Purpose: The aim of this retrospective study is to present data efficacy and safety of bronchoscopic laser therapy in patients with tracheal and bronchial obstruction. Patients and Methods: From February 2004 to April 2010, our electronic database was searched for all patients who had undergone bronchoscopic laser therapy. We collected data on age, gender, performance status, diagnosis leading to bronchoscopic laser treatment, number of procedures per patient, efficacy by means of extend of recanalisation and symptom improvement, additional interventions and procedure-related complications. Results: Two hundred fifty-six procedures were performed in 121 patients. 17% of obstructions were localised in the trachea, 57% in main bronchi and 26% in lobar bronchi including right intermedius bronchus. The sum of complete and partial recanalisation reached 95%, 80% and 68%, respectively. 26% of interventions in lobar bronchi were undertaken to treat haemoptysis which could be controlled in all cases. Moderate bleeding occurred in 6%; severe bleeding in 1%. Cardiac arrhythmias were seen in 2%. We observed one treatment-related death (overall mortality 0.4%). Conclusion: Bronchoscopic laser therapy is a generally safe and effective method to regain airway patency in cases with tracheal or bronchial obstruction and to treat haemoptysis. We observed clinical improvement in terms of reduced dyspnea or controlled haemoptysis in 93% of our patients.Please cite this paper as: Hermes A, Heigener D, Gatzemeier U, Schatz J and Reck M. Efficacy and safety of bronchoscopic laser therapy in patients with tracheal and bronchial obstruction: a retrospective single institution report. Clin Respir J 2012; 6: 67-71.
Following cardiac arrest a 41-year-old patient was resuscitated for 40 min and required mechanical ventilation for 27.5 h. Acute shortness of breath and inspiratory stridor developed 7 days after successful extubation. Bronchoscopy revealed a subtotal tracheal stenosis caused by extensive fibrinous membranes. Local ischaemia caused by cuff pressure seems to be a likely explanation with an additional component of general hypoperfusion and haemodynamic instability which led to gastric bleeding (classification according to Forrest IIc) from ischaemic ulcers.
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