Bronchoscopy during noninvasive ventilation: indications and technique.
Diagnostic or therapeutic flexible bronchoscopy is often necessary in severely ill patients. These patients often have comorbidities that increase the risk of bronchoscopy-related complications. Noninvasive ventilation might decrease the risk of these complications in patients with severe refractory hypoxemia, postoperative respiratory distress, or severe emphysema, and in pediatric patients. Noninvasive ventilation may prevent hypoventilation in patients with obstructive sleep apnea and obesity hypoventilation syndrome who require bronchoscopy, and may assist in the bronchoscopic evaluation of patients with expiratory central-airway collapse. We describe the indications, contraindications, and technique of flexible bronchoscopy during noninvasive ventilation.
Murgu
Septimiu D
SD
Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California School of Medicine, 101 The City Drive South, Building 53, Room 119, Route 81, Orange, CA 92868, USA. smurgu@uci.edu
Pecson
Jocelyn
J
Colt
Henri G
HG
D020680:Bronchoscopes / Q000592:standards*; D001999:Bronchoscopy / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D011175:Positive-Pressure Respiration / Q000295:instrumentation*; D012131:Respiratory Insufficiency / Q000175:diagnosis* / Q000628:therapy