Adult and paediatric size bronchoscopes for bronchoalveolar lavage in mechanically ventilated patients: yield and side effects.

Abstract

Background -Bronchoalveolar lavage is considered a safe procedure. When performed in the mechanically ventilated patient, however, potentially harmful effects

Combined bronchoalveolar lavage and transbronchial lung biopsy: safety and yield in ventilated patients

“…The results showed moderate but not significant reductions in Pa,O 2 . Several studies have evaluated oxygenation parameters in mechanically ventilated patients after BAL [17][18][19][20][21][22][23]. However, results are conflicting, as some authors reported a significant decrease in oxygenation, while others noted no such effects when different ventilator settings were adapted and FI,O 2 was increased during the bronchoscopy.…”

Changes in pulmonary mechanics after fiberoptic bronchoalveolar lavage in mechanically ventilated patients

“…However, these problems occur if the bronchoscope reduces the diameter of the endotracheal tube by more than 50 % [27]. We employed pressure controlled ventilation to maintain opening pressures and avoid alveolar collapse during the procedure.…”

Effects of Fiberoptic Bronchoscopy During Mechanical Ventilation in a Lung Model

“…[1][2][3][4] Many retrospective studies have been done examining the adverse effects and complications of bronchoscopy during the procedure, almost all focusing directly on alterations in arterial blood gas values and hemodynamics, occurring secondary to BAL and transbronchial biopsy procedures. [5][6][7][8][9][10][11][12][13][14][15] Tension pneumothorax and death have been reported as complications of bronchoscopy in patients receiving mechanical ventilation. 1,8,14 Ricou et al 5 compared BAL results, tidal volume (Vt) reduction, and intratracheal pressure changes in a group of 20 adult patients receiving mechanical ventilation, in whom paired bronchoscopies were performed using an adult (5.9-mm outside diameter [OD]) vs a pediatric (3.4-mm OD) bronchoscope.…”

“…[5][6][7][8][9][10][11][12][13][14][15] Tension pneumothorax and death have been reported as complications of bronchoscopy in patients receiving mechanical ventilation. 1,8,14 Ricou et al 5 compared BAL results, tidal volume (Vt) reduction, and intratracheal pressure changes in a group of 20 adult patients receiving mechanical ventilation, in whom paired bronchoscopies were performed using an adult (5.9-mm outside diameter [OD]) vs a pediatric (3.4-mm OD) bronchoscope. BAL recovery compared favorably between the two bronchoscopes, Vt was reduced 46% with the adult bronchoscope and 38% with the pediatric bronchoscope, while intratracheal pressure increased 16% with the adult bronchoscope vs 0% with the pediatric bronchoscope.…”