Background: Partial pressure of carbon dioxide (PCO 2) measured by capnometer is mainly used to evaluate the respiratory condition of the lungs under ventilator control. Recently, the use of bronchoscopy has been reported in the evaluation of lung function after lobectomy in patients with lung cancer and those with chronic obstructive pulmonary disease (COPD), who underwent bronchoscopic lung volume reduction (BLVR). Objectives: To determine the usefulness of bronchoscopic capnometry to assess treatment sites for BLVR. Method: Twenty patients with COPD suspected of having lung cancer who underwent transbronchial biopsy were included. PCO 2 was measured at the healthy side of the segmental bronchus under room air with a capnometer. Distribution of the percentage of low attenuation area (%LAA) as measured by chest computed tomography (CT), was calculated and compared to end-tidal CO 2 (EtCO 2) distribution obtained by the capnometer. Results: All 20 patients displayed homogeneous patterns on CT, but the distribution of EtCO 2 as measured by capnometer was uneven in 3 patients. There was no significant correlation between %LAA and EtCO 2 in the 20 patients, but in 9 patients with higher %LAA values, %LAA correlation significantly with EtCO 2 (r = −0.437, p = 0.023). Conclusions: Capnography was useful in physiologically evaluating local ventilation and perfusion status of the lung. We recommend capnography as an adjunct to CT to assess functional heterogeneity in patients potentially undergoing BLVR.
Airway involvement in relapsing polychondritis (RP) can often be debilitating and life threatening. Interventional procedures such as stenting can be useful to improve airway stenosis. This case was diagnosed with RP with a circumferential obstruction at the left main bronchus. We determined that a silicone airway stent would be placed. The silicone stent was removed after 22 months due to granulation tissue. After stent removal, bronchoscopic findings revealed a collapsing left main bronchus during exhalation, but airway patency was maintained during inhalation without any respiratory symptoms. In this case, bronchomalacia remained after stent removal. However, since there were no severe respiratory symptoms, we decided that stent replacement was unnecessary. In general, it is difficult to remove airway stents in severe tracheobronchomalacia; however, temporary stenting might be a useful procedure in cases with unilateral main bronchial stenosis.
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