Bronchoscopy during non-invasive ventilation in a patient with acute respiratory distress syndrome
1Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
2 Department of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
3 Vita-Salute San Raffaele University, Milan, Italy
DOI: 10.22514/SV131.032017.13 Vol.13,Issue 1,March 2017 pp.103-104
Published: 20 March 2017
A 72-year-old man was transferred to our hospital for refractory severe acute respiratory syndrome. On arrival, he was intubated and mechanically ventilated. Furthermore, he required veno-venous extracorporeal membrane oxygenation. Two days later, he was extubated and sup-ported with periods of non-invasive ven-tilation (NIV), with a new mask. Because of large amounts of bronchial secretions that he was not able to expectorate, flex-ible fiberoptic bronchoscopy (FFB) was performed to remove the secretions, with-out interrupting NIV support. During the procedure, the patient remained hemody-namically stable, breathing spontaneously and with just a mild reduction in oxygen saturation (SpO2) (97.9% vs. 96.8%). This case report highlights the possibility of performing upper endoscopic procedures, such as FFB, during non-invasive ventila-tion in patients in whom this respiratory support is required and its interruption may be harmful.
non-invasive ventilation, acute respiratory distress syndrome, flexible fiber-optic bronchoscopy, intensive care unit
TIZIANA BOVE,CARMINE DOMENICO VOTTA,PAOLA CIRIACO,FEDERICO PAPPALARDO,ALESSANDRO ORIANI,GIOVANNA FRAU,ALBERTO ZANGRILLO. Bronchoscopy during non-invasive ventilation in a patient with acute respiratory distress syndrome. Signa Vitae. 2017. 13(1);103-104.
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