Preparation of the Patient for Awake Flexible Fiberoptic Bronchoscopy

Reed, Allan P.

doi:10.1378/chest.101.1.244

Cited by 68 publications

(22 citation statements)

References 46 publications

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“…Local anaesthesia and sedation were achieved using topical lidocaine spray and intravenous midazolam, respectively, in accordance with standard recommendations [19,20]. Nodes with a shortaxis diameter of o5 mm [21] that were detected during the procedure were sampled under direct ultrasound visualisation with a 21-gauge cytology needle specially designed for EBUS-TBNA (NA2015X-4022; Olympus Optical Co).…”

Section: Methodsmentioning

confidence: 99%

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Endobronchial ultrasound-guided transbronchial needle aspiration for identifying EGFR mutations

García-Olivé¹,

Monsó²,

Andreo³

et al. 2009

Eur Respir J

121

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The presence of somatic mutations of the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) gene in patients with advanced nonsmall cell lung cancer (NSCLC) correlates with a good response to tyrosine kinase inhibitors. The usefulness of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the detection of EGFR mutations in cells recovered from malignant mediastinal nodes in patients with NSCLC was assessed.All patients with lung adenocarcinoma or unspecified NSCLC referred for staging with EBUS-TBNA were included. Nodes with a short-axis diameter of .5 mm were sampled, and genomic DNA from metastatic tumour cells was obtained for analysis of exons 19 and 21. The impact of sampling on management was assessed.EGFR gene analysis of the EBUS-TBNA sample was feasible in 26 (72.2%) out of the 36 patients with lymph node metastasis. Somatic mutations of the EGFR gene were detected in tissue obtained through EBUS-TBNA in two (10%) out of 20 patients with metastasic lung adenocarcinoma.Malignant tissue samples obtained by EBUS-TBNA from patients with nodal metastasis of NSCLC are suitable for the detection of EGFR mutations in most cases, and this technique demonstrates mutated neoplastic cells in a tenth of patients with adenocarcinoma.

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Section: Methodsmentioning

confidence: 99%

“…Fresh specimens were extended over an appropriate slide, fixed in 96% ethanol and stained with Harris' haematoxylin for 1 min. 2) A first round of PCR amplification for each EGFR exon [19,21].…”

Section: Laboratory Methodsmentioning

confidence: 99%

Endobronchial ultrasound-guided transbronchial needle aspiration for identifying EGFR mutations

García-Olivé¹,

Monsó²,

Andreo³

et al. 2009

Eur Respir J

121

View full text Add to dashboard Cite

show abstract

“…Bronchoscopy was performed under local anesthesia and sedation, using a flexible videobronchoscope (BF180; Olympus Optical Co., Tokyo, Japan). Local anesthesia and sedation were achieved using topical lidocaine spray and intravenous midazolam, respectively, in accordance with standard recommendations (5,35). A bronchoalveolar lavage, a bronchial mucosa biopsy specimen, and a bronchial aspirate were collected through the working channel of the bronchoscope during the procedure.…”

Section: Design and Participantsmentioning

confidence: 99%

Microbiome Diversity in the Bronchial Tracts of Patients with Chronic Obstructive Pulmonary Disease

Cabrera‐Rubio¹,

et al. 2012

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i Culture of bacteria from bronchial secretions in respiratory patients has low sensitivity and does not allow for complete assessment of microbial diversity across different bronchial compartments. In addition, a significant number of clinical studies are based on sputum samples, and it is not known to what extent they describe the real diversity of the mucosa. In order to identify previously unrecognized lower airway bacteria and to investigate the complexity and distribution of microbiota in patients with chronic obstructive pulmonary disease (COPD), we performed PCR amplification and pyrosequencing of the 16S rRNA gene in patients not showing signs or symptoms of infection. Four types of respiratory samples (sputum, bronchial aspirate, bronchoalveolar lavage, and bronchial mucosa) were taken from each individual, obtaining on average >1,000 16S rRNA sequences per sample. The total number of genera per patient was >100, showing a high diversity, with Streptococcus, Prevotella, Moraxella, Haemophilus, Acinetobacter, Fusobacterium, and Neisseria being the most commonly identified. Sputum samples showed significantly lower diversity than the other three sample types. Lower-bronchial-tree samples, i.e., bronchoalveolar lavage and bronchial mucosa, showed a very similar bacterial compositions in contrast to sputum and bronchial aspirate samples. Thus, sputum and bronchial aspirate samples are upper bronchial tree samples that are not representative of the lower bronchial mucosa flora, and bronchoalveolar lavage samples showed the results closest to those for the bronchial mucosa. Our data confirm that the bronchial tree is not sterile in COPD patients and support the existence a different microbiota in the upper and lower compartments.

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“…Although FB can be carried out without sedation [14,15], a sedative is often given [16][17][18] since it enables the patient to stay calm and breath without difficulty even while the bronchoscope is in the airways. The drugs used are propofol, midazolam and fentanyl [19]; propofol is the drug of choice, although there are no randomised studies [12].…”

Section: Pre-medication and Sedationmentioning

confidence: 99%

Lung Transplantation and Endoscopic Issues

Callegari

Fracchia

2015

Monaldi Arch Chest Dis

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In the last 20 years lung transplantation has become a therapeutic reality for many end-stage parenchymal and vascular lung diseases; despite the difficulty in finding donors, the results are currently satisfactory [1][2][3].Infections, lung rejection and airway complications are the major causes of morbidity and mortality in patients who undergo lung or heartlung transplantation (LT) [4,5]. The usefulness of transbronchial lung biopsy (TLB) was reported for the first time in 1988 [6]. Since then TLB has become a routine practice in the management of patients who have undergone LT and still remains the "gold standard" for the diagnosis of rejection of a transplanted lung [7][8][9][10][11] Bronchoscopy with a flexible fibre-optic bronchoscope (FB), together with bronchoalveolar lavage (BAL) and TLB, have contributed significantly to the success of LT, being able to identify rejection and infections (bacterial, fungal, viral, protozoan)

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Preparation of the Patient for Awake Flexible Fiberoptic Bronchoscopy

Cited by 68 publications

References 46 publications

Endobronchial ultrasound-guided transbronchial needle aspiration for identifying EGFR mutations

Endobronchial ultrasound-guided transbronchial needle aspiration for identifying EGFR mutations

Microbiome Diversity in the Bronchial Tracts of Patients with Chronic Obstructive Pulmonary Disease

Lung Transplantation and Endoscopic Issues

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