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Ohad Ronen, Alexander Gurevich, Shimon Ivry, Edward Altman, Evgeni Kukuev
We describe a modified technique for percutaneous dilatational tracheostomy using a 15F tube exchanger or Eschmann catheter. A retrospective review of 1180 procedures using this modified technique demonstrated it to be effective with a failure rate of only 0.25% (3 patients). Moreover, it provides an additional safeguard with the ability to rapidly reintroduce the endotracheal tube into the trachea guided by the exchange catheter in the event of accidental extubation during the procedure. This technique needs no additional special devices or equipment (eg, a bronchoscope)...
March 14, 2018: Anesthesia and Analgesia
Christian Viniol, Claus F Vogelmeier
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. While COPD is a mainly chronic disease, a substantial number of patients suffer from exacerbations. Severe exacerbations are related to a significantly worse survival outcome. This review summarises the current knowledge on the different aspects of COPD exacerbations. The impact of risk factors and triggers such as smoking, severe airflow limitation, bronchiectasis, bacterial and viral infections and comorbidities is discussed...
March 31, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
Su-Juan Zhang, Ming Zhang, Jun Zhou, Qiu-Di Zhang, Qian-Qian Xu, Xiong Xu
Background: Peripheral pulmonary lesions (PPLs) are being discovered more frequently. We investigated efficiency, safety, and influencing factors in radial probe endobronchial ultrasound with distance measurement (rEBUS-D) using a thin bronchoscope during transbronchial biopsy (TBB) for the diagnosis of malignant PPLs. Methods: Patients with PPLs who underwent rEBUS were retrospectively analyzed. Cases with rEBUS-D and a gold-standard final diagnosis were considered...
February 2018: Translational Lung Cancer Research
Beomsu Shin, Boksoon Chang, Hojoong Kim, Byeong-Ho Jeong
BACKGROUND: Interventional bronchoscopy is considered an effective treatment option for malignant central airway obstruction (MCAO). However, there are few reports of interventional bronchoscopy in patients with MCAOs due to extra-pulmonary malignancy. Therefore, the objective of this study was to investigate treatment outcomes and prognostic factors for bronchoscopic intervention in patients with MCAO due to extra-pulmonary malignancy. METHODS: We retrospectively analyzed consecutive 98 patients with MCAO due to extra-pulmonary malignancy who underwent interventional bronchoscopy between 2004 and 2014 at Samsung Medical Center (Seoul, Korea)...
March 13, 2018: BMC Pulmonary Medicine
Yojiro Yutaka, Toshihiko Sato, Koichi Matsushita, Hiroyuki Aiba, Yusuke Muranishi, Yasuto Sakaguchi, Tadao Sugiura, Minoru Okada, Tatsuo Nakamura, Hiroshi Date
OBJECTIVE: We developed a novel localization technique for small intrapulmonary lesions using radiofrequency identification (RFID) technology. Micro-RFID markers with nickel-titanium coils were designed to be placed from subsegmental bronchi to the peripheral parenchyma. In this preclinical study, thoracoscopic subsegmentectomy of a canine pseudotumor model was performed to demonstrate the feasibility and three-dimensional positional accuracy of the system. METHODS: To recover subcentimeter pseudotumors, markers were bronchoscopically placed to determine the resection line: 1) next to the pseudotumor, 2) in the responsible subsegmental bronchi as the central margin, 3) on the intersubsegmental plane as the lateral margin...
March 9, 2018: Seminars in Thoracic and Cardiovascular Surgery
Irem Serifoglu, Balam Er Dedekarginoglu, Ebru Hatice Ayvazoglu Soy, Gaye Ulubay, Mehmet Haberal
OBJECTIVES: Hemoptysis is a symptom that can be caused by airway disease, pulmonary parenchymal disease, or pulmonary vascular disease, or it can be idiopathic. Infection is the most common cause of hemoptysis, accounting for 60% to 70% of cases. Hemoptysis is also an initial symptom of diffuse alveolar hemorrhage syndrome, although it may be absent at presentation in one-third of patients. Diffuse alveolar hemorrhage is characterized by disruption of the alveolar-capillary basement membranes because of either injury or inflammation of the arterioles, venules, or capillaries, resulting in bleeding in alveolar spaces...
