title: Fiber-optic bronchoscopy and volume-cycled mouthpiece ventilation for a patient with multiple sclerosis and ventilatory failure.
abstract: Fiber-optic bronchoscopy supported by continuous or bilevel positive airway pressure has helped patients with hypoxemic or hypercapnic respiratory failure avoid respiratory complications. The authors describe a case of a 57-yr-old man with multiple sclerosis with a vital capacity of 250 ml (5% of predicted normal) who was using continuous noninvasive intermittent positive pressure ventilatory support when he underwent bronchoscopy while receiving continuous noninvasive intermittent positive pressure ventilatory support via a 15-mm angled mouthpiece interface. He was switched from a nasal to a 15-mm angled mouthpiece interface for continuous noninvasive intermittent positive pressure ventilatory support for the procedure. Simple mouthpieces may be useful alternatives to other facial interfaces for ventilatory support during bronchoscopy because of patient comfort and operator convenience.
authors.affiliation: From the Firestone Institute for Respiratory Health, Department of Medicine, McMaster University, Hamilton, Ontario, Canada (GY); and Department of Physical Medicine and Rehabilitation (JRB, LS); Department of Neurosciences (JRB, LS); and Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine (AB), Rutgers-New Jersey Medical School, University Hospital, Newark, NJ.
authors.forename: George
authors.initials: G
authors.lastname: Yuan
authors.forename: John Robert
authors.initials: JR
authors.lastname: Bach
authors.forename: Lou
authors.initials: L
authors.lastname: Saporito
authors.forename: Andrew
authors.initials: A
authors.lastname: Berman
mesh_terms: D001999:Bronchoscopy / Q000379:methods*; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation*; D005336:Fiber Optic Technology; D006801:Humans; D007384:Intermittent Positive-Pressure Breathing / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D063087:Noninvasive Ventilation / Q000295:instrumentation; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*