The use of a non-rebreathing mask system for respiratory protection during bronchoscopy
M.L. SHTEINER1,2, A.V. ZHESTKOV2
1Samara Municipal Hospital №4, 125 Michurin Str., Samara, Russian Federation, 443056
2Samara State Medical University, 89 Chapayevskaya Str., Samara, Russian Federation, 443099
Shteiner M.L. ¾ D. Med. Sc., physician-endoscopist, Assistant of endoscopy course of the Surgery Department of Institute of Professional Education, tel. +7-927-207-71-18, e-mail: iishte@yandex.ru
Zhestkov A.V. ¾ D. Med. Sc., Professor, Head of the Department of General and Clinical Microbiology, Immunology and Allergology, tel. (846) 260-33-61, e-mail: zhestkovav@yandex.ru
The safety of flexible bronchoscopy was evaluated in 1000 patients with severe respiratory failure and massive obstruction of tracheobronchial tree due to various underlying lung disorders. In all these patients, bronchoscopy was performed for life-threatening indications. Respiratory protection was provided by spontaneous breathing with an oxygen-air mixture via a bronchoscopic variant of a non-rebreathing mask. No serious events followed by postbronchoscopic respiration inhibition were reported. Cardiovascular events were reported in 61 patients (6.1%) and were also non-fatal.
Key words: bronchoscopy, respiratory protection, bronchoscopic variant of a non-rebreathing mask system.
REFERENCES
- Lebedinskiy K.M., Mazurok V.A., Nefedov A.V. Osnovy respiratornoy podderzhki [Fundamentals of respiratory support]. Saint Petersburg: MAPO, 2006. 220 p.
- Lukomskiy G.I., Shulutko M.L., Vinner M.G., Ovchinnikov A.A. Bronkhopul’monologiya [Bronchopulmonology]. Moscow: Meditsina, 1982. 399 p.
- Kassil’ V.L. Adequacy of respiratory therapy in acute respiratory failure. Vestnik intensivnoy terapii, 2008, no. 3, pp. 56-62 (in Russ.).
- Kassil’ V.L., Leskin G.S., Vyzhigina M.A. Isskustvennaya i vspomogatel’naya ventilyatsiya legkikh [Artificial and auxiliary ventilation of the lungs]. Moscow: Meditsina, 2004. 480 p.
- Zislin B.D. High-frequency ventilation of lungs (HF IVL): yesterday, today, tomorrow. Intensivnaya terapiya, 2005, no. 1 (Internet version) (in Russ.), available at: http: www.icj.ru/ 2005-01-06.html
- Satoh M., Hirabayashi Y., Seo N. Spontaneous breathing combined with high frequency ventilation during bronchoscopic resection of a large tracheal tumour. Brit. J. Anaesth, 2002, vol. 89, pp. 641-643.
- Unzueta M.C., Casas I., Merten A. Endobronchial high-frequency jet ventilation for endobronchial laser surgery: an alternative approach. Anesth. Analg, 2003, vol. 96, pp. 298-300.
- Tremblay L.N., Miatto D., Hamid Q. Injurious ventilation induces wide spread pulmonary epithelial expression of tumor necrosis factor-alpha and interleukin-6 messenger RNA. Crit. Care Med, 2002, vol. 30, no. 8, pp. 1693-1700.
- Gillis R.C., Weireter L.J., Britt R.C., Cole F.J. Lung protective ventilation strategies: have we applied them in trauma patients at risk for acute lung injury and acute respiratory distress. Amer. Surg, 2007, vol. 73, no. 4, pp. 347-350.
- Avdeev S.N. Noninvasive ventilation of the lungs with acute respiratory failure. Pul’monologiya, 2005, no. 6, pp. 37-54 (in Russ.).
- Levina E.M., Baranov V.L., Shustov S.B. Influence of noninvasive ventilation of the lungs on the condition of patients with acute myocardial infarction. Vestnik Sankt-Peterburgskogo universiteta, 2007, series 11, iss. 4, pp. 26-31 (in Russ.).
- Ambrosino N., Vagheggini G. Noninvasive positive pressure ventilation in the acute care setting: where are we? Eur. Respir. J, 2008, vol. 31, rr. 874-886.
- Nava S., Hill N. Non-invasive ventilation in acute respiratory failure. Lancet, 2009, vol. 374, rr. 250-259.
- Heunks L.M., de Bruin C.J., Hoeven J.G., Heijden H.F. Non-invasive mechanical ventilation for diagnostic bronchoscopy using a new face mask: an observational feasibility study. Intensive Care Med, 2010, vol. 36, rr. 143-147.
- Scala R., Naldi M., Maccari U. Early fiberoptic bronchoscopy during non-invasive ventilation in patients with decompensated chronic obstructive pulmonary disease due to community-acquired-pneumonia. Crit. Care, 2010, vol. 14, available at: http://ccforum.com/content/ 14/2/ R80.
- Mehta S., Nava S. Mask ventilation and cardiogenic pulmonary edema: “another brick in the wall”. Intensive Care Med, 2005, vol. 31, rr. 757-759.
- Hess D.R. Airway clearance: physiology, pharmacology, techniques, and practice. Respir. Care, 2007, vol. 52, rr. 1392-1396.
- Shteyner M.L., Danilin A.V. RF patent for utility model no. 36982 dated 11.11.2003 «Device for treatment of bronchopulmonary system» (Russian Federation). Izobreteniya. Poleznye modeli (Ofitsial’nyy byulleten’ Rossiyskogo agentstva po patentam i tovarnym znakam), 10.04.2004, no. 10 (in Russ.).
- Rebrova O.Yu. Statisticheskiy analiz meditsinskikh dannykh. Primenenie paketa prikladnykh programm STATISTICA (3-izdanie) [Statistical analysis of medical data. Application of the STATISTICA software package (3rd edition)]. Moscow: Media Sfera, 2006. 312 p.