Competences in bronchoscopy for Intensive Care Unit, anesthesiology, thoracic surgery and lung transplantation

Solidoro, Paolo; Corbetta, Lorenzo; Patrucco, Filippo; Sorbello, Massimiliano; Piccioni, Federico; D'Amato, Luigia; Renda, Teresa; Petrini, Flavia

doi:10.23736/s0031-0808.18.03565-6

Cited by 31 publications

(13 citation statements)

References 110 publications

(76 reference statements)

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“…If ATI is indicated, [37,38], an experienced operator should perform it [48,49] and administration of intravenous sedation may minimise coughing [50]. Aerosol or vaporised delivery of local anaesthesia should be minimised, and consideration given to the use of mucosal atomisers, swabs and tampons, and if clinical expertise permits, nerve blocks.…”

Section: Tracheal Intubationmentioning

confidence: 99%

The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice

et al. 2020

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Summary Novel coronavirus 2019 is a single‐stranded, ribonucleic acid virus that has led to an international pandemic of coronavirus disease 2019. Clinical data from the Chinese outbreak have been reported, but experiences and recommendations from clinical practice during the Italian outbreak have not. We report the impact of the coronavirus disease 2019 outbreak on regional and national healthcare infrastructure. We also report on recommendations based on clinical experiences of managing patients throughout Italy. In particular, we describe key elements of clinical management, including: safe oxygen therapy; airway management; personal protective equipment; and non‐technical aspects of caring for patients diagnosed with coronavirus disease 2019. Only through planning, training and team working will clinicians and healthcare systems be best placed to deal with the many complex implications of this new pandemic.

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Section: Tracheal Intubationmentioning

confidence: 99%

The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice

et al. 2020

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“…Since the cricoid cartilage is the narrowest part of the trachea, its diameter may be a determinant of the appropriate LDLT size ( 18 ). Since the shape of the LMB is not circular or elliptical, and it is not perpendicular to the cross section in space, it is difficult to measure it ( 12 ). Parab pointed out that the cricoid cartilage is almost always oval in shape and that in 75% of cases ( 19 ), the anterior and posterior diameter is longer.…”

Section: Discussionmentioning

confidence: 99%

“…After the intubation was complete, the anesthetist inserted the FOB to adjust the LDLT to the ideal location. Repeat the FOB control after patient position changes and throughout the intervention if necessary ( 12 ).…”

Section: Methodsmentioning

confidence: 99%

Prediction of Left Double-Lumen Tube Size by Measurement of Cricoid Cartilage Transverse Diameter by Ultrasound and CT Multi-Planar Reconstruction

et al. 2021

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Background: Currently, there is no uniform standard for selecting the left double lumen tubes (LDLT). Advantages, such as safety and convenience of the ultrasonic technology, and measurement accuracy, make it more widely applied in the clinical anesthesia, and computed tomography (CT) multi-planar reconstruction (MPR) technology will certainly provide a more accurate measurement. For better application for thoracic surgery choice LDLT, relieving the injury to patients, and reducing the complications, this study will compare the two approaches.Methods: The first part, 120 cases of patients were selected according to the height and gender; recording the patient's optimum LDLT and measurement the transverse diameter of the cricoid cartilage (TD-C) by ultrasound and CT MPR, and then obtained the TD-C range measurement by ultrasound and CT MPR corresponding to different types of LDLT. The second part, total of 102 patients were divided into the ultrasound group and the CT MPR group. In the ultrasound group, TD-C was measured by ultrasound, the corresponding size for intubation was selected based on the conclusions derived from the first part. In the CT MPR group, TD-C was measured by CT MPR, the corresponding size of LDLT based on the conclusions derived from the first part.Results: In the first part, 120 patients were no significant difference in the basic characteristics (P > 0.05). The accuracy of selecting the LDLT by conventional experience, namely height and gender was 58.3%. Ultrasonic measurement TD-C range was as follows: 32 Fr <15.88, 35 Fr: 15.88–16.80, 37 Fr: 16.75–17.81, and 39 Fr > 17.80. CT MPR measurement TD-C range was as follows: 32 Fr <15.74, 35 Fr: 15.74–16.65, 37 Fr: 16.56–17.68, and 39 Fr > 17.65. In the second part, there was no significant difference in the basic characteristics between the two groups (P > 0.05). The accuracy of intubation in the ultrasound group was 90.2% and the corresponding in the CT MPR group was 94.1% (P > 0.05).Conclusions: The accuracy of selecting the LDLT based on TD-C is significantly higher than conventional experience; it can significantly reduce the post-operative complications and there was no statistical significance in the accuracy of LDLT selected for TD-C measurement by ultrasound vs. CT, and both of them could be safely used for the evaluation before intubation under anesthesia in thoracic surgery.

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“…Therefore, further research on the amount and timing of heparin should be conducted in the future to improve the safety of interventional surgery. Besides, the practices of ECMO and bronchoscopy-guided intervention therapy need adequate technical skills that can be acquired only through defined learning pathways ( 32 ). The case in this article shows that VV-ECMO can provide sufficient oxygenation and safety for bronchoscopy-guided interventional therapy for RP with TBM.…”

Section: Discussionmentioning

confidence: 99%

Bronchoscopy-Guided Intervention Therapy With Extracorporeal Membrane Oxygenation Support for Relapsing Polychondritis With Severe Tracheobronchomalacia: A Case Report and Literature Review

Zhou

Zhang

et al. 2021

Front. Med.

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Relapsing polychondritis is an immune disorder of unknown etiology involving multiple systems that is characterized by persistent inflammation and destruction of cartilage, including the ears, nose, costal, joint, and airways. Airway involvement caused by relapsing polychondritis is common, and tracheobronchomalacia is the most serious complication, which is life-threatening. Currently, the exact mechanism of relapsing polychondritis with tracheobronchomalacia is unknown. Although glucocorticoids and immunosuppressive agents are administered, failures often occur. Currently, bronchoscopy-guided intervention therapy used in tracheobronchomalacia caused by chronic obstructive pulmonary disease or other etiology has gradually increased, but bronchoscopy-guided intervention therapy with extracorporeal membrane oxygenation assist used in tracheobronchomalacia caused by relapsing polychondritis has not been reported. Here, we report a case of relapsing polychondritis with severe tracheobronchomalacia. Although drug therapy was provided and airway stent implantation was performed, the tracheal stenosis was further aggravated. Because conventional anesthesia and mechanical ventilation cannot meet the needs of bronchoscopy-guided intervention therapy or guarantee sufficient safety. The intervention treatment was performed with the support of extracorporeal membrane oxygenation, which was successfully completed without obvious complications. The symptoms were significantly improved, and the patient was discharged uneventfully.

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Competences in bronchoscopy for Intensive Care Unit, anesthesiology, thoracic surgery and lung transplantation

Cited by 31 publications

References 110 publications

The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice

The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice

Prediction of Left Double-Lumen Tube Size by Measurement of Cricoid Cartilage Transverse Diameter by Ultrasound and CT Multi-Planar Reconstruction

Bronchoscopy-Guided Intervention Therapy With Extracorporeal Membrane Oxygenation Support for Relapsing Polychondritis With Severe Tracheobronchomalacia: A Case Report and Literature Review

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