RT Journal Article
SR Electronic
T1 Iatrogenic bleeding during flexible bronchoscopy: risk factors, prophylactic measures and management
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00084-2016
DO 10.1183/23120541.00084-2016
VO 3
IS 2
A1 Maurizio Bernasconi
A1 Coenraad F.N. Koegelenberg
A1 Angela Koutsokera
A1 Adam Ogna
A1 Alessio Casutt
A1 Laurent Nicod
A1 Alban Lovis
YR 2017
UL http://openres.ersjournals.com/content/3/2/00084-2016.abstract
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