title: [Anesthetic care for fibrobronchoscopy in patients with chronic terminal respiratory insufficiency undergoing evaluation for isolated lung transplantation].
abstract: During the first 18 month operation of the isolated lung transplantation program at or Institution, eight patients with terminal chronic respiratory failure underwent fiberoptic bronchoscopy and broncho-alveolar lavage as part of their evaluation for isolated lung transplantation. Four patients had severe obstructive, three restrictive, and one mixed, obstructive and restrictive, disease; all of them were on continuous supplemental oxygen. Procedures were performed under topical anaesthesia, with either light sedation or simple monitored anaesthesia care. Monitoring included non-invasive blood pressure measurement, pulse oximeter and precordial stethoscope. No adverse events were recorded, except in one case, when pulse oximeter reading precipitously dropped below 80%, to a minimum of 68-69%. The procedures was terminated short of its completion, and the patient was briefly assisted with manual bag ventilation on oxygen 100%. Pulse oximeter quickly returned to normal levels (above 90%), and the patient promptly recovered, without complications. The importance of monitored anaesthesia care during fiberoptic bronchoscopy (a usually benign procedure) in critically ill patients is greatly emphasized.
authors.affiliation: Servizio di Anestesia e Rianimazione, IRCCS Ospedale Maggiore di Milano.
authors.forename: M
authors.initials: M
authors.lastname: Solca
authors.forename: A
authors.initials: A
authors.lastname: Elena
authors.forename: M
authors.initials: M
authors.lastname: Croci
authors.forename: G
authors.initials: G
authors.lastname: Damia
mesh_terms: D000328:Adult; D000758:Anesthesia; D001999:Bronchoscopy / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012131:Respiratory Insufficiency / Q000175:diagnosis* / Q000601:surgery
vernacular_title: Assistenza anestesiologica per fibrobroncoscopia a pazienti insufficienti respiratori cronici terminali in valutazione per trapianto di polmone isolato.