Introduction: This study aimed to evaluate the safety and diagnostic yield of cryobiopsy (CB) in comparison to forceps biopsy in endobronchial lesions. Material and methods:Patients with suspected endobronchial lesions were enrolled. Two forceps biopsies and one cryobiopsy were done in the same patient with randomized sequence. The largest diameter of the samples was measured in mm by electronic caliper. Diagnostic yield of each technique and postbronchoscopy bleeding were evaluated. Results: Samples obtained by CB was significantly larger than that of the forceps biopsy (5.9 ± 2.3 vs 2.5 ± 0.8, p = 0.001). Diagnostic yield of CB was significantly higher than forceps biopsy 74.5% versus 51.1% (p = 0.001). Mild and moderate bleeding grades were reported in both techniques with no significant difference (p = 0.063, p = 0.5), respectively. Severe bleeding was not recorded in both techniques. Conclusions: CB represents a safe and effective tool to obtain a larger tissue samples of a good quality with higher diagnostic yield in comparison to standard forceps samples. On the other hand, bleeding occurred more frequently after CB than forceps biopsy. However, without severe adverse effects.

No abstract

No abstract

No abstract

No abstract

Objective: Several studies evaluated the effectiveness of the ventilator care bundle in reducing the occurrence of ventilatorassociated pneumonia. The ventilator care bundle efficacy in early mechanical ventilation weaning has not been adequately assessed. The study aimed to investigate the weaning success among chronic obstructive pulmonary disease (COPD) patients following ventilator care bundle application.Methods: This study is quasi-experimental, recruiting 80 mechanically ventilated COPD patients (40 patients for each bundle and control group). It was conducted at the respiratory intensive care units (ICUs) at Mansoura University Hospital, Egypt. Data were collected using a mechanically ventilated patient (MVP) assessment tool, a ventilator care bundle compliance checklist, and MVP evaluation tools based on the Burns’ Wean Assessment Program (BWAP) checklist and the patient’s ventilation indicators.Results: The results revealed that almost 75% of the bundle group was successfully weaned from invasive mechanical ventilation at the first attempt of the spontaneous breathing trial compared with 32.5% of the control group. The ventilation duration and length of ICU stay were reduced in the bundle compared with the control group.Conclusions: The bundle group demonstrated higher weaning scores than the control group. Therefore, we recommend the integration of the ventilator care bundle in the weaning trial of MVPs to accelerate weaning and reduce the duration of mechanical ventilation.

Background: Delayed resolving pneumonia represents a perplexing diagnostic dilemma. Many methods can lend a hand in diagnosis; however prediction of such a problem wishes a more precision.Objectives: Define to what extent early anticipation of underlying causes of delayed resolving pneumonia via clinical, radiological and bronchoscopic markers would modify management plan and affect their outcomes.Patients and methods: Prospective clinical study was conducted on 122 patients with delayed resolving pneumonia. They underwent chest X-ray, thoracic ultrasound, chest computed tomography (CT) and fiberoptic bronchoscopy (FOB). Tissue biopsy was taken for pathological examination.Results: Studied cases were divided into two groups: group I included 58 patients with malignant etiology (49 cases with lung cancer and 9 cases with pulmonary metastasis) and group II included 64 patients with nonmalignant etiology (nonspecific pneumonia in 42 cases, specific forms of pneumonia in 14 cases, pulmonary sequestration in 4 cases and traction bronchiectasis in 4 cases). Sensitivity of clinical and CT chest markers of malignancy was 72.36% and 53.45% respectively however their specificities were 20.62% and 59.38% respectively. Thoracic ultrasound showed the highest sensitivity (75.86%) but lowest specificity (17.19%). FOB markers of malignancy were significantly higher in malignant than the non-malignant group (p = 0.001). Summation of clinical, FOB, CT chest and sonographic markers increased the probability of malignancy in 67.2% and excluded malignancy in 71.8% of cases with a success rate of 69.7%.Conclusion: Early anticipation of what beyond delayed resolution of pneumonia can assist in earlier verification of causes and supervising course and guard against consequences.

No abstract