752 results match your criteria hypoxemia bronchoscopy


Guidelines on analgosedation, monitoring, and recovery time for flexible bronchoscopy: a systematic review.

BMC Pulm Med 2021 Jun 10;21(1):198. Epub 2021 Jun 10.

Lung Clinic Cologne-Merheim, Thoracic Surgery, Hospital of Cologne, University of Witten/Herdecke, Ostmerheimer Str. 200, 51109, Cologne, Germany.

Background: Patients undergoing bronchoscopy in spontaneous breathing are prone to hypoxaemia and hypercapnia. Sedation, airway obstruction, and lung diseases impair respiration and gas exchange. The restitution of normal respiration takes place in the recovery room. Read More

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RAND appropriateness panel to determine the applicability of UK guidelines on the management of acute respiratory distress syndrome (ARDS) and other strategies in the context of the COVID-19 pandemic.

Thorax 2021 May 27. Epub 2021 May 27.

Guy's and St Thomas' NHS Foundation Trust, London, UK.

Background: COVID-19 has become the most common cause of acute respiratory distress syndrome (ARDS) worldwide. Features of the pathophysiology and clinical presentation partially distinguish it from 'classical' ARDS. A Research and Development (RAND) analysis gauged the opinion of an expert panel about the management of ARDS with and without COVID-19 as the precipitating cause, using recent UK guidelines as a template. Read More

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Delayed Pneumothorax Post Transbronchial Biopsy: A Case Report.

Cureus 2021 Apr 21;13(4):e14614. Epub 2021 Apr 21.

Pulmonary and Critical Care Medicine, Veterans Affairs Medical Center, Washington, DC, USA.

Bronchoscopy is a common and safe procedure with low mortality rates and complications. The risk of pneumothorax (PTX) post bronchoscopy is estimated to be 0.1% but increases to 1-6% with the addition of transbronchial lung biopsy (TBB) to the procedure. Read More

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Case report of recurrent haemoptysis in an older patient with repaired tetralogy of Fallot.

Eur Heart J Case Rep 2021 May 17;5(5):ytab155. Epub 2021 May 17.

Department of Cardiovascular Diseases, Division of Congenital and Structural Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.

Background: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect. Although most infants nowadays undergo surgical repair approximately at the age of 6 months with excellent outcomes, older patients typically underwent a staged approach with an initial systemic-to-pulmonary Blalock-Taussig-Thomas (BTT) shunt reducing hypoxaemia, followed by surgical TOF repair at an older age (with takedown of the BTT shunt). Late complications related to the BTT shunt are rare. Read More

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A 27-Year-Old Man With Persistent Breathlessness After an Inhalational Injury.

Chest 2021 Apr 6;159(4):e197-e201. Epub 2021 Apr 6.

Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.

Case Presentation: A 27-year-old man was hospitalized in the burn unit after sustaining an acute inhalational injury and facial burns after an accidental occupational exposure to an industrial disinfectant consisting of a mixture of hydrogen peroxide (15%-30%), acetic acid (5%-15%), and peracetic acid (5%-15%). He demonstrated cough, shortness of breath, and hoarseness of voice at presentation that had developed 6 h after exposure. In addition to the inhalational injury of the vocal cords and lower airways on bronchoscopy (Fig 1), the patient also was diagnosed with acute inhalational pneumonitis based on the findings of hypoxemic respiratory failure and bilateral perihilar airspace opacities on chest radiography (Fig 2). Read More

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Anti-glomerular basement membrane disease associated with thin basement membrane nephropathy: A case report.

Medicine (Baltimore) 2021 May;100(20):e26095

Department of Internal Medicine.

Rationale: Simultaneous occurrence of anti-glomerular basement membrane (anti-GBM) disease and thin basement membrane nephropathy (TBMN), both of which invade the type IV collagen subunits, is very rare. Here, we present the case of a 20-year-old male patient diagnosed with both anti-GBM disease and TBMN upon presenting dyspnea and hemoptysis.