March 2018: Experimental and Clinical Transplantation
Hester F Shieh, C Jason Smithers, Thomas E Hamilton, David Zurakowski, Gary A Visner, Michael A Manfredi, Russell W Jennings, Christopher W Baird
OBJECTIVE: Posterior descending aortopexy can relieve posterior intrusion of the left mainstem bronchus that may limit the effectiveness of posterior tracheobronchopexy. We review outcomes of patients undergoing both descending aortopexy and posterior tracheopexy for severe tracheobronchomalacia with posterior intrusion and left mainstem compression to determine if there were resolution of clinical symptoms and bronchoscopic evidence of improvement in airway collapse. METHODS: All patients who underwent both descending aortopexy and posterior tracheopexy from October 2012 to October 2016 were retrospectively reviewed...
March 7, 2018: Seminars in Thoracic and Cardiovascular Surgery
Sang Hee Ha, Min-Soo Kim, Jiwoo Suh, Jong Seok Lee
PURPOSE: The self-pressurized air-Q® (air-Q SP) intubating laryngeal airway is a relatively new supraglottic airway (SGA) device. The intracuff pressure of air-Q dynamically equilibrates with the airway pressure and adjusts to the patient's pharyngeal and periglottic anatomy, potentially providing improved airway fit and seal. The aim of this prospective randomized study was to compare the clinical performance of air-Q to the LMA® Classic™ SGA. METHODS: Adult patients requiring general anesthesia for elective surgery were prospectively enrolled and randomly assigned to either air-Q SP or the LMA Classic SGA...
February 6, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Sevak Keshishyan, Arjun Mohan, Saman Ahmed, Samjot Singh Dhillon, Monali Patil, Kassem Harris
Iron Pill Aspiration (IPA) is a challenging medical condition that requires prompt management to prevent detrimental outcomes. One of the most serious complications of IPA is airway inflammation which commonly leads to severe obstruction. Airway complications may require surgical intervention including the resection of the affected lung. Prompt recognition and management of IPA can reduce the risk of airway complications and may prevent the need of a surgical intervention. Bronchoscopic management entails the use of flexible and rigid bronchoscopes along with balloon bronchoplasty, ablation of the inflammatory tissue causing obstruction and airway stenting...
October 8, 2017: Heart, Lung & Circulation
Justin C Sowder, Mar Janna Dahl, Kaitlin R Zuspan, Kurt H Albertine, Donald M Null, Mitchell D Barneck, J Fredrik Grimmer
Objective To (1) compare physiologic changes during rigid bronchoscopy during spontaneous and mechanical ventilation and (2) evaluate the efficacy of a helium-oxygen (heliox) gas mixture as compared with room air during rigid bronchoscopy. Study Design Crossover animal study evaluating physiologic parameters during rigid bronchoscopy. Outcomes were compared with predicted computational fluid analysis. Setting Simulated ventilation via computational fluid dynamics analysis and term lambs undergoing rigid bronchoscopy...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Takayasu Ito, Masahide Oki, Hideo Saka, Yasuhiro Kondoh, Tomoki Kimura, Kensuke Kataoka
A 71-year-old man, who had received long-term oxygen therapy for respiratory failure caused by chronic obstructive pulmonary disease, had an enlarged mediastinal lymph node for one year. As his lung function was poor, we tried performing endobronchial ultrasound-guided transbronchial needle aspiration under non-invasive positive pressure ventilation for diagnosis but could not obtain sufficient specimens. Later, we performed an endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA) using a transesophageal approach...
May 2018: Respirology Case Reports
Xi Zhang, Lei Su, Yu-Ge Ran, Shuai Qie, Xin Zhang, Chan Liu, Hong-Yun Shi
RATIONALE: Extramedullary plasmacytomas (EMPs) are rare solitary soft tissue tumors characterized by monoclonal proliferation of plasma cells. Most lesions occur in the head and neck, but primary tracheal lesions are very rare. PATIENT CONCERNS: In this report, we describe a case of tracheal EMP discovered in a 48-year-old man who presented with a history of progressive dyspnea. DIAGNOSES: Computed tomography (CT) revealed a well-defined nodular mass in the posterior wall of trachea without signs of invasion of the tracheal walls...
January 2018: Medicine (Baltimore)
Tariq M Wani, Ayman Mohammad AlAhdal, Mohammed Hakim, Tanveer Hussein, Abdul Basit Mir, Ravees Jan, Dmitry Tumin, Joseph D Tobias
BACKGROUND: There are limited data to guide the selection of the appropriate sized endobronchial tube for main stem intubation to provide one-lung ventilation in children. The relationship between the cricoid and the main bronchi (right and left) has been previously evaluated using two-dimensional computed tomography (CT) imaging and video-bronchoscopic images. The present study defines the three-dimensional, CT-derived volume-based relationships between the right main-stem bronchus (RMB), left main-stem bronchus (LMB), and the cricoid ring...
