Rigid bronchoscopic intervention in patients with respiratory failure caused by malignant central airway obstruction.
BACKGROUND
Bronchoscopic intervention in patients with malignant central airway obstruction provides initial palliation and stabilization of the airway, allowing the possibility of other effective therapeutic modalities, such as surgery, radiation, or chemotherapy. In critically ill patients, however, the only studies of bronchoscopic intervention are relatively small series.


METHODS
To describe the advantages and limitations of rigid bronchoscopic intervention in critically ill patients, we reviewed the medical records of 36 patients (26 men; median age, 62 years; range, 29 to 76 years) who underwent emergency airway intervention for malignant central airway obstruction.


RESULTS
Dyspnea was relieved in 34 of 36 patients (94.4%). After the airway was widened, additional definitive therapeutic modalities were used for 21 of 34 patients (61.8%). Patients who underwent additional definitive therapy after bronchoscopic intervention survived longer (median, 38.2 months; range 1.7 to 57.0 months) than those who did not (median, 6.2 months; range, 0.1 to 33.7 months; p < 0.001).


CONCLUSIONS
These data show that rigid bronchoscopic intervention in critically ill patients with malignant central airway obstruction may be temporarily life-saving and, in some patients, may serve as a "bridge" to allow time for additional therapies for longer survival.
Jeon
Kyeongman
K
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kim
Hojoong
H
Yu
Chang-Min
CM
Koh
Won-Jung
WJ
Suh
Gee Young
GY
Chung
Man Pyo
MP
Kwon
O Jung
OJ
D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000150:complications*; D001999:Bronchoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000401:mortality / Q000628:therapy*