Journal of bronchology & interventional pulmonology
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J Bronchology Interv Pulmonol · Oct 2015
A Novel, Adaptable Laryngeal Mask to Facilitate a Percutaneous Dilatational Tracheostomy: Proof-of-Concept Prototype Demonstration on a Mannequin Model and Cadaver.
Most percutaneous dilatational tracheostomy (PDT) mortalities result from airway-related complications. Improved airway pressure management and gas delivery are targets for innovation. This study describes an adaptable laryngeal mask (ALM) designed to remove the bronchoscope from the endotracheal tube (ETT) and place it in a separate lumen. Airflow and device efficacy were evaluated during PDTs with an ALM on mannequins and cadavers, respectively. ⋯ Initial testing using an ALM during PDT on mannequins and cadavers showed an improvement in airflow and the removal of the bronchoscope from the ETT, respectively. Further studies using the ALM in a patient population compared with standard techniques would be useful.
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J Bronchology Interv Pulmonol · Oct 2015
Comparative StudyA Comparison of Techniques for Optimal Performance of Bronchoalveolar Lavage.
Bronchoalveolar lavage (BAL) is a commonly used diagnostic and research tool. Currently, there is limited evidence regarding standardizing this technique. The type of suction method and number of aliquots used as well as the anatomic lung segment sampled are not standardized nor well studied. Our primary aim was to compare the quantity and quality of BAL specimens using 2 suction methods, hand-held syringe versus wall suction. Our secondary aim was to assess which anatomic lung segment yields the greatest BAL results and how many aliquots are required. ⋯ No significant difference was observed between hand-held syringe and wall suction in terms of volumes returned and microbiological or diagnostic yield. Performance of BAL in the right middle lobe is associated with increased return and should be preferentially used when performing a nontargeted BAL in patients with diffuse computed tomography chest changes.
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J Bronchology Interv Pulmonol · Oct 2015
Case ReportsMediastinitis and Bronchial Perforations Due to Mucormycosis.
Diabetes mellitus is the most common predisposing condition for mucormycosis, which is emerging as an important invasive fungal infection worldwide. Isolated mediastinitis is a very rare presentation of mucormycosis. A 57-year-old woman with uncontrolled type 2 diabetes mellitus and ketoacidosis presented with septic shock and was subsequently found to have mucor mediastinitis with multiple bronchial perforations. The organism was identified as Rhizopus oryzae with the help of DNA sequencing.
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J Bronchology Interv Pulmonol · Oct 2015
Endobronchial Ultrasound-guided Transvascular Needle Aspiration: A Single-Center Experience.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is well established for the staging and diagnosis of lung cancer and mediastinal lymphadenopathy. Central mediastinal vascular structures may preclude EBUS-TBNA access to lymph nodes in the aortopulmonary window and certain centrally located parenchymal lesions. Thus, a transvascular approach is necessitated. Few such reports exist in the literature. ⋯ From our single-center experience, we conclude that in experienced hands, EBUS-TVNA is feasible, with a high yield, but without complications. Larger prospective trials are warranted to explore its diagnostic potential.
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J Bronchology Interv Pulmonol · Jul 2015
Observational StudyPleuroscopic Pleurodesis Combined With Tunneled Pleural Catheter for Management of Malignant Pleural Effusion: A Prospective Observational Study.
Malignant pleural effusion (MPE) is associated with poor prognosis and it often impinges upon quality of life; effective and efficient management is desirable. Combining pleuroscopic pleurodesis (PP) with a tunneled pleural catheter (TPC) could minimize hospitalization, effect rapid pleurodesis in most cases, and allow ongoing control of MPE for those not successfully pleurodesed. ⋯ The combination of PP with TPC can effect pleurodesis at a rate similar to CPP, shortens LOS, shortens time to pleurodesis, and helps to control symptoms when pleurodesis fails.