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[Painless fiberoptic bronchoscopy in patients with COVID-19: analysis of 33 cases]
Insights
Painless fiberoptic bronchoscopy is safe and feasible for COVID-19 patients. This procedure, utilizing advanced protective measures, demonstrated no adverse events for patients or staff, ensuring effective respiratory care.
Area of Science:
- Pulmonology
- Infectious Diseases
- Anesthesiology
Background:
- Coronavirus disease 2019 (COVID-19) presents unique challenges for respiratory procedures.
- Fiberoptic bronchoscopy is crucial for diagnosing and managing respiratory conditions.
- Ensuring patient safety and procedural feasibility during bronchoscopy in COVID-19 patients is paramount.
Purpose of the Study:
- To evaluate the necessity, safety, and feasibility of painless fiberoptic bronchoscopy in patients with COVID-19.
- To assess the impact of the procedure on patient vital signs and comfort.
- To monitor the health of medical staff during the procedure.
Main Methods:
- Retrospective analysis of 33 COVID-19 patients undergoing painless fiberoptic bronchoscopy.
- Intravenous anesthesia combined with topical airway anesthesia (lidocaine) was administered.
- Monitoring of vital signs, cough intensity, and adverse reactions; medical staff health surveillance was also conducted.
Main Results:
- Bronchoscopy was successfully completed in all 33 patients (ASA class II-IV).
- A transient decrease in SpO2 was observed but manageable with interventions; 84.85% experienced mild cough.
- No anesthesia-related complications occurred in patients, and no medical staff contracted COVID-19.
Conclusions:
- Painless fiberoptic bronchoscopy is a valuable and safe procedure for COVID-19 patients.
- Implementing third-level protection, including powered air-purifying respirators (PAPR), ensures procedural safety for healthcare workers.
- The study confirms the feasibility of performing bronchoscopies in COVID-19 patients with appropriate safety measures.
Objective:
To investigate the necessity, safety and feasibility of painless fiberoptic bronchoscopy in patients with coronavirus disease 2019 (COVID-19).
Objective:
We retrospectively analyzed the clinical characteristics of 33 patients diagnosed with COVID-19 who received painless fiberoptic bronchoscopy in Wuhan First Hospital. The general demographic and clinical data of the patients including age, gender, and ASA classification were collected. The patients received intravenous anesthesia with topical airway anesthesia with lidocaine. The changes in the vital signs of the patients were recorded before, during and after the procedure. The cough intensity of the patients during bronchoscopy were evaluated, and the adverse reactions within 24 h after the procedure were observed. The health status of the medical staff carrying out the procedure was also monitored.
Objective:
The 33 patients with ASA class Ⅱ to Ⅳ included 19 male and 14 female patients with an average age of 63.58±11.85 years. The lowest SpO2 of the patients during bronchoscopy was (94.8±4.3)%, which was significantly lower than that before the procedure [(99.1±1.3)%, P < 0.05] but was restored to more than 95% after such treatment as holding the jaw to open the airway or face mask positive-pressure ventilation. Bronchoscopy was completed successfully in all the patients, and 28 patients (84.85%) had mild cough during the procedure. None of the patients had obvious complications related to anesthesia. While performing the procedure, all the medical staff used third-level protection and facial protection with powered air-purifying respirators (PAPR), and the patients' face were covered with single-use sterile medical plastic curtains that were originally intended for collecting flushing fluid during arthroscopic procedures. No medical personnel was diagnosed with COVID-19 at the end of the study.
Objective:
For patients with COVID-19, painless techniques can be valuable during bronchoscopy, and this procedure can be safe and feasible under third-level protection.
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