Role Of Bronchoscopy Research Articles

The Role of Surveillance Bronchoscopy Following a Lung Transplantation

Pulmonary transplantation (LuTx) is established as a treatment option for patients with end-stage lung diseases, such as chronic obstructive pulmonary disease, cystic fibrosis, interstitial lung disease, and pulmonary arterial hypertension. Acute rejection and infection are implicated as potential risk factors in developing complications such as bronchiolitis obliterans syndrome (BOS) and chronic rejection, leading to high morbidity and mortality rates after the LuTx. Thus, surveillance procedures after transplantation are crucial to prevent further complications. Clinical monitoring is done through pulmonary function tests and procedural methods such as surveillance bronchoscopy and transbronchial biopsy of lung allografts, which are the most commonly used diagnostic tests. In this review, we aim to analyze the role of bronchoscopy as a surveillance procedure in determining the presence of infection or rejection as well as the management of airway complications after LuTx. We have also discussed the risk and benefit ratio of standard transbronchial biopsy (TBB) and transbronchial cryobiopsy (TCB) as routine performance after LuTx.

The Role of Bronchoscopy in Diagnosis of Chronic Cough in Adults: A Retrospective Single-Center Study

Cough is one of the most frequent symptoms reported to pulmonologists. The role of bronchoscopy in the diagnostic work-up of chronic cough is not clearly defined. The aim of this study was to evaluate the utility of fiberoptic bronchoscopy (FOB) and additional testing of samples collected during FOB in the differential diagnosis of chronic cough in adults. This was a single-center retrospective study. Out of 7115 conventional white light FOB examinations, we finally selected 198 with cough as the only indication. In 40.9% of bronchoscopic examinations, no visible cause of cough was found. Visual signs of chronic bronchitis (CB) were detected in 57.6% of reports. Only in 3 cases (1.5%) bronchoscopy revealed a potential cause of chronic cough other than CB. Mycobacterium tuberculosis or other mycobacteria were spotted in none of the samples. In 91.1% of bronchoalveolar lavage (BAL) cytologic examinations, at least one cell count abnormality was detected, but only in case of increased percentage of eosinophils, it might be considered clinically relevant. In 53% of bacteriological culture results, at least one potentially pathogenic bacterium was isolated. The present study results strengthen the evidence that FOB combined with additional testing of airway specimens obtained during FOB is not a powerful tool in the differential diagnosis of chronic cough, and FOB as a diagnostic tool may be overused. The appropriate timing and decision regarding referral for FOB and additional testing of achieved material requires careful clinical consideration.

American Association for Bronchology and Interventional Pulmonology (AABIP) Statement on the Use of Bronchoscopy and Respiratory Specimen Collection in Patients With Suspected or Confirmed COVID-19 Infection.

American Association for Bronchology and Interventional Pulmonology (AABIP) Statement on the Use of Bronchoscopy and Respiratory Specimen Collection in Patients With Suspected or Confirmed COVID-19 Infection.

An update on the role of bronchoscopy in the diagnosis of pulmonary disease.

Bronchoscopy has evolved over the past few decades and has been used by respiratory physicians to diagnose various airway and lung diseases. With the popularization of medical check-ups and growing interest in health, early diagnosis of lung diseases is essential. With the development of endobronchial ultrasound, ultrathin bronchoscopy, and electromagnetic navigational bronchoscopy, bronchoscopy has been able to widen its scope in diagnosing pulmonary diseases. In this review, we have described the brief history, role, and complications of bronchoscopy used in diagnosing pulmonary lesions, from simple flexible bronchoscopy to bronchoscopy combined with several up-to-date technologies.

Diagnosing EVALI in the Time of COVID-19

Diagnosing EVALI in the Time of COVID-19

The Role of Bronchoscopy in Hemoptysis

Massive hemoptysis is a medical emergency that requires intensive treatment with appropriate therapy. The underlying causes of hemoptysis are airway disease, parenchymal disease, and vascular disease. An appropriate diagnostic modality is needed in handling hemoptysis, one of which is by bronchoscopy. Bronchoscopy can identify whether bleeding is still active and see the condition of the patient’s respiratory tract. Apart from being a diagnostic tool, bronchoscopy is also used as one of the therapeutic methods to stop bleeding. Initial bronchoscopy should be performed on massive hemoptysis after the patient is stable and the other side of the lung that is not the source of bleeding has been protected. After the source of bleeding is seen, several therapies can be done.

