Selection of the access channel in bronchoscopic intervention

ABSTRACT

Background

At present, bronchoscopic intervention has become an important treatment approach for central airway obstruction (CAO). Choosing an appropriate access channel for different patients during this operation has become a research focus.

Methods

Data of bronchoscopic interventions in 201 patients with CAO in which one of endotracheal intubation, laryngeal mask, or rigid bronchoscope were used as the only access channel were retrospectively reviewed.

Results

The total immediate effective rate was 94.1% (398/423), and the main complications related to the access channels included hypoxemia, elevated arterial partial pressure of carbon dioxide, arrhythmia, airway mucosa tear, glottic edema, vocal cord injury, tooth loss, massive bleeding, airway mucosal necrosis, and asphyxia. The incidence of complications was 16.8% (71/423). Glottic edema was the most common complication with an incidence of 7.8% (33/423) and accounted for 46.5% of all complications. Glottic edema only occurred in the laryngeal mask and rigid bronchoscope groups, and the incidence was significantly correlated with the operation time (p < 0.001). Massive bleeding related to the access channel remains the most serious complication.

Conclusions

Endotracheal intubation, laryngeal mask, and rigid bronchoscope each have their own advantages and disadvantages. The most appropriate access channel should depend on a comprehensive assessment of the patient.

KEYWORDS:

• Airway obstruction
• bronchoscopy
• complications
• indications
• characteristics

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Hui Chen and Lin Yang have given substantial contributions to the conception or the design of the manuscript. Yang Yao, Shengyu Wang and Song Liu to acquisition, analysis and interpretation of the data. All authors have participated to drafting the manuscript. Lin Yang and Hui Chen revised it critically. All authors read and approved the final version of the manuscript.

Ethical approval

The study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Xi’an Medical University (XYYFY2021LSK-011). Informed consent was not required from patients due to the retrospective nature of the study and this exemption was approved by the above ethics committee.

Additional information

Funding

This paper was not funded.