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Clinics in Chest Medicine Mar 2018Flexible bronchoscopy has changed the course of pulmonary medicine. As technology advances, the role of the flexible bronchoscope for both diagnostic and therapeutic... (Review)
Review
Flexible bronchoscopy has changed the course of pulmonary medicine. As technology advances, the role of the flexible bronchoscope for both diagnostic and therapeutic indications is continually expanding. This article reviews the historical development of the flexible bronchoscopy, fundamental uses of the flexible bronchoscope as a tool to examine the central airways and obtain diagnostic tissue, and the indications, complications, and contraindications to flexible bronchoscopy.
Topics: Bronchoscopy; Humans
PubMed: 29433707
DOI: 10.1016/j.ccm.2017.09.002 -
American Journal of Respiratory and... Jul 2020For over 150 years, bronchoscopy, especially flexible bronchoscopy, has been a mainstay for airway inspection, the diagnosis of airway lesions, therapeutic aspiration of... (Review)
Review
For over 150 years, bronchoscopy, especially flexible bronchoscopy, has been a mainstay for airway inspection, the diagnosis of airway lesions, therapeutic aspiration of airway secretions, and transbronchial biopsy to diagnose parenchymal lung disorders. Its utility for the diagnosis of peripheral pulmonary nodules and therapeutic treatments besides aspiration of airway secretions, however, has been limited. Challenges to the wider use of flexible bronchoscopy have included difficulty in navigating to the lung periphery, the avoidance of vasculature structures when performing diagnostic biopsies, and the ability to biopsy a lesion under direct visualization. The last 10-15 years have seen major advances in thoracic imaging, navigational platforms to direct the bronchoscopist to lung lesions, and the ability to visualize lesions during biopsy. Moreover, multiple new techniques have either become recently available or are currently being investigated to treat a broad range of airway and lung parenchymal diseases, such as asthma, emphysema, and chronic bronchitis, or to alleviate recurrent exacerbations. New bronchoscopic therapies are also being investigated to not only diagnose, but possibly treat, malignant peripheral lung nodules. As a result, flexible bronchoscopy is now able to provide a new and expanding armamentarium of diagnostic and therapeutic tools to treat patients with a variety of lung diseases. This State-of-the-Art review succinctly reviews these techniques and provides clinicians an organized approach to their role in the diagnosis and treatment of a range of lung diseases.
Topics: Bronchoscopy; Humans; Lung Diseases
PubMed: 32023078
DOI: 10.1164/rccm.201907-1292SO -
Seminars in Respiratory and Critical... Dec 2018Rigid bronchoscopy is one of the oldest medical techniques used in the respiratory and thoracic fields. Even though its use declined after the development of flexible... (Review)
Review
Rigid bronchoscopy is one of the oldest medical techniques used in the respiratory and thoracic fields. Even though its use declined after the development of flexible bronchoscopy, it has again gained importance with the growth of interventional pulmonology, becoming a critical technique taught as part of the training in this subspecialty. The therapeutic advantages compared to other approaches of thoracic pathologies makes rigid bronchoscopy a primary component in the present and future of interventional pulmonary medicine.
Topics: Airway Obstruction; Bronchial Diseases; Bronchoscopes; Bronchoscopy; Equipment Design; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Treatment Outcome
PubMed: 30641585
DOI: 10.1055/s-0038-1676647 -
Clinics in Chest Medicine Sep 2013Although bronchoscopy technology continues to evolve at a fairly rapid pace, basic procedures, such as bronchoalveolar lavage, transbronchial lung biopsy, and... (Review)
Review
Although bronchoscopy technology continues to evolve at a fairly rapid pace, basic procedures, such as bronchoalveolar lavage, transbronchial lung biopsy, and transbronchial needle aspiration, continue to play a paramount role in the diagnosis of bronchopulmonary diseases. Pulmonologists should be trained in these basic bronchoscopic procedures.
Topics: Biopsy; Bronchoscopes; Bronchoscopy; Contraindications; History, 20th Century; Humans; Lung; Lung Diseases
PubMed: 23993807
DOI: 10.1016/j.ccm.2013.03.001 -
Revue Des Maladies Respiratoires May 2018
Review
Topics: Bronchoscopes; Bronchoscopy; History, 20th Century; History, 21st Century; Humans; Pliability
PubMed: 29395565
DOI: 10.1016/j.rmr.2017.11.006 -
Seminars in Respiratory and Critical... Dec 2014The purpose of this article is to provide an introduction to rigid bronchoscopy (RB). We will briefly discuss its history, evolution, and resurgence while we highlight... (Review)
Review
The purpose of this article is to provide an introduction to rigid bronchoscopy (RB). We will briefly discuss its history, evolution, and resurgence while we highlight its versatility and usefulness for today's interventional pulmonologist and thoracic surgeon. Despite being one of the earliest pulmonary procedures described, RB is still an important technique. Advances in thoracic medicine have made this skill critical for a fully functional interventional pulmonary program. If the interventional pulmonologist of this century is to be successful, he or she should be facile in this technique. Despite the availability of RB for decades, the invention of flexible bronchoscopy in 1966 led to a significant downturn in its usage. The growth of the interventional pulmonology field brought RB back into the spot light. Apart from the historic role of RB in treatment of central airway lesions and mechanical debulking of endobronchial lesions, RB is the key instrument that can adapt modern therapeutic tools such as laser, argon plasma coagulation, electrocautery, cryotherapy, and stent deployment. Performing RB requires proper preprocedure preparation, exceptional understanding of upper airway anatomy, specific hand-eye coordination, and open communication between the bronchoscopist and the anesthesiologist. These skills can be primarily learned and maintained with repetition. This article will review information relevant to this technique and lay a foundation to be built upon for years to come.