Patient Concerns: No laboratory abnormalities, except arterial hypoxemia (PaO275. Read More

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Perioperative massive cerebral stroke in thoracic patients: Report of three cases.

World J Clin Cases 2021 May;9(13):3170-3176

Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.

Background: Perioperative stroke is a rare but devastating complication. The risk factors for massive cerebral stroke in surgical patients include older age, male sex, prior cerebrovascular disease, hypertension, renal failure, smoking, diabetes mellitus, and atrial fibrillation.

Case Summary: We describe two cases of perioperative massive cerebral stroke following thoracic surgery and one case following bronchoscopy. Read More

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High-flow nasal cannula for oxygenation during emergency tracheal stenting under flexible bronchoscopy guidance.

Lung India 2021 May-Jun;38(3):269-272

Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India.

Central airway obstruction is a common complication of advanced esophageal carcinoma requiring bronchoscopic evaluation and intervention by a pulmonologist. Airway assessment by flexible bronchoscopy is crucial for the selection of the most suitable modality for the management of central airway obstruction. In such situations, flexible bronchoscopy may however be complicated by the development of hypoxemia. Read More

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A Novel Case of Cytomegalovirus Pneumonia in an Acquired Thrombotic Thrombocytopenic Purpura Patient Treated With Rituximab.

Cureus 2021 Mar 30;13(3):e14182. Epub 2021 Mar 30.

Internal Medicine and Nephrology, McLaren Health Care, Flint/MSU, Flint, USA.

Thrombotic thrombocytopenic purpura (TTP) is thrombotic microangiopathy that is universally fatal if not promptly recognized and treated. Standard treatment includes plasma exchange (PLEX) therapy and immunosuppression. We present a case of an 80 years old African American male with a past medical history significant for essential hypertension, chronic obstructive pulmonary disease, and a recent TTP diagnosis for which he was treated with PLEX, glucocorticoids, and rituximab. Read More

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Dexmedetomidine combined with midazolam infusion guided by bispectral index during bronchoscopy.

Clin Respir J 2021 May 2. Epub 2021 May 2.

Department of Respiratory Medicine, The Third Affiliated Hospital of Soochow University (Changzhou First People's Hospital), Changzhou, China.

Background: Conscious sedation guided by bispectral index (BIS) during bronchoscopy has been proved to be a feasible approach. This study aimed to investigate the safety and efficacy of dexmedetomidine combined with midazolam for undergoing conscious sedation during bronchoscopy.

Methods: The trial was registered prior to patient enrollment at the Chinese Clinical Trial Registry. Read More

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Transient maintenance of tracheal patency upon the insertion of a flexible bronchoscope in a patient with an anterior mediastinal mass: a case report.

JA Clin Rep 2021 Apr 29;7(1):39. Epub 2021 Apr 29.

Department of Anesthesiology, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan.

Background: Patients with an anterior mediastinal mass are at risk of perioperative respiratory collapse.

Case Presentation: A 74-year-old woman with a large anterior mediastinal mass that led to partial tracheal collapse (shortest diameter, 1.3 mm) was scheduled for tracheobronchial balloon dilation and stent placement under general anesthesia. Read More

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Acute hypoxemia due to lung collapse in COVID-19: the role of therapeutic bronchoscopy.

Adv Respir Med 2021 Apr 21. Epub 2021 Apr 21.

Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS) New Delhi, India.

Bronchoscopy is an aerosol-generating procedure and involves a high risk of transmission of SARS-CoV-2 to health care workers. There are very few indications for performing bronchoscopy in a patient with confirmed COVID-19. These include atelectasis, foreign body aspiration, and suspected superinfection in immunocompromised patients. Read More

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Hypoxemia during procedural sedation in adult patients: a retrospective observational study.

