Pulmonary Procedures |

A Comparison of Approaches With the EBUS Scope: Airway Versus Esophageal FREE TO VIEW

Nikhil Meena, MD; Thaddeus Bartter, MD
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UAMS, Little Rock, AR

Chest. 2013;144(4_MeetingAbstracts):800A. doi:10.1378/chest.1704377
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SESSION TITLE: Bronchoscopy and Interventional Procedures Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Endobronchial ultrasound (EBUS) plays a vital role in the diagnosis of hilar and mediastinal abnormalities. The full potential of the EBUS scope has yet to be realized. When this bronchoscope is used in the esophagus (EUS-B), the EBUS scope gives access to areas inaccessible via the bronchial tree. We use the EBUS scope for EBUS and EUS-B, and sought whether there was a difference between the two in post-procedural recovery.

METHODS: Database review of patients undergoing either EBUS or EUS-B between October 2012 and March 2013.

RESULTS: Out of a total of 150 procedures, there were 73 combined procedures, 38 EBUS alone and 29 EUS-B alone. Number of stations sampled was 2.0 ± 0.12 for EBUS and 1.4 ± 0.3 for EUS-B. Maximal procedural oxygen liter flow was 6.3 ± 0.26 for EBUS and 4.5 ± 0.56 for EUS-B. Average sedation for EBUS was 4.97 ± 1.2 of versed and 103.94 ± 0.94 of fentanyl. For EUS-B it was 2.8 ± 0.5 of versed and 64.22± 1.3 of fentanyl. After the procedure it took 22.5± 0.38 minutes for the EBUS patients to wean off oxygen while it took the EUS-B group 17.5 ± 0.45 minutes. The EBUS group met respiratory discharge criteria at 53.21 ± 7.56 minutes and the EUS-B group met discharge criteria at 39.96 ± 3.59 minutes.

CONCLUSIONS: In addition to giving access to adenopathy and masses not accessible via the bronchial tree, EUS-B appears to require less sedation and oxygen support during the procedure and to have shorter recovery times.

CLINICAL IMPLICATIONS: Pulmonologist may be able to perform EUS-B more safely than EBUS. This would apply particularly to patients with limited respiratory reserve. We propose that the esophageal approach is superior for lesions equally accessible by both EBUS and EUS-B.

DISCLOSURE: The following authors have nothing to disclose: Nikhil Meena, Thaddeus Bartter

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