Risk factors of complications during noninvasive mechanical ventilation -assisted flexible bronchoscopy |
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| Affiliation: | 1. Department of Pneumonology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland;2. Department of Respiratory Medicine, Allergology and Pulmonary Oncology, Poznan University of Medical Sciences, Poznan, Poland;3. Department of Epidemiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland;4. Department of Cardiac Anaesthesia and Intensive Care, Silesian Centre for Heart Diseases in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland;5. Faculty of Science and Technology, University of Silesia in Katowice, 75 Pułku Piechoty 1A, 41-500, Chorzów, Poland;6. Department of Swimming and Water Rescue, Institute of Sport Science, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland;7. Department of Anaesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland;1. Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran;2. Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran;3. Institute of Population Health Sciences, Barts and the London School of Medicine, Queen Mary University of London, United Kingdom;4. Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran;1. Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland;2. Department of Radiology, Medical University of Bialystok, Bialystok, Poland;3. Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland;1. Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran;2. Department of Biology, Damghan Branch, Islamic Azad University, Damghan, Iran;1. Department of Biomedical Sciences, University of Sassari, Sassari, Italy;2. Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy;3. Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Adelaide, Australia;4. Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, Australia;1. Department of Experimental Oncology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia;2. Department of Biomedical Sciences, University of Hull, Hull, UK |
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| Abstract: | PurposeFlexible bronchoscopy (FB) causes airway narrowing and may cause respiratory failure (RF). Noninvasive mechanical ventilation (NIV) is used to treat RF. Until recently, little was known about noninvasive mechanical ventilation assisted flexible bronchoscopy (NIV-FB) risk and complications.Materials and methodsA retrospective analysis of NIV-FB performed in 20 consecutive months (July 1, 2018–February 29, 2020) was performed. Indications for: FB and NIV, as well as impact of comorbidities, blood gas results, pulmonary function test results and sedation depth, were analyzed to reveal NIV-FB risk. Out of a total of 713 FBs, NIV-FB was performed in 50 patients with multiple comorbidities, acute or chronic RF, substantial tracheal narrowing, or after previously unsuccessful FB attempt.ResultsIn three cases, reversible complications were observed. Additionally, due to the severity of underlining disease, two patients were transferred to the ICU where they passed away after >48h. In a single variable analysis, PaO2 69 ± 18.5 and 49 ± 9.0 [mmHg] (p < 0.05) and white blood count (WBC) 10.0 ± 4.81 and 14.4 ± 3.10 (p < 0.05) were found predictive for complications. Left heart disease indicated unfavorable NIV-FB outcome (p = 0.046).ConclusionsNIV-FB is safe in severely ill patients, however procedure-related risk should be further defined and verified in prospective studies. |
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| Keywords: | Airway assessment Complication risk Flexible bronchoscopy Noninvasive mechanical ventilation Respiratory failure |
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