fiberoptic bronchoscopy


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bronchoscopy

 [brong-kos´kah-pe]
inspection of the interior of the tracheobronchial tree through a bronchoscope, usually a fiberoptic one passed through the nose.
Flexible fiberoptic bronchoscopy. From Malarkey and McMorrow, 2000.
This is used as a diagnostic aid and for therapeutic purposes. As an aid to diagnosis the bronchoscope allows for visualization of the bronchial mucosa and removal of tissue for biopsy. Bronchial washings and collection of secretions are done at the time of bronchoscopy to obtain samples for culture and cytological examination. Therapeutically, the bronchoscope permits removal of foreign bodies that have been aspirated into the bronchial tree and also may be used to facilitate suctioning of the lower airway. The latter technique is done at the bedside and anesthesia is not considered necessary.
Patient Care. If the fiberoptic bronchoscope is used at the bedside as an adjunct to bronchial hygiene and removal of secretions, it should be used only by health care personnel who have been trained in the technique. It has the advantage of allowing for more precise suctioning with less trauma to the respiratory tract, because it is possible to visualize the areas needing suctioning and to reach lower segments not accessible to the larger suction catheter.

Bronchoscopy as a surgical diagnostic procedure requires preparation and instruction of patients in regard to the purpose of the procedure, what they can expect to be done, and how they may cooperate during the procedure. A topical anesthetic is used most often, but in some cases the patient may have general anesthesia.

Food and fluids are withheld for 8 hours before bronchoscopy is performed. The teeth should be brushed and the mouth rinsed thoroughly before the procedure to lessen the danger of introducing bacteria from the mouth into the bronchi. Dentures are removed and any loose teeth are brought to the attention of the physician. A mild sedative such as diazepam or midazolam may be given prior to the bronchoscopy. This medication plus instructions to the patient and a full explanation of what is going to be done will help the patient relax and make the passing of the bronchoscope into the bronchi easier and less traumatic.

After bronchoscopy, fluids and food are withheld until the effects of the local anesthetic have worn off and the gag reflex has returned completely. The patient must be observed for signs of bleeding from the throat and respiratory embarrassment. Since swelling of the larynx may necessitate a tracheostomy, the equipment should be readily at hand. The patient should be kept quiet and discouraged from talking or coughing.

Potential problems following bronchoscopy include arterial hypoxemia, bleeding, pneumothorax, bronchial and laryngeal spasm, and anaphylactic reaction to anesthetic drugs.

Bronchospasm and laryngeal spasm necessitate the intravenous administration of medications such as methylprednisolone (Solu-Medrol) and aminophylline. If an intravenous line was not established before the procedure, the equipment should be at the bedside in case it is needed. Indications that bronchospasm is occurring include pallor, respiratory distress, and an elevation of the pulse rate and rate of respirations.

Supplemental oxygen is needed if arterial blood gas analysis or pulse oximetry indicates a drop in the PaO2; hypoxemia can occur either before or after the procedure. Pulse oximetry and electrocardiographic readings are commonly monitored during the procedure. The amount and character of the sputum should be observed in case bleeding occurs, especially when a biopsy has been done during bronchoscopy. A foul-smelling, purulent sputum in the postoperative period probably indicates an infection. A sputum culture for bacteria and an antimicrobial sensitivity test are then commonly ordered.

Pneumothorax is not a common complication of bronchoscopy; should it occur, a thoracotomy tube must be inserted as soon as possible to allow for reexpansion of the lung. A trocar thoracic kit should be readily available.
fiberoptic bronchoscopy bronchofibroscopy.

fiberoptic bronchoscopy

[-op′tik]
Etymology: L, fibra + Gk, optikos, sight
the visual examination of the tracheobronchial tree through a fiberoptic bronchoscope. Also called bronchofibroscopy. See also bronchoscopy, fiberoptics.
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Fiberoptic bronchoscopy

bronchoscopy

The use of a flexible endoscope to directly examine the upper airways, vocal cords, and the tracheobronchial tree to the 4th to 6th division.

Indications
Evaluate suspected malignancy, haemoptysis, persistent coughing, biopsy (transbronchial) and cytology (e.g., bronchial washings, specimen culture, remove foreign bodies from upper airways).

Relative contraindications
Asthma, severe hypoxia, unstable angina pectoris or recent MI.

fiberoptic bronchoscopy

See Bronchoscopy, Bronchial brushings, Bronchial washings.

bronchoscopy

inspection of the interior of the tracheobronchial tree through a bronchoscope. Bronchoscopy is used as a diagnostic aid and therapeutically.
As an aid to diagnosis the bronchoscope allows for visualization of the bronchial mucosa and removal of tissue for biopsy. Bronchial washings and collection of secretions are done at the time of bronchoscopy to obtain samples for culture and cytological examination. Therapeutically, the bronchoscope permits removal of foreign bodies that have been aspirated into the bronchial tree.

fiberoptic bronchoscopy
bronchofiberoscopy.
References in periodicals archive ?
Flexible fiberoptic bronchoscopy in the critically ill patient.
Effect of fiberoptic bronchoscopy on arterial oxygen tension.
Hemoptysis: comparative study of the role of CT and fiberoptic bronchoscopy.
Flexible fiberoptic bronchoscopy and percutaneous needle lung aspiration for evaluating the solitary pulmonary nodule.
Endotracheal intubation via flexible fiberoptic bronchoscopy (FFB) can be performed when intubation via direct laryngoscopy is impossible or when it is expected to be problematic.
Comparison of three different methods used to achieve local anaesthesia for fiberoptic bronchoscopy.
In our case, lung parenchymal lesions were not found on imaging studies or fiberoptic bronchoscopy.
Myocardial ischemia in sedated patients undergoing fiberoptic bronchoscopy.
Cardiorespiratory effects of flexible fiberoptic bronchoscopy in critically ill patients.
The LMA is also used in the pediatric population at several institutions for fiberoptic bronchoscopy and bronchoalveolar lavage under general anesthesia.
Use of fiberoptic bronchoscopy to retrieve bronchial foreign bodies in adults.