title: Difficult airway intubation with flexible bronchoscope.
abstract: OBJECTIVE
  To describe the efficacy and safety of a flexible bronchoscopy intubation (FBI) protocol in patients with difficult airway.
  
  
  METHODS
  We reviewed the medical records of patients diagnosed with difficult airway who underwent flexible bronchoscopy intubation under spontaneous ventilation and sedation with midazolam and fentanyl from March 2009 to December 2010.
  
  
  RESULTS
  The study enrolled 102 patients, 69 (67.7%) men and 33 (32.3%) women, with a mean age of 44 years. FBI was performed in 59 patients (57.8%) with expected difficult airway in the operating room, in 39 patients (38.2%) in the Intensive Care Unit (ICU), and in 4 patients (3.9%) in the emergency room. Cough, decrease in transient oxygen saturation, and difficult progression of the cannula through the larynx were the main complications, but these factors did not prevent intubation.
  
  
  CONCLUSIONS
  FBI according to the conscious sedation protocol with midazolam and fentanyl is effective and safe in the management of patients with difficult airway.
authors.affiliation: MD, Assistant Physician, Division of Respiratory Endoscopy, Hospital das Clínicas, Universidade de São Paulo, SP, Brazil. Electronic address: ascedio@gmail.com.
authors.forename: Ascedio Jose
authors.initials: AJ
authors.lastname: Rodrigues
authors.affiliation: MD, Assistant Physician, Division of Respiratory Endoscopy, Hospital das Clínicas, Universidade de São Paulo, SP, Brazil.
authors.forename: Paulo Rogério
authors.initials: PR
authors.lastname: Scordamaglio
authors.affiliation: MD, Assistant Physician, Division of Respiratory Endoscopy, Hospital das Clínicas, Universidade de São Paulo, SP, Brazil.
authors.forename: Addy Mejia
authors.initials: AM
authors.lastname: Palomino
authors.affiliation: MD, Assistant Physician, Division of Respiratory Endoscopy, Hospital das Clínicas, Universidade de São Paulo, SP, Brazil.
authors.forename: Eduardo Quintino de
authors.initials: EQ
authors.lastname: Oliveira
authors.affiliation: MD, Assistant Physician, Division of Respiratory Endoscopy, Hospital das Clínicas, Universidade de São Paulo, SP, Brazil.
authors.forename: Marcia
authors.initials: M
authors.lastname: Jacomelli
authors.affiliation: MD; Technical Director, Division of Respiratory Endoscopy, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil.
authors.forename: Viviane Rossi
authors.initials: VR
authors.lastname: Figueiredo
mesh_terms: D000328:Adult; D020680:Bronchoscopes; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D010100:Oxygen / Q000097:blood
chemical_list: D010100:Oxygen
keywords: Airway Management; Bronchoscopy; Deep Sedation; Intubation Intratracheal