Arrhythmias from Fiberoptic Bronchoscopy

Luck, Jerry C.; Messeder, Octavio H.; Rubenstein, M. J.; Morrissey, William L.; Engel, Toby R.

doi:10.1378/chest.74.2.139

Cited by 33 publications

(17 citation statements)

References 8 publications

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“…Major ventricular and supraventricular dysrhythmias may occur in critically ill patients undergoing flexible FOB [149,150]. Katz [14,[16][17][18].…”

Section: Complications Of Flexible Fobmentioning

confidence: 99%

Flexible Fiberoptic Bronchoscopy in the Intensive Care Unit

Brandstetter

1989

J Intensive Care Med

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For the past 20 years, flexible fiberoptic bronchoscopy (FOB) has been shown to be an important procedure in the diagnosis and management of patients in intensive care units (ICU). In adults, FOB is used therapeutically to remove retained secretions and to correct atelectasis not improved by conservative means. In the pediatric population, however, FOB is mainly used to diagnose tracheal disease in critically ill children. The principal risks of FOB are hypoxemia and dysrhythmias; hemor rhage and pneumothorax may occur as a result of biopsy procedures. In competent hands, these adverse compli cations of FOB are minimal. Although rigid bronchos copy remains pivotal in most pediatric bronchoscopic procedures, massive hemoptysis, foreign body removal, and laser therapy for occluding tumors of the upper airway, flexible FOB has an increasingly important role in the diagnosis and management of these disorders.

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“…Major ventricular and supraventricular dysrhythmias may occur in critically ill patients undergoing flexible FOB [149,150]. Katz [14,[16][17][18].…”

Section: Complications Of Flexible Fobmentioning

confidence: 99%

Flexible Fiberoptic Bronchoscopy in the Intensive Care Unit

Brandstetter

1989

J Intensive Care Med

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“…Hypoxemia results from both hypoventilation associated with sedation and ventilation-perfusion mismatch secondary to partial airway occlusion and frequent suctioning. The development of cardiac arrhythmias has been correlated with hypoxemia during FB [45, 46, 47, 48]. Routine use of supplemental oxygen, to maintain a saturation of at least 90%, and continuous monitoring of pulse oximetry, are recommended [4, 43, 49, 50, 51].…”

Section: Discussionmentioning

confidence: 99%

Contraindications and Safety of Transbronchial Lung Biopsy via Flexible Bronchoscopy

et al. 2005

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Background: Transbronchial lung biopsy (TBLB) via flexible bronchoscopy is a common procedure performed by pulmonologists. Limited scientific data exist concerning the risk of this procedure in patients with conditions that may adversely affect the rate of procedural complications. Objectives: To evaluate the current practice pattern and attitude of pulmonologists toward the performance of TBLB in the presence of high-risk conditions. Methods: A survey was constructed and distributed at the American College of Chest Physicians annual meeting, held in Philadelphia, USA, in November of 2001. Results: A total of 227 surveys were distributed with a return of 158 (69.6%). Anticoagulation medications are temporarily held prior to TBLB by the majority of our survey respondents (98.7% for intravenous heparin, 90.5% for warfarin, and 87.3% for low-molecular-weight heparin). Medications with effect on platelet function are held by fewer pulmonologists. There is a wide variation in the pulmonologists’ perception of the risk of performing TBLB when certain medical conditions coexist: pulmonary hypertension [absolute contraindication (AC), 28.7%; relative contraindication (RC) 58.6%], superior vena cava syndrome (AC 19.6%, RC 51%), mechanical ventilation (AC 17.8%, RC 58.6%) and lung cavity/abscess (AC 7%, RC 44.9%). A significant percentage of pulmonologists (55%) do not regard an elevated serum creatinine at any level as AC to TBLB. Thirty-eight percent of the survey participants administer desmopressin prior to TBLB in uremic patients to prevent excessive bleeding. Conclusions: Prior to performing bronchoscopic TBLB, the majority of pulmonologists temporarily holds anticoagulation medications. However, there is a lack of agreement in relation to perceived contraindications and safety of TBLB.

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“…Significant hemodynamic responses to fiberoptic bronchoscopy (FOB) include an increase in heart rate (HR) and mean blood pressure, along with oxygen desaturation [1,2]. Most frequently seen cardiac complications of FOB are arrhythmias, myocardial ischemia and cardiac arrest.…”

Section: Introductionmentioning

confidence: 99%

Sedation for Fiberoptic Bronchoscopy: Fewer Adverse Cardiovascular Effects with Propofol than with Midazolam

Öztürk¹,

Çakan²,

Gülerçe³

et al. 2004

Anasthesiol Intensivmed Notfal

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Propofol, when used as a sedative for FOB, is associated with lower hemodynamic side effects than in patients undergoing FOB with midazolam. In addition, it is well-tolerated by patients with pre-existing pulmonary disease. Even patients without a history of heart disease should be monitored for cardiac arrhythmia while undergoing FOB for pulmonary disease, especially patients with a FEV (1) of less than 50 % of the predicted value.

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Arrhythmias from Fiberoptic Bronchoscopy

Cited by 33 publications

References 8 publications

Flexible Fiberoptic Bronchoscopy in the Intensive Care Unit

Flexible Fiberoptic Bronchoscopy in the Intensive Care Unit

Contraindications and Safety of Transbronchial Lung Biopsy via Flexible Bronchoscopy

Sedation for Fiberoptic Bronchoscopy: Fewer Adverse Cardiovascular Effects with Propofol than with Midazolam

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