Topics: Airway Management; Airway Obstruction; Anesthesia; Bronchoscopy; Foreign Bodies; Hemoptysis; Humans; Intubation, Intratracheal; Lung
PubMed: 25463158
DOI: 10.1055/s-0034-1395500 -
The Indian Journal of Chest Diseases &... 2000Endoscopic therapy has been used extensively in every field of medicine. The bronchial tree is no exception. The rigid bronchoscope was mainly used for foreign body... (Review)
Review
Endoscopic therapy has been used extensively in every field of medicine. The bronchial tree is no exception. The rigid bronchoscope was mainly used for foreign body extraction and hemostasis from and in the bronchial tree. With the evolution of flexible fiberoptic bronchoscope, the scope of therapeutic bronchoscopy has widened. The principles of therapeutic bronchoscopy, the various indications and brief description of such procedures like laser-bronchoscopy, endo-bronchial brachytherapy, management of airway strictures, its role in management of hemoptysis and foreign body removal have been reviewed.
Topics: Airway Obstruction; Brachytherapy; Bronchoscopy; Cryotherapy; Foreign Bodies; Humans
PubMed: 11089321
DOI: No ID Found -
F1000Research 2018Bronchoscopy is a very common tool for diagnosis and therapeutic purposes in dealing with diseases of the lungs and the airways. Thankfully, a multitude of new... (Review)
Review
Bronchoscopy is a very common tool for diagnosis and therapeutic purposes in dealing with diseases of the lungs and the airways. Thankfully, a multitude of new technologies have made it more accessible for the use of physicians. This article is a review of the indication of bronchoscopy as it is being used today for a variety of chest pathologies.
Topics: Bronchoscopy; Humans; Lung Diseases; Pulmonary Medicine; Respiratory Tract Diseases
PubMed: 30364219
DOI: 10.12688/f1000research.14596.1 -
The American Journal of Emergency... Aug 2022Flexible bronchoscopy has been safely used for decades in ambulatory and critical care settings to aid in the diagnosis and treatment of tracheobronchial tree disorders....
BACKGROUND
Flexible bronchoscopy has been safely used for decades in ambulatory and critical care settings to aid in the diagnosis and treatment of tracheobronchial tree disorders. Although emergency physicians have the requisite skills to operate and interpret flexible bronchoscopy, no reports exist on the use of bronchoscopy by emergency physicians apart from endotracheal tube placement and confirmation.
OBJECTIVE
The primary goal of this study was to describe the indications, outcomes and complications of flexible bronchoscopy performed by emergency physicians in an urban academic emergency department.
METHODS
This was a single-center retrospective cohort study involving chart and video review of 146 patients over a 10.5-year study period. Patients of any age were included if they had been tracheally intubated or mechanically ventilated and underwent flexible bronchoscopy in the emergency department. After patients were identified, manual chart and video review was used to collect data on patient demographics, indications for intubation, indications for bronchoscopy, details of the bronchoscopy procedure, procedural findings, outcomes of the procedure, complications, provider training levels, and additional bronchoscopies performed after admission. The data was analyzed using descriptive statistics.
RESULTS
146 patients were included in the study and all bronchoscopies were performed or supervised by attending emergency physicians. After bronchoscopy, 24% of patients displayed improvement in oxygenation or lobar collapse while most patients had no change in clinical status. One patient had temporary hypoxemia after bronchoscopy. When another physician performed a subsequent bronchoscopy during admission, the findings were in agreement with the ED bronchoscopy 86% of the time.
CONCLUSION
At our institution, emergency physicians can safely and effectively use flexible bronchoscopy to diagnose and treat critically ill patients.
Topics: Bronchoscopy; Emergency Service, Hospital; Humans; Intubation, Intratracheal; Pulmonary Atelectasis; Retrospective Studies
PubMed: 35679653
DOI: 10.1016/j.ajem.2022.05.040 -
Pediatric Pulmonology Feb 2001Diagnostic flexible endoscopy for pediatric respiratory diseases is performed in many centers. Technical advances have resulted in performance of interventional... (Review)
Review
Diagnostic flexible endoscopy for pediatric respiratory diseases is performed in many centers. Technical advances have resulted in performance of interventional bronchoscopies, and new diagnostic indications are being explored. Indications with documented clinical benefit include congenital or acquired progressive or unexplained airway obstruction. Pulmonary infections in immunodeficient children who do not respond to empirical antibiotic treatment may be diagnosed by bronchoscopy and bronchoalveolar lavage (BAL). The potential usefulness of bronchoscopy and BAL for managing chronic cough, wheeze, or selected cases with asthma or cystic fibrosis requires further study. The use of transbronchial biopsies (TBB) is established in pediatric lung transplantation. The role of TBB in the diagnosis of chronic interstitial lung disease in children remains to be determined. For a number of interventional applications, rigid endoscopy is required, and pediatric bronchoscopists should be trained in its use. Complications in pediatric bronchoscopy are rare, but severe nosocomial infection or overdosing with local anesthetics has occurred. The issues of quality control, video documentation, interobserver variability of findings, and educational standards will have to be addressed in the future as bronchoscopy use becomes less restricted to only large pediatric pulmonary units.
Topics: Airway Obstruction; Anesthesia, Local; Asthma; Bronchoalveolar Lavage; Bronchoscopy; Child; Child, Preschool; Chronic Disease; Conscious Sedation; Cough; Humans; Infant; Infant, Newborn; Intensive Care Units; Lung Transplantation; Respiratory Sounds; Respiratory Tract Diseases
PubMed: 11180692
DOI: 10.1002/1099-0496(200102)31:2<150::aid-ppul1024>3.0.co;2-6