M.L. SHTEYNER^1,2, Yu.I. BIKTAGIROV¹, A.V. ZHESTKOV¹, E.A. KORYMASOV¹, E.P. KRIVOSHCHEKOV¹

 ¹ Samara State Medical University of the Ministry of Health of the Russian Federation, 89 Chapaevskaya Str., Samara, Russian Federation 443099

 ²Samara City Hospital No. 4, 125 Mivherina Str., Samara, Russian Federation 443056

 Contact details:

 Shteyner M.L. — D. Med. Sc., Assistant Professor of the Department of Surgery with the course of endoscopy of the Institute for Professional Education, Endoscopist, tel. (+7846) 260-33-6, e-mail: [email protected]

Biktagirov Yu.I. — Cand. Med. Sc., Assistant Professor of the Department of Surgery of the Institute for Professional Education, Head of the course of endoscopy, tel. (+7846) 260-33-6, e-mail: [email protected]

Zhestkov A.V. — D. Med. Sc., Professor, Head of the Department of General and Clinical Microbiology, Immunology and Allergology, tel. (+7846) 260-33-6, e-mail: [email protected]

Korymasov E.A. — D. Med. Sc., Head of the Department of Surgery of the Institute of Professional Education, tel. (+7846) 260-33-6, e-mail: [email protected]

Krivoshchekov E.P. — D. Med. Sc., Professor of the Department of Surgery of Vocational Education, tel. (+7846) 260-33-6, e-mail: [email protected]

Received: December 1, 2017, accepted for printing: April 13, 2018

 Seven cases of foreign bodies removal from the tracheobronchial tree in patients with severe respiratory failure in the setting of chronic obstructive pulmonary disease were studied. In this case, transnasal bronchoscopy was combined with retrograde oral excretion of mobilized foreign bodies. This method allowed minimizing the time of bronchoscopy, avoiding additional irritation of the reflexogenic zone of the root of the tongue, reducing the dose of local anesthetics. At the same time, the proposed method requires a lot of personnel experience, complicates the use of a number of options for the respiratory protection of bronchoscopy, and applies significant requirements to the quality of the forcepts. The method can’t be recommended to be used in routine practice, but it can be considered as a possible alternative to traditional bronchoscopy in patients with severe respiratory failure.

 Key words: bronchoscopy, foreign bodies in the tracheobronchial tree, oral insertion of a bronchoscope, transnasal insertion of a bronchoscope, acute respiratory failure.

(For citing: Shteyner M.L., Biktagirov Yu.I., Zhestkov A.V., Korymasov E.A., Krivoshchekov E.P. An approach to the removal of foreign bodies from the tracheobronchial tree in patients with acute respiratory failure. Practical medicine. 2018)

REFERENCES

1. Shteyner M.L., Biktagirov Yu.I., Korymasov E.A., Krivoshchekov E.P., Zhestkov A.V., Protasov A.D. Foreign bodies of the tracheobronchial tree: problems of adult practice. Prakticheskaya meditsina, 2017, no. 4 (105), pp. 91–96 (in Russ.).
2. Lemoine J.M. Endoscopische Befunde der wesentlichen bronchopulmonalen Krankhei-ten. Internist, 1971, Bd.12, pp. 430–436.
3. Ovchinnikov A.A. Tracheobronchoscopy: history and progress. Atmosfera: pulmo-nologiya i allergologiya, 2005, no. 1, pp. 18-22 (in Russ.).
4. Lukomskiy G.I., Shulutko M.L., Vinner M.G., Ovchinnikov A.A. Bronkhopulmono-logiya [Bronchopulmonology]. Moscow: Meditsina, 1982. 399 p.
5. Oho K., Amemiya R. Practical Fiberoptic Bronchoscopy. 2nd edn. Tokyo: Igaky-Shoin, 1984. 156 r.
6. Shteyner M.L. Postbronchoscopic respiratory depression: the effectiveness of various options for respiratory protection. Fundamentalnye issledovaniya, 2011, no. 3, pp. 172–180 (in Russ.).
7. Lebedinskiy K.M., Mazurok V.A., Nefedov A.V. Osnovy respiratornoy podderzhki [Fundamentals of respiratory support]. Saint Petersburg: MAPO, 2006. 220 p.
8. Okada S., Yamauchi H., Sato S., Fujimura S. Endoscopic treatment with laryngeal masks for the removal of tracheobronchial foreign bodies. Nihon Kokyuki Gakkai Zasshi, 1998, vol. 36(7), rr. 601–606.
9. Swanson K.L., Prakash U.B.S., Midthun D.E. Flexible bronchoscopic management of airway foreign bodies in children. Chest, 2002, vol. 121, pp. 1695–1700.
10. Chernekhovskaya N.E., Korzheva I.Yu., Maltseva I.M. et al. Clinico-endoscopic diagnosis of foreign bodies of the bronchi. Pulmonologiya, 2009, no. 2, pp. 120–123 (in Russ.).
11. Svistushkin V.M., Mustafaev D.M. Foreign bodies in the respiratory tract. Rossiyskiy meditsinskiy zhurnal, 2013, no. 33, pp. 1681–1685 (in Russ.).
12. Hsia D.W., Tanner N.T., Shamblin C. et al. The latest generation in flexible broncho-scopes: a description and evaluation. J. Bronchology Interv. Pulmonol, 2013, vol. 20 (4), rr. 357–362.
13. Shteyner M.L., Zhestkov A.V., Biktagirov Yu.I. et al. Udostoverenie na ratsionalizatorskoe predlozhenie no. 334 ot 19.01.2016 “Sposob udaleniya inorodnykh tel trakheobronkhialnogo dereva s ispolzovaniem nazalnogo dostupa”. Prinyato GBOU VPO “Samarskiy gosudarstvennyy meditsinskiy universitet” Ministerstva zdravookhraneniya RF k ispolzovaniyu 3.02.2016 [Certificate on rationalization proposal No. 334 of 19.01.2016 «Method of removal of foreign bodies of the tracheobronchial tree with the use of nasal access.» It was adopted by the State Medical University of Samara State Medical University of the Ministry of Health of the Russian Federation for use on February 3, 2016].
14. Shteyner M.L., Zhestkov A.V., Biktagirov Yu.I. et al. Udostoverenie na ratsionalizatorskoe predlozhenie no. 376 ot 16.01.2017 “Variant udaleniya inorodnykh tel trakheobronkhialnogo dereva iz segmentarnykh i subsegmentarnykh bronkhov”. Prinyato FGBOU VO “Samarskiy gosudarstvennyy meditsinskiy universitet” Ministerstva zdravookhraneniya RF k ispolzovaniyu 26.01.2017 [Certificate for the rationalization proposal No. 376 dated January 16, 2017 «Option of removal of foreign bodies of the tracheobronchial tree from segmental and subsegmental bronchi». Adopted by FGBOU VO «Samara State Medical University» of the Ministry of Health of the Russian Federation for use on 01/26/2017].