Tuberc Respir Dis.  2004 May;56(5):523-531. 10.4046/trd.2004.56.5.523.

Physiologic Changes During Bronchoscopy in Mechanically Ventilated Patients

• Pyun YJ
• Suh GY
• Koh WJ
• Yu CM
• Jeon K
• Jeon IS
• Ham HS
• Kang EH
• Chung MP
• Kim H
• Kown OJ

• KMID: 2132978
• DOI: http://doi.org/10.4046/trd.2004.56.5.523

Abstract

BACKGROUND: Bronchoscopy in patients on mechanical ventilation is being performed much more frequently. However, there is little data on the changes in physiologic parameters and no established mechanical ventilation protocol during bronchoscopy. A decreasing or the removal of positive end-expiratory pressure (PEEP) during bronchoscopy may precipitate severe hypoxemia and/or derecruitment.
METHODS
Our standardized mechanical ventilation protocol, without changing the PEEP level, was used during bronchoscopy. The physiological parameters were measured during the bronchoscopic procedure.
RESULTS
During bronchoscopy, respiratory acidosis, elevation of peak pressure, elevation of heart rate and auto-PEEP were developed, but were reversible changes. Procedure-related gross barotraumas or other severe complications did not developed.
CONCLUSION
No serious complications developed during bronchoscopy under our standardized mechanical ventilation protocol when the PEEP level remained unchanged. The procedure time should be kept to a minimum to decrease the exposure time to undesirable physiological changes.

Keyword

Intensive Care Units; Artificial Respiration; Intratracheal Intubation; Bronchoscopy; Bronchoscopes; Pulmonary gas exchange; Respiratory Mechanics; Adverse effects

MeSH Terms

Acidosis, Respiratory
Anoxia
Barotrauma
Bronchoscopes
Bronchoscopy*
Heart Rate
Humans
Intensive Care Units
Intubation, Intratracheal
Positive-Pressure Respiration
Positive-Pressure Respiration, Intrinsic
Pulmonary Gas Exchange
Respiration, Artificial
Respiratory Mechanics