Role of bronchoscopy in pleural effusion bacterial infection

Background: In the present study was to investigate that the role of Bronchoscopy in pleural effusion in bacterial growth condition. Pleural effusion is one of the commonest problems with which patients present to the hospital. Pleural effusion is always abnormal and indicates the presence of an underlying disease. Despite the fact that there are many causes of pleural effusion, it is estimated that 90% of all pleural effusions are the result of only 5 disease processes: malignancy, pneumonia, pulmonary embolism viral infection, congestive heart failure.Methods: This is a Prospective and Observational Study. All patients diagnosed to have pleural effusion by x-ray, clinical examination and ultrasound examination of pleura if needed will undergo informed.Results: All 80 patients were included of whom 60(70%) were males and 20(30%) were females. Out of 80 patients, 5 patients are having bacterial growth (6.3%). All 5 patients who had exudative effusion, 4 were males and 1 female, 4 cases were right side effusion and 1 left sided effusion.Conclusions: Authors conclude that bronchoscopy has a definite role in the etiological diagnosis of pleural effusion in bacterial infection.

Pediatric tracheal injuries: Report on 5 cases with special view on the role of bronchoscopy and management

IntroductionThe purpose of these case reports is to draw the attention to the difficulties of diagnosing trachea injuries in children, who are often part of a polytrauma scenario. MaterialsA retrospective multicenter analysis of 5 cases were analysed. The age of the children was between 1 and 16 years old. Injury mechanism was blunt thoracic trauma, misintubation and shot injury. ResultsCase No.1. a three-year-old child suffered a train accident. Resuscitation and decompression of the tension pneumothorax were performed. CT found a pneumomediastinum and bubbles along the trachea. Thoracolaparotomy was performed. Bronchoscopy could not rule out a tracheal injury. The child died of a cerebral edema. Case No. 2: a 13 month drowned and was resuscitated. A chest drain was inserted to treat the pneumothorax. CT revealed a pneumomediastinum, which was drained and a small tear of the trachea. Bronchoscopy was not preformed. Case No. 3: 9 year-old polytrauma patient was airlifted with bilateral mini thoracostomies and chest drains for pneumothorax. CT revealed bilateral pneumothorax and pneumomediastinum. The chest drains were repositioned oxygenation improved, but some ventilation difficulties remained. CT revealed pneumomediastinum and a tracheal injury. This was bridged by a tube, and the mediastinum drained. The ventilation difficulties were resolved. Case No. 4: an eight-year-old boy was shot on the neck. The region was explored surgically and the laceration of the trachea was sutured. Case No. 5: 12-year-old girl suffered blunt thoracic trauma. CT revealed bilateral pneumothorax and pneumomediastinum. Bilateral thoracic drainage was performed, some ventilation problems persisted. CT and fiberoscopy revealed a rupture of the trachea. Thoracotomy was performed and the laceration was closed. ConclusionPneumomediastinum and persistent ventilation difficulties should raise suspicion of a tracheal injury in a typical clinical scenario. Bronchoscopy is recommended for early diagnosis, despite the possibility of misdiagnosis. In certain cases CT scan only and close observation may be considered.

Role of Bronchoscopy in Atelectasis

Role of Bronchoscopy in Atelectasis

Role of Bronchoscopy in Bronchiectasis

Role of Bronchoscopy in Bronchiectasis

Analysis of Bronchoscopy on Acute Exacerbation of Pulmonary Emphysema Chronic Obstructive Pulmonary Disease Using CT Chest Imaging

Purpose: To understand the role of bronchoscopy in the treatment of chest CT images for patients with acute exacerbation of emphysema phenotype chronic obstructive pulmonary disease (COPD). Methods: 89 cases with chest CT images suggesting acute exacerbation of emphysema phenotype COPD were included and divided into the experimental group and the control group according to whether underwent bronchoscopy. Arterial blood gas indexes (pH value, PaO2, PaCO2), total glucocorticoid usage, length of stay, serum inflammatory factors (TNF-α, IL-6, IL-10) before and after treatment were compared between the two groups. Results: The hospitalization time of the experimental group was significantly shorter than that of the control group (11.88 ± 8.61 d vs. 16.50 ± 12.15 d, P = 0 045); the total use of methylprednisolone test group was 213.66 ± 32.07mg, and the control group was 250.83 ± 102.55 mg. The difference between the two groups was statistically significant (P = 0 028). The trend of repeated analysis of variance (F = 12 11,P = 0 001) were statistically significant. PaCO2 significantly decreased before and after the test in the experimental group (49.40 14.85 mmhg vs. 43.30 12.48 mmhg, P = 0.000). Plasma TNF-α and IL-6 decreased and IL-10 increased before and after the test. TNF-α and IL-6 increased and IL-10 decreased before and after the control group test, and the changes and trends of TNF-α, IL-6 and IL-10 before and after the two groups were statistically different (P = 0.000). These symptoms can be analyzed using CT imaging. Conclusion: In patients with acute exacerbation of emphysema phenotype COPD who are initially ineffective, bronchoscopy, alveolar lavage, and anti-contamination brush sampling guide anti-infective treatment can improve patient ventilation, and reduce glucocorticoid consumption.

