and forceps biopsies led to the diagnosis in 28 patients (65%). The addition of TBNA increased the diagnostic yield by 14% (6 patients) to 79% overall. In 32 patients staging of mediastinal lymph nodes was attempted. Positive TBNA proved inoperability in 9 patients. In 7 patients TBNA was used to investigate peripheral masses. Two patients had a malignant tumor, of which one was diagnosed by TBNA. Overall, TBNA revealed important information with clinical consequences in 16 of 72 patients (22%). There were no complications. We conclude that TBNA significantly increases the diagnostic yield of fiberoptic bronchoscopy and carries only a minimal risk. Our results, obtained in the clinical routine setting of a teaching hospital, are comparable to the reported results of controlled studies.

Biopsy, Needle↗
PubMed1994

Pulse oximetry during fibreoptic bronchoscopy in local anaesthesia: frequency of hypoxaemia and effect of oxygen supplementation.

The indication for oxygen supplementation during diagnostic fibreoptic bronchoscopy (FOB) in local anaesthesia was evaluated by means of pulse oximetry in 160 patients (108 men, 52 women), median age 62 years. The patients were allocated at random into four groups of each 40 persons, which were comparable concerning pulmonary function and the dose of benzodiazepine used for premedication. The oxygen saturation of the haemoglobin (SpO2) in the tip of the index finger and the pulse rate were continuously recorded. Group 1 was examined without O2 supplement. Group 2a received O2 2 litres/min through a catheter placed in the vestibulum nasi. Group 2b received O2 2 litres/min through a pharyngeal catheter. Group 3 received O2 3 litres/min through a pharyngeal catheter. SpO2 mean values during FOB were 92 +/- (SD) 3% in group 1 and 96 +/- 2% in groups 2a, 2b and 3 (p < 0.001). SpO2 trough levels were mean 87 +/- 4% in group 1 vs. 93 +/- 2% in groups 2a and 2b, and 94 +/- 3% in group 3 (p < 0.001). Transient hypoxaemia, i.e., SpO2 < 85%, occurred with a frequency of 35% in group 1, 2.5% in group 2a, 0% in group 2b, and 2.5% in group 3. Tachycardia and bradycardia during FOB occurred with a frequency of 20% in group 1, 25% in group 2a, 18% in group 2b, and 10% in group 3. Pulse oximetry increases the safety of FOB, and is recommended for routine use. During FOB, oxygen supplement 2-3 litres/min should be administered to all patients, preferably through a pharyngeal catheter, as a preventive measure against hypoxaemia.

Adult↗
PubMed1995

Diagnostic yield of transthoracic needle aspiration biopsy following negative fiberoptic bronchoscopy in 103 patients with peripheral circumscribed pulmonary lesions.

The diagnostic potential of secondary transthoracic needle biopsy (TNB) following negative fiberoptic bronchoscopy (FOB) in patients with peripheral circumscribed pulmonary lesions was evaluated in a retrospective study. The records from 224 patients who had TNB over a 5-year period were reviewed. Of these, 103 patients met the criteria for inclusion in this series. The overall diagnostic yield of TNB in malignancy was 73.8% (54 of 73 patients). TNB allowed cytologic classification of the tumor type in 72.2% (39 of the 54 patients). Five of the 54 patients (9.3%) presented with small-cell anaplastic bronchogenic carcinoma, diagnosed at TNB, and were referred to chemotherapy. Of the 49 patients with a negative TNB, 27 went on to diagnostic surgical procedures; 19 had malignancy, 3 benign tumor, 2 infection, and 3 sequelae after pulmonary infarction. The remaining 22 undiagnosed patients were followed up over a long period of time, 5 showed progression of the pulmonary lesion suggesting malignancy. TNB appeared unsuitable for the diagnosis of benign lesions. Unspecific inflammation was not considered evidence of benignity, and therefore no definitive benign diagnosis was made by TNB in this series. There were no serious complications to TNB. In 18.1% of the procedures a pneumothorax developed, indicating a chest tube in 8.6% of the procedures. TNB is a suitable diagnostic procedure with a high diagnostic yield in patients with peripheral localized malignant pulmonary lesions.

Adult↗
PubMed1995

Comparison of samples collected by sputum induction and bronchoscopy from asthmatic and healthy subjects.

To compare markers of inflammation in secretions obtained by sputum induction (SI), bronchial wash (50 ml instillate [BW]), and bronchoalveolar lavage (4 x 60 ml instillates [BAL]), we analyzed markers of inflammation in samples obtained by these methods in 10 healthy and 10 asthmatic subjects. Of the asthmatic subjects 8 had mild disease (FEV1, % of predicted > 75%). Within subjects from both groups, we found that sputum, compared with either BW or BAL, had higher numbers of nonsquamous cells (p = 0.0001) and higher levels of eosinophil cationic protein (ECP) (p = 0.0001), albumin (p = 0.0001), and mucin-like glycoprotein (p = 0.0001). The eosinophil percentages and the ECP levels in sputum correlated more closely with those in BW (r = 0.67, p = 0.005; r = 0.69, p = 0.0008, respectively) than in BAL (r = 0.5, p = 0.03; r = 0.37, p = 0.11). Comparing the asthmatic and healthy subgroups, we found that eosinophil percentages were higher in sputum (p = 0.0003) and BW (p = 0.006) from asthmatic subjects and that ECP levels were higher in BW (p = 0.001) and BAL (p = 0.0005) from asthmatic subjects. We conclude that analysis of induced sputum reveals information qualitatively similar to that obtained by analysis of BW and BAL and that sputum induction is not only noninvasive and easily repeated but also yields samples more concentrated and richer in airway secretions than those obtained by bronchoscopy.

Adult↗
PubMed1995

Analysis of K-ras gene mutations in malignant and nonmalignant endobronchial tissue obtained by fiberoptic bronchoscopy.

Using polymerase chain reaction DNA amplification, we identified K-ras oncogene mutations in bronchial biopsies obtained from patients undergoing bronchoscopy for clinical indications. We hypothesized that these mutations would be found in a field encompassing malignant and nonmalignant tissues in patients with pulmonary carcinomas, and also possibly in tissue from some patients who smoked but did not have pulmonary malignancy. We found K-ras mutations in endobronchial biopsies from nine of 22 patients (41%) with carcinoma of the lung. In five of these patients, mutations were found in both malignant and nonmalignant specimens. In two instances, mutations were found only in the neoplastic tissue, and in two cases mutations were present only in the nonmalignant tissue. Furthermore, we identified two patients with K-ras mutations among seven patients in whom no clinical malignancy was apparent. Our data suggest that some oncogene activations may occur over a broad area in smokers with and without malignancy, and they imply that K-ras mutations may serve as surrogate markers for malignant potential.

Aged↗