Bronchoscopy

Jump to: navigation, search
This drawing shows a bronchoscope inserted through the mouth, trachea, and bronchus into the lung; lymph nodes along trachea and bronchi; and cancer in one lung. Inset shows patient lying on a table having a bronchoscopy.

WikiDoc Resources for Bronchoscopy

Articles

Most recent articles on Bronchoscopy

Most cited articles on Bronchoscopy

Review articles on Bronchoscopy

Articles on Bronchoscopy in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Bronchoscopy

Images of Bronchoscopy

Photos of Bronchoscopy

Podcasts & MP3s on Bronchoscopy

Videos on Bronchoscopy

Evidence Based Medicine

Cochrane Collaboration on Bronchoscopy

Bandolier on Bronchoscopy

TRIP on Bronchoscopy

Clinical Trials

Ongoing Trials on Bronchoscopy at Clinical Trials.gov

Trial results on Bronchoscopy

Clinical Trials on Bronchoscopy at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Bronchoscopy

NICE Guidance on Bronchoscopy

NHS PRODIGY Guidance

FDA on Bronchoscopy

CDC on Bronchoscopy

Books

Books on Bronchoscopy

News

Bronchoscopy in the news

Be alerted to news on Bronchoscopy

News trends on Bronchoscopy

Commentary

Blogs on Bronchoscopy

Definitions

Definitions of Bronchoscopy

Patient Resources / Community

Patient resources on Bronchoscopy

Discussion groups on Bronchoscopy

Patient Handouts on Bronchoscopy

Directions to Hospitals Treating Bronchoscopy

Risk calculators and risk factors for Bronchoscopy

Healthcare Provider Resources

Symptoms of Bronchoscopy

Causes & Risk Factors for Bronchoscopy

Diagnostic studies for Bronchoscopy

Treatment of Bronchoscopy

Continuing Medical Education (CME)

CME Programs on Bronchoscopy

International

Bronchoscopy en Espanol

Bronchoscopy en Francais

Business

Bronchoscopy in the Marketplace

Patents on Bronchoscopy

Experimental / Informatics

List of terms related to Bronchoscopy


Overview

Bronchoscopy is a medical procedure where a tube is inserted into the airways, usually through the nose or mouth. This allows the practitioner to examine inside a patient's airway for abnormalities such as foreign bodies, bleeding, tumors, or inflammation. The practitioner often takes samples from inside the lungs: biopsies, fluid (bronchoalveolar lavage), or endobronchial brushing. The practitioner may use either a rigid bronchoscope or flexible bronchoscope.

History

A German, Gustav Killian, performed the first bronchoscopy in 1897. From then until the 1970s, doctors evaluated people’s airways using a rigid bronchoscope.

Rigid Bronchoscopy

A rigid bronchoscope is a straight, hollow, metal tube. Doctors perform rigid bronchoscopy less often today, but it remains the procedure of choice for removing foreign material. Rigid bronchoscopy also becomes useful when bleeding interferes with viewing the examining area.

Flexible Bronchoscopy

A flexible bronchoscope is a long thin tube that contains small clear optical fibers that transmit light images as the tube bends. Its flexibility allows this instrument to reach further into the airway. The procedure can be performed easily and safely under local anesthesia.

Indications

Diagnostic Procedures

Therapeutic Procedures

Bronchoscopy - The Procedure

The bronchoscopy is performed in 1 of 3 areas:

One will be given antianxiety and antisecretory medications (to prevent oral secretions from obstructing the view), generally atropine (Atropair, I-Tropine) and morphine (Duramorph, Oramorph, Roxanol), half an hour before the procedure.

During the procedure, doctors provide an agent such as midazolam (Versed) to sedate although one would remain conscious. Lidocaine may also be used to anesthetize the upper airways.

One will be monitored during the procedure with periodic blood pressure checks, continuous ECG monitoring of the heart and oxygen measurement. Monitoring is particularly important when the patient remains conscious during the procedure.

The doctor inserts a flexible bronchoscope through either the nose or mouth either in the sitting or lying down position.

Once the bronchoscope is inserted into the upper airway, the doctor examines the vocal cords. The doctor continues to advance the instrument to the trachea and further down into the bronchus, examining each area as the bronchoscope passes.

If doctors discover an abnormality, they may sample it, using a brush, a needle, or forceps.They also may sample a large number of alveoli. Doctors can obtain a specimen of lung tissue (transbronchial biopsy) often using a real-time x-ray (fluoroscopy).

After the procedure

Although most adults tolerate bronchoscopy well, doctors require that one remains under a brief period of observation.

Nurses watch closely for 2-4 hours following the procedure, usually every 15 minutes. Keep patient in semi-fowler position. Most complications occur early and are readily apparent at the time of the procedure. Assess for respiratory difficulty (stridor and dyspnea resulting from laryngeal edema or laryngospasm). Monitoring continues until the effects of sedative drugs wear off and gag reflex has returned. If one has had a transbronchial biopsy, doctors will take a chest x-ray to rule out any air leakage in the lungs (pneumothorax) after the procedure One will be hospitalized if there occurs any bleeding, air leakage (pneumothorax), or respiratory distress.

Risks

Although the rigid bronchoscope can scratch or tear airway or damage the vocal cords, the risk for bronchoscopy is limited. The conditions for which doctors use it are ongoing, life-threatening cardiac problems or severely low oxygen.

Complications from fiberoptic bronchoscopy remain extremely low.

Common complications include either heart and blood vessel problems or excessive bleeding following biopsy. A lung biopsy also may cause leakage of air called pneumothorax. Pneumothorax occurs in less than 1% of cases requiring lung biopsy.

References

See also

de:Bronchoskopie eu:Bronkoskopia it:Broncoscopia he:ברונכוסקופיה nl:Bronchoscopie sv:Bronkoskopi uk:Бронхоскопія



Linked-in.jpg