Interventional bronchoscopy with the use of mechanical ventilation by larynx mask or tracheal intubation under general anesthesia

Abstract

To explore and evaluate the technique of performing interventional bronchoscopy by using mechanical ventilation with larynx mask or tracheal intubation under general anesthesia. From July 2009 to January 2010, 29 patients received interventional bronchoscopy by using mechanical ventilation with larynx mask or tracheal intubation under general anesthesia. Airway pressure and tidal volume before and after bronchoscope insertion, arterial blood gas analysis during interventional bronchoscopy, complications and operation time were recorded. The factors influencing ventilation effects were evaluated. All the patients' condition were kept stable during interventional bronchoscopy and no severe complications occurred. Tidal volume was reduced by 27.1%, while peak airway pressure, plateau pressure and mean airway pressure were increased by 63.1%, 43.7% and 32.4% following insertion of the bronchoscope respectively. Patients using tracheal intubation had their peak pressure increased by 79.3%, which was higher than that of patients using larynx mask (55.3%). Interventional bronchoscopy by using mechanical ventilation with larynx mask or tracheal intubation under general anesthesia was safe and reliable. Although peak airway pressure increased following insertion of bronchoscope, the mean airway pressure was maintained in a low level. When performing interventional bronchoscopy during mechanical ventilation, the inside diameter of larynx mask and tracheal intubation should be as large as possible to minimize airway pressure and auto-PEEP.