Iatrogenic bleeding during flexible bronchoscopy: risk factors, prophylactic measures and management

Bernasconi, Maurizio; Koegelenberg, Coenraad F.N.; Koutsokera, Angela; Ogna, Adam; Casutt, Alessio; Nicod, Laurent; Lovis, Alban

doi:10.1183/23120541.00084-2016

Cited by 46 publications

(62 citation statements)

References 71 publications

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“…this is slightly higher than that reported in other study. 18 the probable reason for this could be our study included only those patients who underwent eBB. eBB is associated with more incidences of bleeding than when bronchoscopy was performed without it.…”

Section: Discussionmentioning

confidence: 99%

Complications and predictors of diagnostic yield of endobronchial forceps biopsy in visible lesions

et al. 2019

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Background: Fiberoptic bronchoscopy is an important and relatively safe procedure for evaluation of various pulmonary diseases. Endobronchial forceps biopsy is commonly performed sampling technique for visible lesions in tracheobronchial tree. Diagnostic yield of biopsy depends upon lesion type and the number of biopsy samples taken. This study aimed to evaluate the complications and diagnostic yield of endobronchial forceps biopsy in visible lesions and correlate the number of biopsy samples taken with the yield. Methods: This was an observational study conducted at two tertiary care hospitals in Chitwan; Chitwan Medical College Teaching Hospital and B P Koirala Memorial Cancer Hospital. One hundred and forty patients who underwent endobronchial forceps biopsy of bronchoscopically visible lesions were included. Complications and diagnostic yield of the biopsy samples and its correlation with number of biopsies taken were evaluated. Results: The common complications observed were transient drop in saturation > 4% (22%) and mild bleeding (9.9%). The net diagnostic yield was 67.4% that significantly improved with an increase in the number of biopsies taken. The yield was better for exophytic growths compared to submucosal/ mucosal lesions (83.7% vs. 57%, OR = 8.1 (2.2 – 29.9), P<0.001). The association of improved yield with increased number of biopsy was more pronounced in exophytic growths compared to submucosal/mucosal lesions. Conclusion: Endobronchial forceps biopsy is a safe procedure that gives a good diagnostic yield in bronchoscopically visible lesions, provided adequate number of biopsy sample are taken. The probability of getting a positive yield is high in exophytic growths.

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Section: Discussionmentioning

confidence: 99%

Complications and predictors of diagnostic yield of endobronchial forceps biopsy in visible lesions

et al. 2019

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“…15 Iatrogenic hemoptysis occurring from procedures is reported in 0.26% to 5% of diagnostic bronchoscopies; however, massive hemoptysis complicates only a minute fraction of these procedures. 16 Although 20% of patients with lung cancer are estimated to experience hemoptysis at some point in their clinical course, massive hemoptysis affects only 3% of this population. 17,18 Up to 80% of patients with malignancy-related massive hemoptysis present with episodes of sentinel bleeding during the weeks prior to their event.…”

Section: Epidemiology and Prognostic Factorsmentioning

confidence: 99%

Managing Massive Hemoptysis

Davidson

Shojaee

2020

Chest

151

109

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“…36 These drugs have been associated to an increase rate of spontaneous bleeding and should therefore be withheld before performing invasive bronchoscopic interventions according to guidelines, considering and balancing the risk of thrombotic complications. [37][38][39]…”

Section: P Rmentioning

confidence: 99%

Competence in pulmonary endoscopy emergencies

et al. 2019

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in clinical practice, interventional pulmonologists face several situations which can lead to dramatic consequences especially regarding ventilation and require immediate intervention. We describe the main pathological conditions where an urgent bronchoscopy is crucial because they act through mechanisms such as airway obstructions or alteration of the anatomic integrity of the tracheobronchial tree. We point out the problems resulting from inhalation of foreign bodies, one of the most dramatic respiratory emergencies typical in childhood which needs not only the appropriate endoscopic equipment suitable for the age, but also great experience in the management of the possible related complications. massive hemoptysis is then discussed in order to help to choose the right endoscope and to clarify the steps requested to face this dramatic event. Lastly, iatrogenic tracheal injuries are described, in spite of their low occurrence. The correct endoscopic assessment of the lesions enables to select the proper multidisciplinary therapeutic approach together with surgeons and anesthetists. due to their peculiarities, emergencies do not allow classic training so it is difficult to estimate the procedure volume necessary to achieve an adequate endoscopic experience. We think, in this field, it is advisable to refer to numbers proposed for elections endoscopic procedures. For these reasons, we consider desirable the use of simulators and clinic case discussions during interventional pulmonologist's training.

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Iatrogenic bleeding during flexible bronchoscopy: risk factors, prophylactic measures and management

Cited by 46 publications

References 71 publications

Complications and predictors of diagnostic yield of endobronchial forceps biopsy in visible lesions

Complications and predictors of diagnostic yield of endobronchial forceps biopsy in visible lesions

Managing Massive Hemoptysis

Competence in pulmonary endoscopy emergencies

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