Bronchial thermoplasty and anesthesia

The role of anesthesiologist in nonoperating room procedures including pulmonary interventions is expanding. Bronchial thermoplasty (BT) is a minimally invasive bronchoscopic intervention for patients with severe asthma refractory to conventional pharmacotherapy. It involves the application of controlled radiofrequency thermal energy to large- and medium-sized airways. We report our experience for perioperative anesthetic management of patients scheduled for BT. Three patients with severe asthma were planned for BT under general anesthesia...

UNLABELLED: Bronchial thermoplasty (BT) is an interventional bronchoscopic treatment for severe asthma. There is a need to define patient selection criteria to guide clinicians in offering the appropriate treatment options to patients with severe asthma. METHODOLOGY: An expert group formed this statement under the aegis of the Indian Chest Society. We performed a systematic search of the MEDLINE and EMBASE databases to extract evidence on patient selection and the technical performance of BT...

Bronchial thermoplasty is a nonpharmacological treatment for severe asthma that delivers thermal energy to the bronchial walls and reduces hypertrophied smooth muscle mass. Previous studies have shown its efficacy and safety, resulting in approval from the Food and Drug Administration in 2010. In Korea, the first bronchial thermoplasty was carried out in 2014; 4 patients have undergone the procedure so far. This case series presents the medical history and treatment outcomes of these 4 patients. All patients presented with uncontrolled asthma despite optimal medical treatment...

Bronchial thermoplasty (BT) is an upcoming treatment for patients with asthma refractory to traditional pharmacotherapy. BT is an invasive procedure which carries a risk of coughing, wheezing, bronchospasm, and laryngospasm during and after the procedure. Some of these complications can be minimized using better anesthetic techniques during BT. We hereby report a case of a 63-year-old female with poorly controlled asthma posted for BT done under general anesthesia (GA) with supraglottic device. GA provides better working conditions for pulmonologists when compared with sedation...

Bronchial thermoplasty (BT) is a bronchoscopic treatment for patients with severe asthma who remain symptomatic despite optimal medical therapy. In this "expert best practice" paper, the background and practical aspects of BT are highlighted. Randomized, controlled clinical trials have shown BT to be safe and effective in reducing severe exacerbations, improving quality of life, and decreasing emergency department visits. Five-year follow-up studies have provided evidence of the functional stability of BT-treated patients with persistence of a clinical benefit...

Bronchial thermoplasty (BT) is a recently introduced bronchoscopic treatment for patients with asthma refractory to pharmacotherapy. Intraprocedural sedation management is important for successful performance of BT. However, the results of general anesthesia in patients undergoing BT have not been well described. The aim of this study was to evaluate the feasibility and safety of general anesthesia in patients undergoing BT. We retrospectively reviewed the records of 10 consecutive BT treatments performed under general anesthesia in 4 patients...

Bronchial thermoplasty is a novel procedure for patients with severe asthma showing a stable lung function. We herein report two cases with a deteriorating lung function. The lung function tended to improve in one case, while the other case discontinued mepolizumab medication after the procedure. Treatment was performed safely under general anesthesia in both cases. The use of bronchial thermoplasty may therefore be useful for the treatment of patients with a deteriorating lung function.

Bronchial thermoplasty (BT) is a novel, Food and Drug Administration-approved nondrug treatment for patients whose asthma remains uncontrolled despite traditional pharmacotherapy. BT involves application of controlled radiofrequency energy to reduce airway smooth muscle in large- and medium-sized airways. Although BT is often performed under general anesthesia, anesthetic management strategies for BT are poorly described. We describe the anesthetic management of 7 patients who underwent 19 BT treatments in a tertiary academic medical center...

BACKGROUND: Bronchial thermoplasty (BT) is a rapidly emerging bronchoscopic treatment for patients with moderate-to-severe asthma. Different sedation strategies are currently used, ranging from mild midazolam sedation to general anesthesia requiring tracheal intubation. OBJECTIVES: The aim of this study was to assess the feasibility, safety, and both patients' and bronchoscopists' satisfaction with propofol and remifentanil sedation administered by specialized sedation anesthesiology nurses during BT in severe asthma patients...

PURPOSE OF REVIEW: As the field of interventional pulmonology continues to expand and develop at a rapid pace, anesthesiologists are increasingly called upon to provide well tolerated anesthetic care during these procedures. These patients may not be candidates for surgical treatment and often have multiple comorbidities. It is important for anesthesiologists to familiarize themselves with these procedures and their associated risks and complications. RECENT FINDINGS: The scope of the interventional pulmonologist's practice is varied and includes both diagnostic and therapeutic procedures...

OBJECTIVE: To compare the effectiveness of high-frequency jet ventilation via Wei jet nasal airway and controlled ventilation with improved laryngeal mask airway during bronchial thermoplasty. METHODS: Twenty-eight patients undergoing bronchial thermoplasty were equally divided into two groups: group A (high-frequency jet ventilation through Wei jet nasal airway) and group B (controlled ventilation with improved laryngeal mask airway). Pulse oxygenation,heart rate,and mean arterial blood pressure were recorded after entering the operating room (T0), 1 minute after administration/induction (T1), bronchoscope inserting (T2), 15 minutes (T3)/30 minutes (T4)/45 minutes (T5) after ventilation,at the end of the operation (T6), and at the recovery of patients' consciousness (T7)...

Over the past 15 years, patients with a myriad of pulmonary conditions have been diagnosed and treated with new technologies developed for the pulmonary community. Advanced diagnostic and therapeutic procedures once performed in an operating theater under general anesthesia are now routinely performed in a bronchoscopy suite under moderate sedation with clinically meaningful improvements in outcome. With the miniaturization of scopes and instruments, improvements in optics, and creative engineers, a host of new devices has become available for clinical testing and use...

Dexmedetomidine used in monitored anesthesia care produces a safe and effective technique well documented in research. We report the successful use of dexmedetomidine for sedation during bronchial thermoplasty, a new treatment for patients with severe persistent asthma refractory to inhaled corticosteroids and long-term beta-2 agonists.