April 2018: International Journal of Pediatric Otorhinolaryngology
James C Hurley
Staphylococcus aureus ( S. aureus ) is a common Ventilator-Associated Pneumonia (VAP) isolate. The objective here is to define the extent and possible reasons for geographic variation in the incidences of S. aureus -associated VAP, MRSA-VAP and overall VAP. A meta-regression model of S. aureus -associated VAP incidence per 1000 Mechanical Ventilation Days (MVD) was undertaken using random effects methods among publications obtained from a search of the English language literature. This model incorporated group level factors such as admission to a trauma ICU, year of publication and use of bronchoscopic sampling towards VAP diagnosis...
February 27, 2018: Microorganisms
Karan Madan, Anant Mohan, Ritesh Agarwal, Vijay Hadda, Gopi C Khilnani, Randeep Guleria
Background: There is a lack of contemporaneous data on the practices of flexible bronchoscopy in India. Aim: The aim of the study was to study the prevalent practices of flexible bronchoscopy across India. Methods: The "Indian Bronchoscopy Survey" was a 98-question, online survey structured into the following sections: general information, patient preparation and monitoring, sedation and topical anesthesia, procedural/technical aspects, and bronchoscope disinfection/staff protection...
March 2018: Lung India: Official Organ of Indian Chest Society
Alexander C Chen, Colin T Gillespie
PURPOSE: Bronchoscopy for peripheral pulmonary lesions continues to present challenges to clinicians. One potential limitation may be the inability to advance conventional bronchoscopes into close proximity of peripheral lesions prior to biopsy. This study was performed to assess the reach of a robotic endoscopic system within human cadaveric lungs compared to conventional thin bronchoscopes. DESCRIPTION: All segmental bronchi (RB1-10, LB1-10) were accessed in two human cadavers using a conventional thin bronchoscope and robotic endoscope of identical outer diameter...
February 24, 2018: Annals of Thoracic Surgery
Paola Papoff, Roberto Cicchetti, Francesco Montecchia, Fabio Midulla, Silvia Ceccanti, Denis Cozzi
We describe a nonsurgical technique for managing gastric distention in infants with type C esophageal atresia, involving intubating the trachea with an umbilical catheter and entering the stomach through the fistula as soon as a flexible bronchoscope found its wide-open orifice. This technique might have a special role when gastric distention precedes other commonly used preventive measures.
February 26, 2018: Paediatric Anaesthesia
Lenard Tai Win Cheng, Tiong Beng Sim, Win Sen Kuan
BACKGROUND: Critical central airway obstruction (CAO) requires emergent airway intervention, but current guidelines lack specific recommendations for airway management in the emergency department (ED) while awaiting rigid bronchoscopy. There are few reports of the use of noninvasive ventilation (NIV) in tracheomalacia, but its use as a temporizing treatment option in fixed, malignant CAO has not, to the best of our knowledge, been reported. CASE REPORT: An 84-year-old woman presented to the ED in respiratory distress, too breathless to speak and using her accessory muscles of respiration, with bilateral rhonchi throughout the lung fields...
February 23, 2018: Journal of Emergency Medicine
Gabriele Casso, Patrick Schoettker, Georges L Savoldelli, Andrea Azzola, Tiziano Cassina
BACKGROUND: Virtual reality (VR) simulation is an effective and safe method of teaching bronchoscopic skills. Few VR bronchoscopy simulators exist; all are expensive. The present study aimed to describe the design, development, and evaluation of a new, affordable, VR bronchoscopy simulator. METHODS: Anesthesiologists and engineers collaborated to design and develop the Computer Airway Simulation System (CASS), an iPad-based, high-fidelity, VR bronchoscopy simulator...
February 23, 2018: Anesthesia and Analgesia
Yi-Ming Zeng, Yun-Feng Chen, Hui-Huang Lin, Xiao-Bin Zhang
BACKGROUND: Location of the affected bronchus of pleural air leaks is the most important step of trans-bronchoscopic bronchial occlusion for the treatment of intractable pneumothorax. The balloon occlusion test is the most commonly used technique, but has failed in some cases. The aim of the present study was: (1) to determine if endo-bronchial end-tidal CO2 (EtCO2 ) measurement can identify the affected bronchus that is the source of a persistent pleural air leak; and (2) to establish a methodology for endo-bronchial EtCO2 testing in locating affected bronchus in intractable pneumothorax...
January 2018: Therapeutic Advances in Respiratory Disease
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