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Non-invasive mechanical ventilation for diagnostic bronchoscopy using a new face mask: an observational feasibility study.

Heunks LM, de Bruin CJ, van der Hoeven JG, van der Heijden HF - Intensive Care Med (2009)

Bottom Line: A commercially available full face mask was modified to allow introduction of the bronchoscope without interfering with the ventilator circuit.A microbiological diagnosis could be established in 8 of 12 patients with suspected for infection.Our modified face mask for non-invasive positive pressure ventilation is a valuable tool to aid diagnostic bronchoscopy in hypoxemic patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Intensive Care Medicine (551), Radboud University Medical Centre, Postbox 9101, 6500 HB Nijmegen, The Netherlands. L.Heunks@ic.umcn.nl

ABSTRACT

Purpose: Bronchoscopy is an indispensable tool for invasive pulmonary evaluation with high diagnostic yield and low incidence of major complications. However, hypoxemia increases the risk of complications, in particular after bronchoalveolar lavage. Non-invasive positive pressure ventilation may prevent hypoxemia associated with bronchoalveolar lavage. The purpose of this study is to present a modified total face mask to aid bronchoscopy during non-invasive positive pressure ventilation.

Methods: A commercially available full face mask was modified to allow introduction of the bronchoscope without interfering with the ventilator circuit. Bronchoscopy with bronchoalveolar lavage was performed in 12 hypoxemic non-ICU patients during non-invasive positive pressure ventilation in the ICU.

Results: Patients had severely impaired oxygen uptake as indicated by PaO(2)/FiO(2) ratio 192 +/- 23 mmHg before bronchoscopy. Oxygenation improved after initiation of non-invasive positive pressure ventilation. In all patients the procedure could be completed without subsequent complications, although in one patient SpO(2) decreased until 86% during bronchoscopy. A microbiological diagnosis could be established in 8 of 12 patients with suspected for infection.

Conclusions: Our modified face mask for non-invasive positive pressure ventilation is a valuable tool to aid diagnostic bronchoscopy in hypoxemic patients.

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Related in: MedlinePlus

Full face mask modified for the use of bronchoscopy during non-invasive positive pressure ventilation. A synthetic cylinder was secured in the mask. A disposable cap sealed the cylinder and prevented air leakage during bronchoscopy
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Fig1: Full face mask modified for the use of bronchoscopy during non-invasive positive pressure ventilation. A synthetic cylinder was secured in the mask. A disposable cap sealed the cylinder and prevented air leakage during bronchoscopy

Mentions: A commercially available full face mask (Repironics®) was modified by the authors to allow introduction of the bronchoscope without interfering with the ventilator circuit. Accordingly, a plastic cylinder was secured in the mask at a position that allows introduction of bronchoscope through the mouth (Figs. 1, 2). A disposable cap (from a swivel connector) was used to seal the cylinder and prevent air leakage during bronchoscopy.Fig. 1


Non-invasive mechanical ventilation for diagnostic bronchoscopy using a new face mask: an observational feasibility study.

Heunks LM, de Bruin CJ, van der Hoeven JG, van der Heijden HF - Intensive Care Med (2009)

Full face mask modified for the use of bronchoscopy during non-invasive positive pressure ventilation. A synthetic cylinder was secured in the mask. A disposable cap sealed the cylinder and prevented air leakage during bronchoscopy
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2807591&req=5

Fig1: Full face mask modified for the use of bronchoscopy during non-invasive positive pressure ventilation. A synthetic cylinder was secured in the mask. A disposable cap sealed the cylinder and prevented air leakage during bronchoscopy
Mentions: A commercially available full face mask (Repironics®) was modified by the authors to allow introduction of the bronchoscope without interfering with the ventilator circuit. Accordingly, a plastic cylinder was secured in the mask at a position that allows introduction of bronchoscope through the mouth (Figs. 1, 2). A disposable cap (from a swivel connector) was used to seal the cylinder and prevent air leakage during bronchoscopy.Fig. 1

Bottom Line: A commercially available full face mask was modified to allow introduction of the bronchoscope without interfering with the ventilator circuit.A microbiological diagnosis could be established in 8 of 12 patients with suspected for infection.Our modified face mask for non-invasive positive pressure ventilation is a valuable tool to aid diagnostic bronchoscopy in hypoxemic patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Intensive Care Medicine (551), Radboud University Medical Centre, Postbox 9101, 6500 HB Nijmegen, The Netherlands. L.Heunks@ic.umcn.nl

ABSTRACT

Purpose: Bronchoscopy is an indispensable tool for invasive pulmonary evaluation with high diagnostic yield and low incidence of major complications. However, hypoxemia increases the risk of complications, in particular after bronchoalveolar lavage. Non-invasive positive pressure ventilation may prevent hypoxemia associated with bronchoalveolar lavage. The purpose of this study is to present a modified total face mask to aid bronchoscopy during non-invasive positive pressure ventilation.

Methods: A commercially available full face mask was modified to allow introduction of the bronchoscope without interfering with the ventilator circuit. Bronchoscopy with bronchoalveolar lavage was performed in 12 hypoxemic non-ICU patients during non-invasive positive pressure ventilation in the ICU.

Results: Patients had severely impaired oxygen uptake as indicated by PaO(2)/FiO(2) ratio 192 +/- 23 mmHg before bronchoscopy. Oxygenation improved after initiation of non-invasive positive pressure ventilation. In all patients the procedure could be completed without subsequent complications, although in one patient SpO(2) decreased until 86% during bronchoscopy. A microbiological diagnosis could be established in 8 of 12 patients with suspected for infection.

Conclusions: Our modified face mask for non-invasive positive pressure ventilation is a valuable tool to aid diagnostic bronchoscopy in hypoxemic patients.

Show MeSH
Related in: MedlinePlus