Can J Anaesth 2021 Apr 20. Epub 2021 Apr 20.

Section of vital functions, Department of Anesthesiology, UMC Utrecht, Heidelberglaan 100, Utrecht, The Netherlands.

Purpose: Since 2010, new guidelines for procedural sedation and the Helsinki Declaration on Patient Safety have increased patient safety, comfort, and acceptance considerably. Nevertheless, the administration of sedatives and opioids during sedation procedures may put the patient at risk of hypoxemia. However, data on hypoxemia during procedural sedation are scarce. Read More

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Anesthesia and airway management in a patient with acromegaly and tracheal compression caused by a giant retrosternal goiter: a case report.

J Int Med Res 2021 Apr;49(4):300060521999541

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

A giant retrosternal goiter can lead to compression of vital organs in the mediastinum with high risk of acute cardiorespiratory decompensation. Additionally, patients with acromegaly are prone to developing severe airway obstruction and ventilation difficulties during anesthetic induction, leading to hypoxia and an increased partial pressure of carbon dioxide. Therefore, more comprehensive airway management strategies are needed. Read More

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Safety application of muscle relaxants and the traditional low-frequency ventilation during the flexible or rigid bronchoscopy in patients with central airway obstruction: a retrospective observational study.

BMC Anesthesiol 2021 Apr 6;21(1):106. Epub 2021 Apr 6.

Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China.

Background: Bronchoscopy treatments of central airway obstruction (CAO) under general anesthesia are high-risky procedures, and posing a giant challenge to the anesthesiologists. We summarized and analyzed our clinical experience in patients with CAO undergoing flexible or rigid bronchoscopy, to estimate the safety of skeletal muscle relaxants application and the traditional Low-frequency ventilation.

Methods: Clinical data of 375 patients with CAO who underwent urgent endoscopic treatments in general anesthesia from January 2016 to October 2019 were retrospectively reviewed. Read More

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Diagnosis and Treatment Process of Tracheobronchopathia Osteochondroplastica with Concurrent Chronic Eosinophilic Pneumonia: a Case Report.

Tanaffos 2020 Jul;19(3):267-271

Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Tracheobronchopathia Osteochondroplastica (TBPO) is a rare disease with a benign period affecting the bronchial system. It is characterized by the presence of numerous osseous submucosal nodules or cartilaginous protruding into the tracheobronchial lumen. These wounds are diagnosed incidentally during bronchoscopy. Read More

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High-flow therapy: physiological effects and clinical applications.

Breathe (Sheff) 2020 Dec;16(4):200224

Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Humidified high-flow therapy (HFT) is a noninvasive respiratory therapy, typically delivered through a nasal cannula interface, which delivers a stable fraction of inspired oxygen ( ) at flow rates of up to 60 L·min. It is well-tolerated, simple to set up and ideally applied at 37°C to permit optimal humidification of inspired gas. Flow rate and should be selected based on patients' inspiratory effort and severity of hypoxaemia. Read More

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December 2020

Flexible Bronchoscopy in a Patient With Pneumomediastinum and Hypoxemic Respiratory Failure: High-Flow Nasal Cannula to the Rescue.

Cureus 2021 Jan 20;13(1):e12800. Epub 2021 Jan 20.

Pulmonary Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, IND.

Flexible bronchoscopy with bronchoalveolar lavage carries a significant risk of hypoxia in patients with acute hypoxemic respiratory failure. Noninvasive positive pressure ventilation and high-flow nasal cannula are the most commonly used modalities for reducing procedure-related hypoxemia in such patients. There is no guideline on how to safely perform a bronchoscopy in patients with spontaneous pneumomediastinum and hypoxemic respiratory failure. Read More

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January 2021

Safety and incidence of complications associated with bronchoscopy in an obese population.

Clin Respir J 2021 Feb 20. Epub 2021 Feb 20.