Role of Bronchoscopic Techniques in the Diagnosis of Thoracic Sarcoidosis.

The diagnosis of sarcoidosis relies on clinical and radiological presentation, evidence of non-caseating granulomas in histopathology and exclusion of alternative causes of granulomatous inflammation. Currently, a proper diagnosis, with a high level of confidence, is considered as key to the appropriate diagnosis and management of the disease. In this sense, this review aims to provide a brief overview on the role of bronchoscopy in the diagnosis of thoracic sarcoidosis, incorporating newer techniques to establish, including endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), transesophageal ultrasound-guided needle aspiration with the use of an echo bronchoscope (EUS-B-FNA) and transbronchial lung cryobiopsy (TBLC). Most of the literature reports the diagnostic superiority of endosonographic techniques, such as EBUS-TBNA alone or in combination with EUS-FNA, over conventional bronchoscopic modalities in diagnosing Scadding stages I and II of the disease. Moreover, TBLC may be considered a useful and safe diagnostic tool for thoracic sarcoidosis, overcoming some limitations of transbronchial lung biopsy (TBLB), avoiding more invasive modalities and being complementary to endosonographic procedures such as EBUS-TBNA.

Management of hemoptysis in patients with lung cancer.

Hemoptysis related to malignancy is common and accounts for nearly a quarter of all cases of hemoptysis in the US, and approximately 20% of patients with lung cancer will experience some degree of hemoptysis during their disease course. Both minor and massive hemoptysis come with diagnostic and treatment challenges and are associated with increased mortality. We will discuss the definition and epidemiology of hemoptysis related to malignancy, outline our approach to the initial evaluation and diagnostic workup, and extensively review the management of minor and massive hemoptysis. Specific emphasis will be on relevant signs and symptoms, imaging, and the role of bronchoscopy, and the differences in approach for minor hemoptysis compared to massive hemoptysis. While the role of surgical management is very limited in this patient population, the role of endobronchial and endovascular management will be discussed in detail.

Role of bronchoscopy in management of central squamous cell lung carcinoma in situ.

Squamous cell carcinoma in situ (SCIS) is the pre-invasive stage of squamous cell carcinoma. Early detection and management of SCIS can prevent further progression. Although surgery and external beam radiation therapy are treatment options for SCIS, smaller lesions can be easily managed by bronchoscopic modalities like photodynamic therapy (PDT), cryotherapy, mechanical debulking with biopsy forceps, electrocautery and argon plasma coagulation (APC). Endobronchial brachytherapy (EBBT) and lasers may be judiciously utilized in selected cases. Although, previous studies of treatment modalities may have inadvertently included cases of invasive carcinomas, the advent of new technologies like radial probe endobronchial ultrasound (RP-EBUS) and optical coherence tomography (OCT) can help accurately determine the of depth of invasion. Superficial extent can also be better demarcated with techniques like auto-fluorescence bronchoscopy and narrow band imaging (NBI). New drugs for PDT with deeper penetration and less phototoxicity are being developed. These advances hopefully will allow us to perform superior clinical trials in future and improve our understanding of diagnosis and management of SCIS.

Toward a Deeper Understanding of Chronic Obstructive Pulmonary Disease: The Role of Bronchoscopy in Therapeutic Discovery.

Toward a Deeper Understanding of Chronic Obstructive Pulmonary Disease: The Role of Bronchoscopy in Therapeutic Discovery.

