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Non-invasive mechanical ventilation for diagnostic bronchoscopy using a new face mask: an observational feasibility study

PURPOSE: Bronchoscopy is an indispensable tool for invasive pulmonary evaluation with high diagnostic yield and low incidence of major complications. However, hypoxemia increases the risk of complications, in particular after bronchoalveolar lavage. Non-invasive positive pressure ventilation may pre...

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Autores principales: Heunks, Leo M. A., de Bruin, Charlotte J. R., van der Hoeven, Johannes G., van der Heijden, Henricus F. M.
Formato: Texto
Lenguaje:English
Publicado: Springer-Verlag 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2807591/
https://www.ncbi.nlm.nih.gov/pubmed/19774365
http://dx.doi.org/10.1007/s00134-009-1662-6
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author Heunks, Leo M. A.
de Bruin, Charlotte J. R.
van der Hoeven, Johannes G.
van der Heijden, Henricus F. M.
author_facet Heunks, Leo M. A.
de Bruin, Charlotte J. R.
van der Hoeven, Johannes G.
van der Heijden, Henricus F. M.
author_sort Heunks, Leo M. A.
collection PubMed
description PURPOSE: Bronchoscopy is an indispensable tool for invasive pulmonary evaluation with high diagnostic yield and low incidence of major complications. However, hypoxemia increases the risk of complications, in particular after bronchoalveolar lavage. Non-invasive positive pressure ventilation may prevent hypoxemia associated with bronchoalveolar lavage. The purpose of this study is to present a modified total face mask to aid bronchoscopy during non-invasive positive pressure ventilation. METHODS: A commercially available full face mask was modified to allow introduction of the bronchoscope without interfering with the ventilator circuit. Bronchoscopy with bronchoalveolar lavage was performed in 12 hypoxemic non-ICU patients during non-invasive positive pressure ventilation in the ICU. RESULTS: Patients had severely impaired oxygen uptake as indicated by PaO(2)/FiO(2) ratio 192  ± 23 mmHg before bronchoscopy. Oxygenation improved after initiation of non-invasive positive pressure ventilation. In all patients the procedure could be completed without subsequent complications, although in one patient SpO(2) decreased until 86% during bronchoscopy. A microbiological diagnosis could be established in 8 of 12 patients with suspected for infection. CONCLUSIONS: Our modified face mask for non-invasive positive pressure ventilation is a valuable tool to aid diagnostic bronchoscopy in hypoxemic patients.
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spelling pubmed-28075912010-01-22 Non-invasive mechanical ventilation for diagnostic bronchoscopy using a new face mask: an observational feasibility study Heunks, Leo M. A. de Bruin, Charlotte J. R. van der Hoeven, Johannes G. van der Heijden, Henricus F. M. Intensive Care Med Brief Report PURPOSE: Bronchoscopy is an indispensable tool for invasive pulmonary evaluation with high diagnostic yield and low incidence of major complications. However, hypoxemia increases the risk of complications, in particular after bronchoalveolar lavage. Non-invasive positive pressure ventilation may prevent hypoxemia associated with bronchoalveolar lavage. The purpose of this study is to present a modified total face mask to aid bronchoscopy during non-invasive positive pressure ventilation. METHODS: A commercially available full face mask was modified to allow introduction of the bronchoscope without interfering with the ventilator circuit. Bronchoscopy with bronchoalveolar lavage was performed in 12 hypoxemic non-ICU patients during non-invasive positive pressure ventilation in the ICU. RESULTS: Patients had severely impaired oxygen uptake as indicated by PaO(2)/FiO(2) ratio 192  ± 23 mmHg before bronchoscopy. Oxygenation improved after initiation of non-invasive positive pressure ventilation. In all patients the procedure could be completed without subsequent complications, although in one patient SpO(2) decreased until 86% during bronchoscopy. A microbiological diagnosis could be established in 8 of 12 patients with suspected for infection. CONCLUSIONS: Our modified face mask for non-invasive positive pressure ventilation is a valuable tool to aid diagnostic bronchoscopy in hypoxemic patients. Springer-Verlag 2009-09-23 2010 /pmc/articles/PMC2807591/ /pubmed/19774365 http://dx.doi.org/10.1007/s00134-009-1662-6 Text en © The Author(s) 2009 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Brief Report
Heunks, Leo M. A.
de Bruin, Charlotte J. R.
van der Hoeven, Johannes G.
van der Heijden, Henricus F. M.
Non-invasive mechanical ventilation for diagnostic bronchoscopy using a new face mask: an observational feasibility study
title Non-invasive mechanical ventilation for diagnostic bronchoscopy using a new face mask: an observational feasibility study
title_full Non-invasive mechanical ventilation for diagnostic bronchoscopy using a new face mask: an observational feasibility study
title_fullStr Non-invasive mechanical ventilation for diagnostic bronchoscopy using a new face mask: an observational feasibility study
title_full_unstemmed Non-invasive mechanical ventilation for diagnostic bronchoscopy using a new face mask: an observational feasibility study
title_short Non-invasive mechanical ventilation for diagnostic bronchoscopy using a new face mask: an observational feasibility study
title_sort non-invasive mechanical ventilation for diagnostic bronchoscopy using a new face mask: an observational feasibility study
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2807591/
https://www.ncbi.nlm.nih.gov/pubmed/19774365
http://dx.doi.org/10.1007/s00134-009-1662-6
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