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Medicine Sep 2022During fiberoptic-guided tracheal intubation, impingement between the distal tip of the endotracheal tube and the airway tissue can cause difficulties in tube insertion... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
During fiberoptic-guided tracheal intubation, impingement between the distal tip of the endotracheal tube and the airway tissue can cause difficulties in tube insertion or tissue damage during the tube advancement over the bronchoscope. This randomized controlled study aimed to investigate the effects of the endotracheal tube's bevel direction on the complications associated with airway injury when performing fiberoptic-guided tracheal intubation.
METHODS
The study subjects were divided into 2 groups: L (control) and D (study). When advancing the tube over the bronchoscope, the tube's bevel was facing the patients' left in Group L and the dorsal direction in Group D. According to the degree of resistance at the time of tube advancement, the insertion score was graded in 3 stages; the severity of the patients' sore throat and hoarseness was evaluated and recorded postoperatively.
RESULTS
The severity of postoperative sore throat was higher in Group L than in Group D 3 hours and 24 hours after surgery. (P = .008, P = .023, respectively). The tube insertion score was comparable between the groups. The severity of postoperative hoarseness did not vary significantly between the groups.
CONCLUSION
Endotracheal tube insertion with the bevel facing the dorsal direction of the patient during fiberoptic-guided tracheal intubation reduced the severity of postoperative sore throat in patients undergoing laparoscopic gynecologic surgery.
Topics: Bronchoscopes; Female; Fiber Optic Technology; Hoarseness; Humans; Intubation, Intratracheal; Pain; Pharyngitis
PubMed: 36107530
DOI: 10.1097/MD.0000000000030372 -
Archives of Disease in Childhood Sep 1997
Review
Topics: Bronchoscopes; Bronchoscopy; Child; Foreign Bodies; Humans; Lung; Lung Diseases; Respiratory System Abnormalities
PubMed: 9370913
DOI: 10.1136/adc.77.3.272 -
Respiratory Care Nov 2020Single-use flexible bronchoscopes have gained popularity in recent years for various advantages over the traditional reusable bronchoscope. There are several...
BACKGROUND
Single-use flexible bronchoscopes have gained popularity in recent years for various advantages over the traditional reusable bronchoscope. There are several commercially available disposable bronchoscopes; however, all have limitations compared to reusable bronchoscopes. The Vathin H-SteriScope is a single-use flexible bronchoscope that may have overcome some of these limitations.
METHODS
We designed a survey to evaluate the performance of this new single-use bronchoscope on a bronchoscopy model with operators who are familiar with current single-use and reusable bronchoscopes. The operators were asked to rank overall assessment, scope quality, handling, maneuverability, tool interaction, and image quality of the H-SteriScope on a scale of 0-100. These operators were then asked to rank their current single-use and reusable bronchoscopes with the same scale. The results were evaluated to determine the operator perception of the H-SteriScope.
RESULTS
The H-SteriScope and current reusable bronchoscopes were perceived to have significant differences compared with currently available single-use bronchoscopes in overall assessment of the scope, scope quality, handling, maneuverability, tool interaction, and image quality ( < .001). The H-SteriScope was perceived to have similar maneuverability as the reusable bronchoscope ( = .86). There were no differences among the H-SteriScope ( = .88), the current single-use bronchoscope ( = .84), and the current reusable bronchoscope ( = .89) between the training and nontraining interventional pulmonology subgroups.
CONCLUSIONS
In terms of operator perception, the H-SteriScope appears to have similar maneuverability as the reusable bronchoscope. Both the H-SteriScope and the reusable bronchoscopes performed better in all measured sectors than the current single-use bronchoscope. Additional studies are required to evaluate the practicality, safety, and cost efficiency of the H-SteriScope in clinical practice.
Topics: Bronchoscopes; Bronchoscopy; Humans; Perception; Reference Standards; Surveys and Questionnaires
PubMed: 32487752
DOI: 10.4187/respcare.07574 -
Anesthesiology Feb 2006
Topics: Bronchoscopes; Bronchoscopy; Fiber Optic Technology; Humans; Intubation, Intratracheal; Trachea
PubMed: 16436863
DOI: 10.1097/00000542-200602000-00029 -
Respiratory Care May 2010Diagnostic or therapeutic flexible bronchoscopy is often necessary in severely ill patients. These patients often have comorbidities that increase the risk of... (Review)
Review
Diagnostic or therapeutic flexible bronchoscopy is often necessary in severely ill patients. These patients often have comorbidities that increase the risk of bronchoscopy-related complications. Noninvasive ventilation might decrease the risk of these complications in patients with severe refractory hypoxemia, postoperative respiratory distress, or severe emphysema, and in pediatric patients. Noninvasive ventilation may prevent hypoventilation in patients with obstructive sleep apnea and obesity hypoventilation syndrome who require bronchoscopy, and may assist in the bronchoscopic evaluation of patients with expiratory central-airway collapse. We describe the indications, contraindications, and technique of flexible bronchoscopy during noninvasive ventilation.
