Journal of bronchology & interventional pulmonology
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J Bronchology Interv Pulmonol · Oct 2014
Case ReportsEndobronchial occlusion for massive hemoptysis with a guidewire-assisted custom-made silicone spigot: a new technique.
Endobronchial Watanabe spigot is a device used to occlude bronchus for a variety of indications. It has been recently used for endobronchial occlusion for hemoptysis. ⋯ To facilitate its placement, we developed a new technique using a guidewire and a custom-made spigot. We report a case of massive hemoptysis from a left lung cancer describing this new approach.
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J Bronchology Interv Pulmonol · Jul 2014
Impact of bedside bronchoscopy in critically ill lung transplant recipients.
Over 32,000 lung transplants have been performed worldwide for a variety of end-stage lung diseases (http://www.ishlt.org/). Flexible bronchoscopy (FB) is frequently used as a bedside-tool for diagnosis and management of respiratory failure among critically ill lung transplant recipients (LTRs). We study the indications, results, therapeutic impact, and complications of FB in LTRs admitted to medical intensive care unit (MICU). ⋯ Use of FB modified clinical management in one third of airway evaluation and microbiological sampling procedures for critically ill LTRs. No fatalities were attributed to bronchoscopy in this critically ill population.
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J Bronchology Interv Pulmonol · Jul 2014
Value of different bronchoscopic sampling techniques in diagnosis of sarcoidosis: a prospective study of 151 patients.
The exact position of routine bronchoscopic sampling techniques in diagnostic workup of sarcoidosis is often debated. Herein, we ascertain the role of transbronchial needle aspiration (TBNA), endobronchial ultrasound-guided TBNA (EBUS-TBNA), transbronchial lung biopsy (TBLB), and endobronchial biopsy (EBB) in diagnosis of sarcoidosis. ⋯ TBLB is an important tool in bronchoscopic diagnosis of sarcoidosis. If endobronchial abnormalities are seen during bronchoscopy, TBLB with EBB gives the best results otherwise TBLB combined with conventional TBNA and EBB or EBUS-TBNA are required to maximize the diagnostic yield.
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J Bronchology Interv Pulmonol · Jul 2014
Case ReportsRecurrent pleural effusion due to duropleural fistula.
A 76-year-old woman with history of multiple spinal surgeries was found to have chronic recurrent pleural effusion. Thoracentesis was performed, which showed a clear, "water-like" transudative fluid with a total protein level of 0.2 g/dL, glucose level equivalent to serum (118 mg/dL), low LDH level (76 U/dL), and low nucleated cell count. Given the appearance of the fluid, β-2-transferrin was checked, which confirmed the presence of cerebrospinal fluid in the pleural space. On the basis of the clinical presentation, pleural fluid analysis, clear appearance of the pleural fluid, and β-2-transferrin positivity, the patient was diagnosed with duropleural fistula.