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Updated: May 1, 2026

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
Fiber-optic bronchoscopy and volume-cycled mouthpiece ventilation for a patient with multiple sclerosis and
George Yuan1, John Robert Bach, Lou Saporito
1From the Firestone Institute for Respiratory Health, Department of Medicine, McMaster University, Hamilton, Ontario, Canada (GY); and Department of Physical Medicine and Rehabilitation (JRB, LS); Department of Neurosciences (JRB, LS); and Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine (AB), Rutgers-New Jersey Medical School, University Hospital, Newark, NJ.
Abstract:
Fiber-optic bronchoscopy supported by continuous or bilevel positive airway pressure has helped patients with hypoxemic or hypercapnic respiratory failure avoid respiratory complications. The authors describe a case of a 57-yr-old man with multiple sclerosis with a vital capacity of 250 ml (5% of predicted normal) who was using continuous noninvasive intermittent positive pressure ventilatory support when he underwent bronchoscopy while receiving continuous noninvasive intermittent positive pressure ventilatory support via a 15-mm angled mouthpiece interface. He was switched from a nasal to a 15-mm angled mouthpiece interface for continuous noninvasive intermittent positive pressure ventilatory support for the procedure. Simple mouthpieces may be useful alternatives to other facial interfaces for ventilatory support during bronchoscopy because of patient comfort and operator convenience.
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