Divisions of Critical Care, Pulmonary and Sleep Medicine, McGovern Medical School at the University of Texas Health Sciences Center, Houston, TX, USA.

Introduction: The safety of bronchoscopy in obese patients and those with obstructive sleep apnea (OSA) is unclear. Our objective was to evaluate the incidence of complications during bronchoscopy under moderate sedation in obese patients and to assess the impact of OSA, body mass index (BMI), and duration of the procedure.

Methods: We performed a retrospective study in adult patients undergoing bronchoscopy from January 2010 to August 2019. Read More

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February 2021

Everolimus induced organizing pneumonia in a patient with tuberous sclerosis complex.

Respir Med Case Rep 2021 24;32:101347. Epub 2021 Jan 24.

University of Tennessee Health Science Center, USA.

Organizing pneumonia is characterized by a distinct histologic pattern in the lung interstitium and presents clinically as hypoxemia, fever, cough, and dyspnea that is not attributable to concurrent infection. Typical etiologies of this condition include inflammatory disease, malignancy, toxic inhalation, and an array of medications including the mTOR inhibitor everolimus. In this report, we describe the case of a female with tuberous sclerosis complex on everolimus therapy for renal angiomyolipomas who presented to the hospital with persistent cough, dyspnea, and fevers and bilateral lower lobe opacities on chest X-ray despite multiple courses of antibiotic therapy. Read More

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January 2021

Pulmonary vein stenosis after lung transplantation: a case report and literature review.

Ann Transl Med 2021 Jan;9(2):181

Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Pulmonary vein stenosis (PVS) is a rare event following lung transplantation which increases the risk of morbidity and mortality. Early detection and rapid treatment of this condition is crucial for its management. Although several reports on PVS have been published, there is little consensus regarding its diagnosis and the methods of management. Read More

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January 2021

Assessment of Systemic and Cerebral Oxygen Saturation during Diagnostic Bronchoscopy: A Prospective, Randomized Study.

Emerg Med Int 2020 9;2020:8540350. Epub 2020 Dec 9.

Department of Anesthesiology and Intensive Care, University of Debrecen, Faculty of Medicine, Health and Medical Science Centre, Debrecen, Hungary.

Background: Arterial hypoxemia occurs in about 2.5-69% of cases during fiberoptic bronchoscopy and may necessitate administration of supplemental oxygen. Whether routine supplementary administration is indicated for all patients is a debated issue. Read More

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December 2020

Combined use of a videolaryngoscope and a flexible bronchoscope for awake tracheal intubation when front-of-neck airway is not an option.

Anaesth Rep 2021 Jan-Jun;9(1):12-15. Epub 2021 Jan 13.

Department of Surgery Aga Khan University Hospital Karachi Pakistan.

We report a case of successful tracheal intubation with the combined use of a videolaryngoscope and flexible bronchoscope in a patient with difficult airway when both techniques had individually failed. A 35-year-old man presented with airway obstruction due to massive neck swelling causing hypoxia, stridor and respiratory distress. He had a history of oral cancer which had been resected with bilateral neck dissection and free flap reconstruction 2 months previously. Read More

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January 2021

Diagnostic yield and safety of the ProCore versus the standard EBUS-TBNA needle in subjects with suspected sarcoidosis.

Expert Rev Med Devices 2021 Feb 22;18(2):211-216. Epub 2021 Jan 22.

Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

: No randomized trial has compared the yield of the ProCore needle, a novel needle for endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA), with standard needles.: Consecutive subjects with intrathoracic lymphadenopathy due to suspected sarcoidosis were randomized 1:1 to undergo EBUS-TBNA with either the 22-gauge ProCore (EchoTip-ProCore, Cook-Medical) or the 22-gauge standard (Vizishot, Olympus) needle. The primary outcome was the diagnostic sensitivity; the secondary outcomes included the number of adequate aspirates obtained and procedure-related complications. Read More

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February 2021

Apneic laryngeal oxygenation during elective fiberoptic intubation - a technical simulation.

