PT  - JOURNAL ARTICLE
AU  - Maurizio Bernasconi
AU  - Coenraad F.N. Koegelenberg
AU  - Angela Koutsokera
AU  - Adam Ogna
AU  - Alessio Casutt
AU  - Laurent Nicod
AU  - Alban Lovis
TI  - Iatrogenic bleeding during flexible bronchoscopy: risk factors, prophylactic measures and management
AID  - 10.1183/23120541.00084-2016
DP  - 2017 Apr 01
TA  - ERJ Open Research
PG  - 00084-2016
VI  - 3
IP  - 2
4099  - http://openres.ersjournals.com/content/3/2/00084-2016.short
4100  - http://openres.ersjournals.com/content/3/2/00084-2016.full
SO  - erjor2017 Apr 01; 3
AB  - Significant iatrogenic bleeding during flexible bronchoscopy is fortunately rare and usually self-limiting. Life-threatening bleeding, however, can occur, especially after conventional or cryoprobe-assisted transbronchial biopsy. The aim of this review is to provide the practising pulmonologist with a concise overview of the incidence, severity and risk factors for bleeding, to provide sensible advice on prophylactic measures and to suggest a plan of action in the case of significant bleeding. Bronchoscopy units should have a standardised approach and plan of action in the case of life-threatening haemorrhage. Wedging the bronchoscope in the bleeding segment, turning the patient in an anti-Trendelenburg position and onto the side in order for the bleeding lung to be in the dependent position, installing vasoconstrictors and using a tamponade balloon early are the recommended first-line strategies. Involving a resuscitation team should be considered early in the case of massive bleeding, desaturation and haemodynamic instability.Iatrogenic bleeding during flexible bronchoscopy http://ow.ly/w9Fy30bsoe5