ABSTRACT
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Subject(s)
Humans , Male , Adult , Hemoptysis/etiology , Exostoses, Multiple Hereditary/complications , Osteochondroma/diagnosis , Bronchoscopy , Radiography, ThoracicSubject(s)
Humans , Female , Middle Aged , Pleural Effusion/complications , Amyloidosis/complications , Heart Failure/complications , DrainageABSTRACT
OBJECTIVE: To describe our experience with interventional bronchoscopy in the treatment of central airway stenosis. PATIENTS AND METHODS: We reviewed patient records and bronchoscopic findings. Clinical data, findings from computed tomography, techniques performed, complications, and results were recorded. RESULTS: One-hundred and thirty-six patients (90 males and 46 females) were treated. The mean (SD) age was 57 (7) years (range, 3-81). A total of 320 therapeutic interventions were performed: 145 laser treatments, 33 balloon or mechanical dilatations, 26 electrocauterizations, and 116 stent insertions. Pathogenesis varied: in 64 (47%) patients, the stenosis was caused by a tumor (48 were bronchopulmonary and 16 nonpulmonary); in 72 (53%) patients, stenosis was secondary to a nontumor-related process, of which the most common was prolonged intubation (42% of these cases). Central airway patency was achieved in 92% (59/64) of the tumor-related stenoses and 96% (69/72) of those unrelated to tumors. Improvement in dyspnea was observed in 96% of all patients. Two deaths (due to hemoptysis and to acute myocardial infarction) occurred in the first week, for a 1.4% mortality rate. The most common complications were stent migration (8%; 9/116 cases) and the formation of granulomas (9%; 11/116). CONCLUSIONS: Interventional bronchoscopy is an effective technique to resolve life-threatening obstructions of the central airways. Dyspnea improves immediately and there is no significant morbidity or mortality.
Subject(s)
Airway Obstruction/surgery , Bronchoscopy , Adolescent , Adult , Aged , Aged, 80 and over , Airway Obstruction/diagnosis , Airway Obstruction/drug therapy , Airway Obstruction/therapy , Bronchial Diseases/etiology , Bronchial Neoplasms/complications , Bronchial Neoplasms/surgery , Bronchoscopes , Bronchoscopy/statistics & numerical data , Catheterization/methods , Catheterization/statistics & numerical data , Child , Child, Preschool , Dyspnea/etiology , Dyspnea/surgery , Electrocoagulation/methods , Electrocoagulation/statistics & numerical data , Female , Foreign-Body Migration/etiology , Granuloma/etiology , Hemoptysis/mortality , Humans , Intraoperative Complications/epidemiology , Intubation, Intratracheal/adverse effects , Laser Therapy/methods , Laser Therapy/statistics & numerical data , Lung Neoplasms/complications , Lung Neoplasms/surgery , Male , Middle Aged , Myocardial Infarction/mortality , Postoperative Complications/mortality , Retrospective Studies , Stents , Tracheal Neoplasms/complications , Tracheal Neoplasms/surgery , Treatment Outcome , Vocal Cords/injuriesABSTRACT
Objetivo: Describir nuestra experiencia en estenosis de la vía aérea principal (VAP) tratadas mediante broncoscopia intervencionista. Pacientes y métodos: Se han revisado las historias clínicas e informes de broncoscopia y se han registrado los datos clínicos, informe de tomografía axial computarizada, técnicas realizadas, complicaciones y resultados. Resultados: Se trató a 136 pacientes (90 varones y 46 mujeres), con una edad media ± desviación estándar de 57 ± 7 años (rango: 3-81), en quienes se realizaron 320 procedimientos terapéuticos, que incluyeron 145 tratamientos con láser, 33 dilataciones con balón o mecánicas, 26 tratamientos mediante electrocauterio y la colocación de 116 prótesis. La etiología de la estenosis fue diversa: hubo 64 (47%) de causa tumoral (48 de origen broncopulmonar y 16 tumores extrapulmonares), mientras que en 72 pacientes (53%) la estenosis fue secundaria a una enfermedad no tumoral; de éstas, la causada por intubación prolongada fue la más frecuente (el 42% de los casos). La permeabilidad de la VAP se logró en el 92%(59/64) de las estenosis de etiología tumoral y en el 96% de las no tumorales (69/72), y se observó mejoría de la disnea en el 96% de todos los pacientes. En la primera semana hubo 2 fallecimientos (por hemoptisis e infarto agudo de miocardio), lo que representa una mortalidad del 1,4%. Las complicaciones más frecuentes fueron la migración de prótesis en un 8% (9/116) y en un 9% la formación de granulomas (11/116). Conclusiones: La broncoscopia intervencionista es una técnica eficaz para resolver las situaciones de riesgo vital de la VAP, con mejoría inmediata de la disnea y sin morbimortalidad significativa