BMC Anesthesiol 2020 12 9;20(1):300. Epub 2020 Dec 9.

University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department of Anaesthesiology and Intensive Care Medicine, Kerpener Strasse 62, 50937, Cologne, Germany.

Background: Sedation during elective fiberoptic intubation for difficult airway can cause respiratory depression, apnea and periods of desaturation. During apneic episodes, hypoxemia can be prevented by insufflation of oxygen in the deep laryngeal space. The aim of this study was to evaluate an oropharyngeal oxygenation device (OOD) designed for deep laryngeal insufflation during fiberoptic intubation. Read More

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December 2020

Bronchial arterial embolization may reduce the risk of severe bleeding in central airway obstruction due to renal cell carcinomas during bronchoscopic procedures.

Ther Adv Respir Dis 2020 Jan-Dec;14:1753466620976012

Department of Oncology, Emergency General Hospital, Beijing, China.

Background: Hemorrhage is a life-threatening complication during bronchoscopic intervention in patients with central airway obstruction (CAO) due to metastatic renal cell carcinoma (RCC). Whether pre-bronchoscopic bronchial arterial embolization (BAE) can reduce the risk of severe bleeding in CAO patients due to metastatic RCC remains unclear.

Methods: A total of 31 CAO patients due to metastatic RCC were included retrospectively and divided into a BAE group (receiving pre-bronchoscopic BAE) and non-BAE group in this study. Read More

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December 2020

Supraglottic jet oxygenation and ventilation reduces desaturation during bronchoscopy under moderate to deep sedation with propofol and remifentanil: A randomised controlled clinical trial.

Eur J Anaesthesiol 2021 Mar;38(3):294-301

From the Department of Anesthesiology, 180th Hospital of PLA, Quanzhou, China (BZ, ZW, PX, HX, LX) and Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA (HW).

Background: Hypoxaemia is frequently seen during flexible bronchoscopies that are done with a nasal approach under the traditional sedation with propofol. This study investigated the potential benefits of supraglottic jet oxygenation and ventilation (SJOV) using the Wei nasal jet tube (WNJ) in reducing hypoxaemia in patients undergoing bronchoscopy under moderate to deep intravenous sedation using a propofol, lidocaine and remifentanil cocktail.

Objectives: Our primary objective was to evaluate the efficacy and complications of SJOV via the WNJ during flexible bronchoscopy under moderate to heavy sedation with propofol and remifentanil. Read More

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An unusual presentation of inhalation injury in a patient with high voltage electrical injury: A case report.

Int J Surg Case Rep 2020 4;77:357-361. Epub 2020 Nov 4.

Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; The Burn Center, MedStar Washington Hospital Center, Washington, DC, USA; Departments of Surgery and Biochemistry, Georgetown University School of Medicine, Washington, DC, USA. Electronic address:

Background: Electrical injuries comprise a minority of burn center admissions but are associated with significant morbidity and mortality. This is a case of a patient who suffered high-voltage electrical injury who survived despite developing several sequalae, who had an unusual presentation of inhalation injury complicated by the aspiration of metal screws.

Case Presentation: This is a 20-year-old male who suffered electrical contact injury, and 45. Read More

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November 2020

Oxygen desaturation during flexible bronchoscopy with propofol sedation is associated with sleep apnea: the PROSA-Study.

Respir Res 2020 Nov 19;21(1):306. Epub 2020 Nov 19.

Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital of Basel, Petersgraben 4, 4031, Basel, Switzerland.

Background: Obstructive sleep apnea (OSA) is characterized by repetitive episodes of complete or partial obstruction of the upper airways during sleep. Conscious sedation for flexible bronchoscopy (FB) places patients in a sleep-like condition. We hypothesize that oxygen desaturation during flexible bronchoscopy may help to detect undiagnosed sleep apnea. Read More

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November 2020