New trends in interventional pulmonology

Abstract

The review summarizes the procedures now commonly performed by interventional pulmonologists and interventional radiologists. It discusses the anesthetic considerations for and common complications of these procedures to prepare anesthesiologists to safely care for these patients. Investigational techniques are also described.

Analysis of Infusion Patterns of Propofol and Remifentanil During Rigid Bronchoscopy Under Total Intravenous Anesthesia

“…Endobronchial tumor destruction and removal are commonly performed using rigid bronchoscopy. Other frequently used indications include mechanical dilation, endobronchial ablation, and airway stent placement for obstructions, tracheoesophageal fistulae, or tracheobronchomalacia ( 14 - 16 ). In this study, the most frequent indication for this procedure was a therapeutic approach to mass effects, such as granulations and tumor growth (46.9%).…”

Anesthesia for interventional pulmonology procedures: a review of advanced diagnostic and therapeutic bronchoscopy

“…Using real-time ultrasound imaging, this technique achieves a sensitivity and negative predictive value close to 90% with a very low complication rate (\0.5%). 11,24,25 Radial probe EBUS uses a 360°-view small-sized ultrasound probe that fits through the working channel of a flexible bronchoscope. It is typically used in conjunction with standard bronchoscopy using a guide sheath or navigational techniques, such as electromagnetic navigation bronchoscopy (ENB) or virtual bronchoscopy (VB).…”

“…Other frequently used indications include mechanical dilation (for central airway obstruction) and endobronchial ablation (laser, argon plasma coagulation, electrocautery, and cryodebridement). 24,[90][91][92] Rigid bronchoscopy is particularly suitable for foreign object removal because it allows securing the airway while facilitating its inspection. This helps prevent accidental object dislodgement into the distal airways.…”

“…In patients with a high risk of central airway obstruction, availability of extracorporeal circulation devices or ability to perform emergency tracheotomy is advisable. 24 Appropriate ventilation method selection is fundamental, as this may be the source for complications. Spontaneous ventilation is associated with an 18% risk of hypoxemia and a 1% risk of bronchospasm and laryngospasm.…”

Complications of bronchial thermoplasty using laryngeal mask: case series

“…Severe asthma is defined as a condition that fails to respond to high doses of inhaled or systemic steroids, or long-acting bronchodilators (1). Interventional pulmonology has made significant progress in the management of this condition using bronchial thermoplasty (3). The procedure involves high frequency administration on the bronchial smooth muscle to reduce muscular hypertrophy, which improves airway resistance (1).…”