Objective: To describe our experience with interventional bronchoscopy in the treatment of central airway stenosis. Patients and Methods: We reviewed patient records and bronchoscopic findings. Clinical data, findings from computed tomography, techniques performed, complications, and results were recorded. Results: One-hundred and thirty-six patients (90 males and 46 females) were treated. The mean (SD) age was 57 (7) years (range, 3-81). A total of 320 therapeutic interventions were performed: 145 laser treatments, 33 balloon or mechanical dilatations, 26 electrocauterizations, and 116 stent insertions. Pathogenesis varied: in 64 (47%) patients, the stenosis was caused by a tumor (48 were bronchopulmonary and 16 nonpulmonary); in 72 (53%) patients, stenosis was secondary to a nontumor-related process, of which the most common was prolonged intubation (42% of these cases). Central airway patency was achieved in 92% (59/64) of the tumor-related stenoses and 96% (69/72) of those unrelated to tumors. Improvement in dyspnea was observed in 96% of all patients. Two deaths (due to hemoptysis and to acute myocardial infarction) occurred in the first week, for a 1.4% mortality rate. The most common complications were stent migration (8%; 9/116 cases) and the formation of granulomas (9%; 11/116). Conclusions: Interventional bronchoscopy is an effective technique to resolve life-threatening obstructions of the central airways. Dyspnea improves immediately and there is no significant morbidity or mortality
Subject(s)
Humans , Tracheal Stenosis/etiology , Tracheal Stenosis/therapy , Bronchoscopy , Bronchial Diseases/therapyABSTRACT
OBJECTIVE: To evaluate long-term domiciliary oxygen therapy (LTOT) in our setting and the utility of pulse oxymetry for follow-up control. PATIENTS AND METHOD: 140 patients were studied. The data on the indication for LTOT and the degree of therapeutic compliance were obtained by means of a clinical interview; spirometry, full blood count, arterial blood gas measurement, and pulse oxymetry were also carried out. RESULTS: 12 (8.6%) patients who fulfilled criteria for provisional oxygen therapy were excluded and 22 (15.7%) due to recent exacerbations. Of the remaining 106 individuals, 67 (63%) were men and 39 (37%) women, and the mean age was 73 +/- 12 years. 54% (57/106) of the patients used the oxygen therapy for at least 15 hours/day. Only 36 (34%) patients fulfilled the indication criteria for LTOT and only 24 (23%) both fulfilled the indication criteria and demonstrated appropriate administration of the LTOT. The oxygen saturation measured by pulse oxymetry (SpO2) showed a good correlation with the partial pressure of oxygen (PaO2) obtained by arterial blood gas measurement (r=0.857 and K=0.937). CONCLUSIONS: In our setting, the follow-up control of LTOT and therapeutic compliance were not optimal. The SpO2 shows a good correlation with the PaO2 and represents a good alternative for the follow-up control of LTOT.
Subject(s)
Home Care Services , Oximetry , Oxygen Inhalation Therapy/methods , Oxygen/therapeutic use , Respiratory Insufficiency/therapy , Aged , Cross-Sectional Studies , Female , Follow-Up Studies , Heart Failure/therapy , Humans , Lung Diseases, Interstitial/therapy , Lung Diseases, Obstructive/therapy , Male , Middle Aged , Oxygen/blood , Treatment OutcomeABSTRACT
Objetivo: Evaluar la oxigenoterapia continua domiciliaria (OCD) en nuestro medio y la rentabilidad de la pulsioximetría en su control. Pacientes y método: Se estudian 140 pacientes. Los datos sobre indicación y grado de cumplimentación de la OCD quedan registrados mediante entrevista clínica, además se les realiza espirometría, hematimetría, gasometría arterial y pulsioximetría. Resultados: Fueron excluidos 12 pacientes (8,6%) que cumplían criterios de oxigenoterapia provisional y 22 (15,7%) que presentaban agudización. De los 106 individuos restantes, 67 eran hombres (63%) y 39 mujeres (37%), edad media de 73 ± 12 años. El 54% de los enfermos (57/106) mantenían la oxigenoterapia al menos 15 horas/ día, sólo 36 pacientes (34%) cumplían criterios de indicación de OCD y únicamente 24 (23%) presentaban criterios de indicación y adecuada administración de la OCD. La saturación de oxígeno determinada por pulsioximetría (SpO2) mostró una buena correlación con la presión arterial de oxígeno (PaO2) obtenida por gasometría arterial (r = 0,857 y K= 0,937). Conclusiones: En nuestro medio, el control y cumplimiento de la OCD no es óptimo. La SpO2 muestra una buena correlación con la PaO2 y representa una buena alternativa para el control de la OCD (AU)
