Perioperative management of massive hemoptysis during flexible bronchoscopy: Case report

Publication date: Available online 8 July 2017 Source:Colombian Journal of Anesthesiology Author(s): Juan Camilo Segura-Salguero, Lorena Díaz-Bohada, Juan Ricardo Lutz-Peña, Adriana Maria Posada, Vivian Ronderos Flexible bronchoscopy is a diagnostic or therapeutic procedure with a low incidence of complications (0.08–6.8%). Bleeding after transbronchial biopsy is a rare complication (0–2.8% of the cases), usually resulting in minor bleeding that resolves with local measures. There is no clear definition of massive hemoptysis and due to the low incidence of this condition, there are no practical guidelines for the treatment of this complication that may be catastrophic. This case discusses the occurrence of massive hemoptysis during a transbronchial biopsy under flexible bronchoscopy, including a literature review on perioperative management.
Source: Colombian Journal of Anesthesiology - Category: Anesthesiology Source Type: research

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AbstractFailure to manage bleeding in the airway is an important cause of airway-related death. The purpose of this narrative review is to identify techniques and strategies that can be employed when severe bleeding in the upper airway may render traditional airway management (e.g., facemask ventilation, intubation via direct/video laryngoscopy, flexible  bronchoscopy) impossible because of impeded vision. An extensive literature search was conducted of bibliographic databases, guidelines, and textbooks using search terms related to airway management and bleeding. We identified techniques that establish a definitive a...
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research
In conclusion, cryobiopsy has great potential to be a breakthrough to improve diagnostic bronchoscopy for PPLs.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
Introduction: ILD transbronchial cryobiopsy (ILD-C) guidelines (Hetzel 2018, Dhooria et al 2019) mention FVC
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
Conclusions: Cryotherapy via flexible bronchoscopy is a safe and feasible method for cap-shaped bronchial foreign body extraction, even in pediatrics.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
Conclusion: The diagnostic accuracy and prevalence of complications obtained by TBCB from this single centre study on unclassified ILD patients equals findings from existing literature. Our findings support TBCB as a valuable alternative to SLB to diagnose ILD in well-selected patients.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
Introduction: PH is common in the sicker subsets of ILD. ILD transbronchial cryobiopsy (ILD-C) guidelines (Hetzel 2018, Dhooria et al 2019) mention PH [echocardiographic pulmonary artery pressure (PASP)> 40mmHg] as a relative contraindication (RC) due to risk of bleeding and worsening hypoxemia. These recommendations are extrapolated from surgical sampling.Aim: We analysed ILD-C high-PH (PASP> 40mmHg) in real world situations, and the role of pre-optimization in facilitating ILD-C in this group, otherwise contraindicated for ILD-C.Methods: Retrospective review of 150 ILD-C procedures, identifying patients with PASP&g...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
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Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
A 40-year-old man was treated with tonsillectomy and underwent early surgical exploration because of bleeding. Postoperative bleeding complications were treated with bronchoscopy. In addition to obesity, normal thyroid function, type 2 diabetes mellitus, and current tobacco abuse with severe obstructive sleep apnea syndrome, biochemistry revealed severe hypercholesterolemia (total cholesterol 572 mg/dL) and hypertriglyceridemia (1,220 mg/dL). During the postoperative period, low doses of propofol (up to 2 mg/kg/h for 10 hours), along with remifentanil (up to 0.0016 mg/kg/h for 20 hours), midazolam, and tramadol, were neede...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
Abstract Failure to manage bleeding in the airway is an important cause of airway-related death. The purpose of this narrative review is to identify techniques and strategies that can be employed when severe bleeding in the upper airway may render traditional airway management (e.g., facemask ventilation, intubation via direct/video laryngoscopy, flexible bronchoscopy) impossible because of impeded vision. An extensive literature search was conducted of bibliographic databases, guidelines, and textbooks using search terms related to airway management and bleeding. We identified techniques that establish a def...
Source: Canadian Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Can J Anaesth Source Type: research
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Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
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