ArticleCritical care (London, England)2011
Fiber optic bronchoscopy in patients with acute hypoxemic respiratory failure requiring noninvasive ventilation--a feasibility study.
Article in Critical care (London, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 55 citations in OpenAlex.
- High-flow nasal cannula oxygen versus non-invasive ventilation in patients with acute hypoxaemic respiratory failure undergoing flexible bronchoscopy--a prospective randomised trial.Critical care (London, England) · 2014Trial
- IS FLEXIBLE BRONCHOSCOPY A SAFE PROCEDURE FOR CRITICAL CARE PATIENTS WITH RESPIRATORY FAILURE?Acta clinica Croatica · 2023Article
- Oxygenation strategies during flexible bronchoscopy: a review of the literature.Respiratory research · 2021Review
- Clinical Value of Bronchoscopy in Acute Respiratory Failure.Diagnostics (Basel, Switzerland) · 2021Review
- Is ventilated hospital-acquired pneumonia a worse entity than ventilator-associated pneumonia?European respiratory review : an official journal of the European Respiratory Society · 2020Review
- Benefit-to-risk balance of bronchoalveolar lavage in the critically ill. A prospective, multicenter cohort study.Intensive care medicine · 2020Article
- ISCCM Guidelines for the Use of Non-invasive Ventilation in Acute Respiratory Failure in Adult ICUs.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2020Article
- Noninvasive Ventilation-assisted Bronchoscopy in High-risk Hypoxemic Patients.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2019Article
- A prospective randomized comparative study of high-flow nasal cannula oxygen and non-invasive ventilation in hypoxemic patients undergoing diagnostic flexible bronchoscopy.Journal of thoracic disease · 2019Article
- Invasive and non-invasive diagnostic approaches for microbiological diagnosis of hospital-acquired pneumonia.Critical care (London, England) · 2019Article
- Effectiveness and Safety of High-Flow Nasal Cannula Oxygen Delivery during Bronchoalveolar Lavage in Acute Respiratory Failure Patients.Tuberculosis and respiratory diseases · 2018Article
- Can fiberoptic bronchoscopy be applied to critically ill patients treated with noninvasive ventilation for acute respiratory distress syndrome? Prospective observational study.BMC pulmonary medicine · 2016Observational
- Review
- Pathophysiological Basis of Acute Respiratory Failure on Non-Invasive Mechanical Ventilation.The open respiratory medicine journal · 2015Article
- Role of bronchoscopy during non invasive ventilation in hypercapnic respiratory failure.The Egyptian journal of chest diseases and tuberculosis · 2014Article
- Evaluation of early mini-bronchoalveolar lavage in the diagnosis of health care-associated pneumonia: a prospective study.Critical care (London, England) · 2013Article
- The feasibility and safety of fiberoptic bronchoscopy during noninvasive ventilation in patients with established acute lung injury: another small brick in the wall.Critical care (London, England) · 2011Article
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7 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionNoninvasive ventilation (NIV) is a standard procedure in selected patients with acute respiratory failure. Previous studies have used noninvasive ventilation to ensure adequate gas exchange during fiberoptic bronchoscopy in spontaneously breathing hypoxemic patients, thus avoiding endotracheal intubation. However, it is unknown whether bronchoscopy can be performed safely in patients with acute hypoxemic respiratory failure already in need of NIV prior to the decision for bronchoscopy.
methodsWe prospectively investigated 40 consecutive, critically ill, adult patients with acute hypoxemic respiratory failure (14 women, 26 men, age 61 ± 15 years, partial pressure for oxygen/fraction of inspired oxygen (PaO2/FiO2) < 300 under noninvasive ventilation, Simplified Acute Physiology scores (SAPS II) 47 ± 9.9 points). All patients required noninvasive ventilation prior to the decision to perform bronchoscopy (median 10.5 h; range 2.2 to 114). Blood gases, heart rate, blood pressure and ventilation were monitored before, during and up to 120 minutes after bronchoscopy.
resultsBronchoscopy could be completed in all patients without subsequent complications. Oxygen saturation fell to < 90% in two patients (5%), and the lowest value during the procedure was 84%. The mean PaO2/FiO2 ratio improved from 176 ± 54 at baseline to 240 ± 130 (P < 0.001) at the end of bronchoscopy and 210 ± 79 after 120 minutes. The transient mean partial pressure of carbon dioxide in the arterial blood (PaCO2) increase was 9.4 ± 8.1 mm Hg. Four patients (10%) required endotracheal intubation during the first eight hours after the procedure. Bronchoalveolar lavage yielded diagnostic information in 26 of 38 (68%) patients.
conclusionsIn critically ill patients with acute hypoxemic respiratory failure requiring noninvasive ventilation, bronchoscopy can be performed with an acceptable risk. Since these patients per se have a high likelihood of subsequent endotracheal intubation due to failure of NIV, bronchoscopy should only be performed by experienced clinicians.
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