Effect of fiberoptic bronchoscopy on respiratory performance in patients with chronic airways obstruction.

Salisbury, B. G.; Metzger, Louis F.; Altose, Murray D.; Stanley, N. N.; Cherniack, Neil S.

doi:10.1136/thx.30.4.441

Cited by 44 publications

(23 citation statements)

References 12 publications

(4 reference statements)

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“…Although many possibilities can be proposed to explain our results, drawing a definite conclusion is difficult because the available information on other pulmonary functions are not sufficient to make a reliable estimation. The Pao2 depression after lidocaine inhalation was already reported by SALISBURY et al (1974). On the other hand, CROSS et al (1976) andJAIN et al (1973) observed no appreciable change in blood gas tension before and after airway anaesthesia.…”

Section: Discussionmentioning

confidence: 80%

Augmented ventilatory activities after airway anaesthesia in humans.

1986

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The effect of airway anaesthesia by nebulization of 4% lidocaine was studied in 14 healthy human subjects. After airway anaesthesia, a small but significant increase in forced vital capacity and a decrease in expiratory peak flow rate were observed in the pulmonary function test. Blood gas analysis revealed the appreciable depression in arterial oxygen tension. This change was accompanied by the increased alveoler/arterial oxygen tension difference (p <0.01) and increased oxygen uptake (p <0.01). Resting respiratory rate increased. Although minute ventilation was not changed, mouth occlution pressure (P02) was significantly elevated. Hypercapnic ventilatory responses were augmented, both in terms of VE/PETco2 and P0 .2/PETcp2 slopes. The load compensation ratio, expressed as P02 loaded/P0.2 unloaded at rest, was reduced. These results suggested that preferential blockade of vagally mediated pulmonary stretch receptors by airway anaesthesia rather than the irritant receptors may have resulted in augmentation in ventilatory activities.

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Section: Discussionmentioning

confidence: 80%

Augmented ventilatory activities after airway anaesthesia in humans.

1986

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“…A pre-procedural arterial blood gas is recommended in the 2001 BTS guidelines for the same patients who may benefit from a pre-procedural PFT, FEV 1 less than 40% predicted or SaO2 <93% (BTS, 2001). There is scant available data to support this recommendation except for the report by Salisbury in which one patient whose PaO2 plummeted from 60 mm Hg to 38 mm Hg intra-procedurally and resolved with removal of the bronchoscope (Salisbury et al, 1975).…”

Section: Laboratory Testingmentioning

confidence: 93%

“…The BTS recommends using supplemental oxygen to maintain a goal of SaO2 greater than 89% during and after FFB (BTS, 2001). Patients who undergo FFB are frequently at increased risk for hypercapnea due to intravenous sedation or underlying lung disease (Salisbury et al, 1975). While capnography is also more sensitive to hypercapnea than physical exam, there is no clear recommendation or evidence to support the routine use of capnography during FFB with moderate levels of sedation.…”

Section: Supplemental Oxygenmentioning

confidence: 97%

“…The BTS guideline suggests testing be performed when forced expiratory volume at one second (FEV 1 ) is less than 40% predicted or oxygen saturation (SaO 2 ) is less than 93% (BTS, 2001). One small prospective trial reported a drop of 13.8% in FEV 1 (baseline 1.37 ± 0.16L) approximately 15 minutes into bronchoscopy (Salisbury et al, 1975). A slightly larger retrospective review reported patients who had a FEV 1 /forced expiratory volume (FVC) ratio less than 50% or an FEV 1 less than one liter with an FEV 1 /FVC ratio less than 69% had a bronchoscopic complication rate of 5% compared to 0.6% of controls with normal spirometric function (Peacock et al, 1994).…”

Section: Pulmonary Function Testingmentioning

confidence: 99%

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Monitoring, Sedation, and Anesthesia for Flexible Fiberoptic Bronchoscopy

Morris¹,

Kwon²,

Zanders³

2012

Global Perspectives on Bronchoscopy

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“…It has been shown that FB leads to a reversible impairment in lung function, especially in patients with chronic airway obstruction [54, 55, 56]. …”

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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Effect of fiberoptic bronchoscopy on respiratory performance in patients with chronic airways obstruction.

Cited by 44 publications

References 12 publications

Augmented ventilatory activities after airway anaesthesia in humans.

Augmented ventilatory activities after airway anaesthesia in humans.

Monitoring, Sedation, and Anesthesia for Flexible Fiberoptic Bronchoscopy

Contraindications and Safety of Transbronchial Lung Biopsy via Flexible Bronchoscopy

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