Journal of bronchology & interventional pulmonology
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J Bronchology Interv Pulmonol · Oct 2012
Review Comparative StudyNavigational bronchoscopy with biopsy versus computed tomography-guided biopsy for the diagnosis of a solitary pulmonary nodule: a cost-consequences analysis.
Solitary pulmonary nodules (SPNs) are frequent and can be malignant. Both computed tomography-guided biopsy and electromagnetic navigational bronchoscopy (ENB) with biopsy can be used to diagnose a SPN. A nondiagnostic computed tomography (CT)-guided or ENB biopsy is often followed by video-assisted thoracoscopic surgery (VATS) biopsy. The relative costs and consequences of these strategies are not known. ⋯ An ENB with biopsy strategy is associated with decreased pneumothorax rate but increased costs and increased use of VATS. Combining CT-guided biopsy and ENB with biopsy serially can decrease costs and complications.
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J Bronchology Interv Pulmonol · Oct 2012
Case ReportsCritical airway management: a suggested modification to the rigid fiber-optic stylet based on 301 novice intubations.
Emergent airways in critically ill patients outside the operating room (critical airways) are often difficult airways frequently managed by intensivists. Current advanced airway management tools have not been adequately evaluated for critical airways and are not specifically designed for intensivists. The rigid fiber-optic stylet has the potential to fill this niche as it is an established difficult intubation technique very similar to bronchoscopy. The purpose of this study was to evaluate the rigid fiber-optic stylet and identify characteristics that would affect its use for critical airway management by intensivists. ⋯ A multilumen sheath designed with 2 working channels has the potential to overcome all identified barriers to the use of rigid fiber-optic stylet as a critical airway management device by intensivists. This modification should be evaluated in a clinical study.
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J Bronchology Interv Pulmonol · Oct 2012
Effect of routine clopidogrel use on bleeding complications after ultrasound-guided thoracentesis.
Thoracentesis is one of the most commonly performed medical procedures with an excellent safety profile. Clopidogrel (a compound that inhibits adenosine diphosphate-induced platelet aggregation) is often prescribed for primary or secondary prevention of cardiovascular disease and has been associated with bleeding complications in patients undergoing surgical procedures. The purpose of this study was to assess the safety of ultrasound (US)-guided thoracentesis in patients receiving clopidogrel therapy. ⋯ Patients who are receiving clopidogrel and present with symptomatic pleural effusion can safely undergo US-guided thoracentesis without interrupting clopidogrel before the procedure. Larger studies are required to confirm these results.
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J Bronchology Interv Pulmonol · Oct 2012
Case ReportsLung cancer in "true tracheal bronchus": a rare coincidence.
Tracheal bronchus is a rare congenital anomaly (incidence ranging from 0.1% to 2%) of bronchial tree in which an aberrant bronchus originates in trachea anywhere above carina, but usually within 2 cm of carina. Cancer within the bronchial anomaly is further uncommon. ⋯ We present a case of true tracheal bronchus with malignancy of the affected RUL. To the best of our knowledge, in world literature, this is the second case of true tracheal bronchus affected by lung cancer.
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J Bronchology Interv Pulmonol · Oct 2012
Case ReportsAspiration of capsule endoscope and successful bronchoscopic extraction.
Capsule endoscopy is a novel tool for the diagnosis of small intestinal disorders. Recently, a new complication of the procedure in the form of the capsule's aspiration into the lungs has been reported. The aspiration of capsule endoscope can lead to a variety of complications including respiratory failure. A low threshold to suspect this complication and urgent bronchoscopic extraction in appropriate patients can prevent serious sequelae.