Evaluation of the role of bronchoscopy in the intensive care units

ObjectivesThe aim of this study was to evaluate the role of bronchoscopy in the intensive care units (indications, advantages, disadvantages, results, and complications).Patients and methodsBronchoscopy (rigid or fibroptic) was performed in Ain shams University hospital and Ain Shams University Specialized Hospitals on 80 ICU patients requiring diagnostic and/or therapeutic indication. The patients were grouped into ventilated and nonventilated.ResultsA total of 50 (62%) fibroptic bronchoscopies and 30 (37%) rigid bronchoscopies were performed on 30 (37.5%) ventilated patients and 50 (62.5%) nonventilated. Overall, 90% of flexible bronchoscopies were done for ventilated patients and 54% of rigid bronchoscopies was done in nonventilated patients (54%). Moreover, 80% of the procedures were done for diagnostic purposes using fibroptic bronchoscopies in 98%, whereas 36.7% of bronchoscopies were done for combined indications and 13.3% of therapeutic indications bronchoscopies were done with rigid bronchoscopy. In addition, 51.25% of the procedures that were done with bronchoscopies were lavage followed by stent insertion (25%). In 83.3% of ventilated patients, lavage was done, whereas stent insertion was more in nonventilated patient group. Overall, 26.25% of the patients were diagnosed as having malignant disease and 20% had infections of lower respiratory tract. Complications occurred in 21.25%, with mortality rate of 0.0%, and hypoxia was the most common.ConclusionSafety is one of the most important issues when deciding to perform bronchoscopy in the ICU, which depends on the accuracy of selection of the patients for the procedure and the experience of the bronchoscopist and facilities available.

The Role of Bronchoscopy in Childhood Foreign Body Aspirations: A 3-year Experience

The Role of Bronchoscopy in Childhood Foreign Body Aspirations: A 3-year Experience

Role of Bronchoscopy in the Diagnosis of Pulmonary Tuberculosis in Sputum Smear Negative Patients

Role of Bronchoscopy in the Diagnosis of Pulmonary Tuberculosis in Sputum Smear Negative Patients

Role of bronchoscopy in diagnosis of pulmonary infections in non-HIV immune compromised host

Background: The occurrence of pulmonary infections is a common life threatening complication in immunocompromised patients, necessitating timely diagnosis and specific treatment. In our study bronchoscopic diagnostic techniques that include fiber optic bronchoscopy (FOB) and bronchoalveolar lavage (BAL) were applied in non-HIV immunocompromised conditions to determine the aetiology infectious microorganisms and comparing the clinical characteristics with bronchoscopic yield and to assess the influence of these methods on therapeutic outcome in this population.Methods: This prospective observational study was conducted at Rajiv Gandhi Government General Hospital, Park Town, Chennai, for a period of 8 months from January 2016 – August 2016.After meeting the requirements of eligibility criteria, the study included 65 immunocompromised patients consecutively who presented with pulmonary diseases. The primary outcome measure was the diagnostic yield of bronchoscopy among non-HIV immunocompromised patients. The secondary outcome measures were collecting the data including etiology of different microorganisms and non-infectious causes of pulmonary diseases among non- HIV immunocompromised patients, comparing the symptoms at the time of presentation, different radiological pattern with bronchoscopic yield and comparing the different subgroups of non-HIV immunocompromised patients with regards to presenting symptoms, radiological patterns, bronchoscopic yield, treatment modification, different spectrum of infections and complications.Results: The mean age of the patients was 41.91 ranging from 15-74 years. Majority (n=36) patients showed chest symptoms alone. On bronchoscopy, 52 cases (80%) out of 65 showed positive results and negative result was noticed in 13 cases (20%). Among them bacterial infections were predominant with 24%. After BAL culture bacterial culture was positive in 23 (35%) patients and fungal culture was positive in 15 (23%) cases. After bronchoscopy, current treatment plan was changed in 37 patients and clinical improvement was seen in 26 cases i.e. yield of bronchoscopy was 71%. Minor complications were noticed in 16 cases after bronchoscopy.Conclusion: Our study concludes, in clinically stable patients FOB was the preferred technique for finding the cause of lung infiltrates in non-HIV immunocompromised patients. Because our results signifies that the yield of bronchoscopy was high (80%) despite empirical antimicrobial therapy.

Is bronchoscopy an obsolete tool in cystic fibrosis? The role of bronchoscopy in cystic fibrosis and its clinical use.

Cystic fibrosis (CF) is a progressive life threatening multisystem genetic disease which affects the CF transmembrane conductance regulator channel. Respiratory causes remain the most common mortality in CF. With the onset of newborn screening, initiating treatments both for prophylaxis and disease management, optimizing nutritional support, and developing therapies targeting CF transmembrane conductance regulator protein, this has significantly changed the face of managing this devastating disease. Bronchoscopy and related procedures such as bronchoalveolar lavage (BAL), transbronchial biopsies, and protected brush sampling have been looked at in the management of CF as patients with CF continue to live longer with the help of newer therapies, the microbiome in the lung becomes less diverse along with increased occurrences for noninfectious causes of airway diseases. Though bronchoscopy has been used in conjunction with other modalities such as computed tomography and sputum induction providing a better understanding of the progression of the disease, it still remains valuable in the diagnosis and management of CF.