Journal of bronchology & interventional pulmonology
-
J Bronchology Interv Pulmonol · Jan 2012
Diagnosis of lung nodules with peripheral/radial endobronchial ultrasound-guided transbronchial biopsy.
: Pulmonary nodules are frequently encountered in clinical practice, but diagnostic sensitivity of traditional bronchoscopy remains less than desirable. Transbronchial biopsy (TBBX) under fluoroscopic guidance with flexible bronchoscopy has a sensitivity of 34% for lesions <20 mm and 63% for lesions >20 mm. Navigational technologies such as electromagnetic navigation bronchoscopy have increased the yields of TBBX to approximately 73%. We examine the sensitivity and factors that may impact the diagnostic yield of a similar technology, namely, radial endobronchial ultrasound (EBUS). ⋯ : Lesion size, distance, presence of a computerized tomography bronchus sign, or lobar location may not impact the diagnostic yield of bronchoscopic biopsy of peripheral lung nodules with radial EBUS navigation.
-
J Bronchology Interv Pulmonol · Oct 2011
A new endotracheal tube designed to enable a single operator to perform percutaneous dilatational tracheostomy while maintaining the airway, providing continuous bronchoscopic guidance, and minimizing procedural complications: demonstration of feasibility on a mannequin and a cadaver.
: We designed a double-lumen endotracheal tube (the EZ [Easy] Tracheostomy [EZT]) to enable a single operator to safely perform percutaneous dilatational tracheostomy (PDT) at the bedside while providing continuous bronchoscopic guidance. The EZT design also aims to ensure uninterrupted mechanical ventilation during most of the PDT procedure via a secure airway. It aims to significantly minimize hypoxia, hypoventilation, auto-positive end-expiratory pressure, airway loss, posterior wall laceration, and damage to the endoscope related to the current methodology. ⋯ : It is feasible for a single operator to perform PDT with continuous bronchoscopic guidance when using the EZT on cadaver and mannequin models. Clinical studies are warranted to evaluate this new tool.
-
J Bronchology Interv Pulmonol · Oct 2011
Randomized Study of 21-gauge Versus 22-gauge Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Needles for Sampling Histology Specimens.
: Histologic specimens obtained by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) often provide valuable information for diagnosis or management decisions; however, little has been reported about the sampling yield. Besides the conventional 22-gauge needle, a 21-gauge needle is now available for this procedure. The purpose of this study was to elucidate and compare the respective histologic specimen retrieval yields of EBUS-TBNA using 21-gauge and 22-gauge needles. ⋯ : Histologic specimens can be obtained with a high sampling yield using either of the needles. Our study found no difference in the sampling yield between the 2 needles.
-
J Bronchology Interv Pulmonol · Jul 2011
Severe acute fibrinous and organizing pneumonia causing acute respiratory distress syndrome and shock.
Acute fibrinous and organizing pneumonia (AFOP) is a newly recognized form of diffuse lung injury. The histologic pattern is described as a variant of cryptogenic organizing pneumonia. AFOP is a very rare finding in a human immunodeficiency virus-infected patient. ⋯ He had clinical and radiologic improvement with a course of systemic corticosteroids. This case illustrates that interstitial lung diseases, specifically AFOP, should be included in the differential diagnosis of diffuse lung diseases in patients with respiratory failure with or without shock. Flexible bronchoscopy aids in establishing the diagnosis.