SESSION TYPE: Therapeutic Bronchoscopy
PRESENTED ON: Sunday, October 21, 2012 at 01:15 PM - 02:45 PM
PURPOSE: Interventional bronchoscopy using a rigid bronchoscope requires deep general anesthesia to prevent bucking and body movement during treatment, and the bad part about this technique is the possibility that excessively deep anesthesia could inhibit patient's respiration and result in hypoxia. There is no effective way that has been established to solve these contradicting problems simultaneously. The purpose of this study was to investigate whether the use of Biphasic Cuirass Ventilation (BCV) during interventional bronchoscopy using a rigid bronchoscope can prevent hypoventilation during treatment, thereby providing safer treatment condition.
METHODS: From August, 2010 to February, 2012, 11 patients received interventional bronchoscopy by a rigid bronchoscope with combined use of BCV. The underlying diseases/disorders in these 11 patients included tracheal stenosis secondary to lung cancer in 8 patients, post-intubation tracheal stenosis in 1, rt. bronchial stenosis due to esophageal cancer in 1, and post-tuberculosis bronchial stenosis in 1. BCV was used in all patients, and the number of spontaneous respiration, tidal volume, SpO2, and the frequency of discontinuation of procedure were evaluated.
RESULTS: The treatment procedure could be safely done in all the patients. It was possible to fully maintain minute ventilation during treatment and none of the patients experienced discontinuation of procedure due to hypoxia. Therefore, patients were able to receive sufficient anesthesia, which could lead to reduced bucking during treatment. There was no complication associated with BCV.
CONCLUSIONS: During interventional bronchoscopy using a rigid bronchoscope, the use of BCV enabled the maintenance of minute ventilation during treatment and administration of sufficient anesthesia, suggesting its clinical usefulness.
CLINICAL IMPLICATIONS: This is the first study reporting the use of BCV as a supportive ventilation system during interventional bronchoscopy with a rigid bronchoscope. We report this study because we strongly recommend this technique to be tested especially in medical facilities that have hesitated to use the rigid bronchoscope or those that are anxious about respiratory management during the treatment with the use of rigid bronchoscope.
DISCLOSURE: The following authors have nothing to disclose: Hibiki Kanda
No Product/Research Disclosure InformationNational Hospital Organization Matsue Medical Center, Matsue City, Japan