Work

Intubated or rigid bronchoscopy under high‐flow oxygenation and deep sedation without ventilator or anesthesiologist: A report on a new technique

Year: 2024

Type: article

Abstract: As the demand for advanced bronchoscopic procedures increases, prolonged sedation with adequate oxygenation has become essential. Traditionally, these procedures require an anesthesiologist to provide (positive-pressure or jet) ventilator support. However, recent innovations have enabled advanced bronchoscopy under high-flow endotracheal oxygenation and deep sedation without these requirements. Following oropharyngeal lidocaine anaesthesia, deep sedation was induced using fentanyl and remimazolam. Thereafter lidocaine was instilled into the larynx, trachea, and main bronchi using a flexible bronchoscope with a spray catheter. Finally, either an uncuffed endotracheal tube (Case 1) or a rigid bronchoscope (Case 2) was inserted, and advanced bronchoscopic procedures, such as cryobiopsy and stent insertion, were successfully performed without a ventilator or an anesthesiologist. Our novel technique is expected to facilitate the easier and adequate performance of advanced high-level bronchoscopic procedures by pulmonologists, even in resource-limited settings.

Source: Respirology Case Reports

DOI: 10.1002/rcr2.70017

Authors: Hee Yun Seol, Ganghee Chae, Jin Hyoung Kim, Yun Seong Kim, Seong Hoon Yoon, Taehoon Lee

Institutions: Pusan National University Yangsan Hospital, Pusan National University, University of Ulsan, Ulsan University Hospital

Language: English

Topic: Airway Management and Intubation Techniques

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,130