Topics: Bronchoscopes; Bronchoscopy; Equipment Design; Humans; Positive-Pressure Respiration; Respiratory Insufficiency
PubMed: 20420731
DOI: No ID Found -
Journal of Thoracic Disease Nov 2017Persistent air leak (PAL) is a cause of significant morbidity in patients who have undergone lung surgery and those with significant parenchymal lung disease suffering... (Review)
Review
Persistent air leak (PAL) is a cause of significant morbidity in patients who have undergone lung surgery and those with significant parenchymal lung disease suffering from a pneumothorax. Its management can be complex and challenging. Although conservative treatment with chest drain and observation is usually effective, other invasive techniques are needed when conservative treatment fails. Surgical management and medical pleurodesis have long been the usual treatments for PAL. More recently numerous bronchoscopic procedures have been introduced to treat PAL in those patients who are poor candidates for surgery or who decline surgery. These techniques include bronchoscopic use of sealants, sclerosants, and various types of implanted devices. Recently, removable one-way valves have been developed that are able to be placed bronchoscopically in the affected airways, ameliorating air-leaks in patients who are not candidates for surgery. Future comparative trials are needed to refine our understanding of the indications, effectiveness, and complications of bronchoscopic techniques for treating PAL. The following article will review the basic principles of management of PAL particularly focusing on bronchoscopic techniques.
PubMed: 29268535
DOI: 10.21037/jtd.2017.10.122 -
Cyborg and Bionic Systems (Washington,... 2023Transbronchial biopsy sampling, as a minimally invasive method with relatively low risk, has been proved to be a promising treatment in the field of respiratory surgery....
Transbronchial biopsy sampling, as a minimally invasive method with relatively low risk, has been proved to be a promising treatment in the field of respiratory surgery. Although several robotic bronchoscopes have been developed, it remains a great challenge to balance size and flexibility, while integrating multisensors to realize navigation during complex airway networks. This paper proposes a novel robotic bronchoscope system composed by end effector with relatively small size, relevant actuation unit, and navigation system with path planning and surgical guidance capability. The main part of the end effector is machined by bidirectional groove on a nickel-titanium tube, which can realize bending, rotation, and translation 3 degrees of freedom. A prototype of the proposed robotic bronchoscope system is designed and fabricated, and its performance is tested through several experiments to verify the stiffness, flexibility, and navigation performance. The results show that the proposed system is with good environment adaptiveness, and it can become a promising biopsy method through natural cavity of the human body.
PubMed: 36951809
DOI: 10.34133/cbsystems.0013 -
IEEE Transactions on Bio-medical... Dec 2015Bronchoscopy is a commonly used minimally invasive procedure for lung-cancer staging. In standard practice, however, physicians differ greatly in their levels of...
Bronchoscopy is a commonly used minimally invasive procedure for lung-cancer staging. In standard practice, however, physicians differ greatly in their levels of performance. To address this concern, image-guided intervention (IGI) systems have been devised to improve procedure success. Current IGI bronchoscopy systems based on virtual bronchoscopic navigation (VBN), however, require involvement from the attending technician. This lessens physician control and hinders the overall acceptance of such systems. We propose a hands-free VBN system for planning and guiding bronchoscopy. The system introduces two major contributions. First, it incorporates a new procedure-planning method that automatically computes airway navigation plans conforming to the physician's bronchoscopy training and manual dexterity. Second, it incorporates a guidance strategy for bronchoscope navigation that enables user-friendly system control via a foot switch, coupled with a novel position-verification mechanism. Phantom studies verified that the system enables smooth operation under physician control, while also enabling faster navigation than an existing technician-assisted VBN system. In a clinical human study, we noted a 97% bronchoscopy navigation success rate, in line with existing VBN systems, and a mean guidance time per diagnostic site = 52 s. This represents a guidance time often nearly 3 min faster per diagnostic site than guidance times reported for other technician-assisted VBN systems. Finally, an ergonomic study further asserts the system's acceptability to the physician and long-term potential.
Topics: Aged; Bronchoscopes; Bronchoscopy; Equipment Design; Female; Humans; Lung Neoplasms; Male; Middle Aged; Phantoms, Imaging; Surgery, Computer-Assisted; Tomography, X-Ray Computed
PubMed: 25675452
DOI: 10.1109/TBME.2015.2401514 -
Respirology (Carlton, Vic.) Feb 2023
Topics: Humans; Bronchoscopy; Bronchoscopes; Lung Neoplasms; Biopsy; Lung
PubMed: 36319029
DOI: 10.1111/resp.14402 -
Therapeutic Advances in Respiratory... 2023To evaluate both efficacy and safety parameters for insufflation through the bronchoscope as a method of recovery from sedation-induced hypoxia. To explore parameters...
OBJECTIVES
To evaluate both efficacy and safety parameters for insufflation through the bronchoscope as a method of recovery from sedation-induced hypoxia. To explore parameters applicable to use in human beings using an animal model.
MATERIALS AND METHODS
Two adult pigs were sedated enough to depress respiratory drive. The effects of insufflation at 15 l/min (the upper limits of flow that might be used clinically) were then evaluated. Pressure and volume responses to bronchoscopy during intubation and without an endotracheal tube in place were recorded. Several assays were performed for each scenario, with each animal acting as its own control. Recovery from hypoxemia using insufflation was compared with recovery using mechanical ventilation.
RESULTS
Insufflation was effective, with rapid increases in fraction of inspired oxygen (FIO), saturation, and partial pressure of arterial oxygen (PaO). The rate of recovery using insufflation was faster than that from institution of mechanical ventilation. Insufflation in an intubated animal with cuff inflated led to a rapid and dangerous rise in pressure. With balloon deflated, there were no adverse pressure consequences from insufflation the endotracheal tube at a rate of 15 l/min.
CONCLUSION
Insufflation through the bronchoscope for episodes of sedation-induced hypoxia should be safe and effective as long as not delivered within a closed system.
Topics: Adult; Animals; Humans; Swine; Oxygen; Insufflation; Bronchoscopes; Hypoxia; Respiration, Artificial
PubMed: 37067028
DOI: 10.1177/17534666231164539