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Bronchoscopy during noninvasive ventilation: indications and technique.
Septimiu D Murgu1, Jocelyn Pecson, Henri G Colt
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California School of Medicine, 101 The City Drive South, Building 53, Room 119, Route 81, Orange, CA 92868, USA. smurgu@uci.edu
Noninvasive ventilation may reduce complications during flexible bronchoscopy in critically ill patients. This approach benefits those with hypoxemia, respiratory distress, emphysema, and specific airway collapse conditions.
Area of Science:
- Pulmonology
- Critical Care Medicine
Background:
- Flexible bronchoscopy is crucial for diagnosing and treating severely ill patients.
- Comorbidities in these patients elevate the risk of bronchoscopy-related complications.
Purpose of the Study:
- To explore the use of noninvasive ventilation (NIV) during flexible bronchoscopy.
- To detail the indications, contraindications, and techniques for performing bronchoscopy with NIV.
Main Methods:
- Review of current literature and clinical guidelines.
- Description of patient populations and conditions where NIV is beneficial during bronchoscopy.
Main Results:
- NIV may mitigate complications in patients with severe hypoxemia, respiratory distress, or emphysema.
- NIV can prevent hypoventilation in obstructive sleep apnea and obesity hypoventilation syndrome.
- NIV aids in evaluating expiratory central-airway collapse.
Conclusions:
- Noninvasive ventilation is a viable adjunct for flexible bronchoscopy in select critically ill patients.
- Careful patient selection and technique are essential for safe and effective bronchoscopy with NIV.
