Safety and Efficacy of Bronchoalveolar Lavage Using a Laryngeal Mask Airway in Cases of Acute Hypoxaemic Respiratory Failure with Diffuse Lung Infiltrates
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- Matsumoto Takafumi
- Department of Anesthesiology and Intensive Care Medicine, Tokyo Women's Medical University, Japan
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- Sato Yoko
- Department of Anesthesiology and Intensive Care Medicine, Tokyo Women's Medical University, Japan
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- Fukuda Satoshi
- Department of Anesthesiology and Intensive Care Medicine, Tokyo Women's Medical University, Japan
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- Katayama Shinshu
- Department of Anesthesiology and Intensive Care Medicine, Tokyo Women's Medical University, Japan
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- Miyazaki Yuya
- Department of Anesthesiology and Intensive Care Medicine, Tokyo Women's Medical University, Japan
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- Ozaki Makoto
- Department of Anesthesiology and Intensive Care Medicine, Tokyo Women's Medical University, Japan
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- Kotani Toru
- Department of Anesthesiology and Intensive Care Medicine, Tokyo Women's Medical University, Japan
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抄録
Objective Fibre-optic bronchoscopy with bronchoalveolar lavage (FOB-BAL) is an important tool for diagnosing and selecting treatment for acutely hypoxaemic patients with diffuse lung infiltrates. However, FOB-BAL carries a risk of significant hypoxaemia and subsequent tracheal intubation during and after the procedure. The application of FOB-BAL using a laryngeal mask airway (LMA) in combination with continuous positive airway pressure (CPAP) may minimize the incidence of hypoxaemia; however, the safety and efficacy of this procedure have not been investigated.<br> Methods A retrospective chart review was performed from April to September 2013. Data regarding the recovered volume of BAL fluid, incidence of tracheal intubation within eight hours after the completion of FOB-BAL, respiratory and haemodynamic parameters and treatment modifications were collected for the evaluation.<br> Results Ten trials of FOB-BAL using an LMA and CPAP were performed in nine patients with severe acute hypoxaemia associated with diffuse lung infiltrates. The BAL fluid recovery rate was 56%, and the procedure was completed without subsequent complications. In addition, the percutaneous arterial oxygen saturation decreased to 95.7%±3.8%, although it was never lower than 90.0% during the procedure, and no patients required intubation. Furthermore, the arterial blood pressure significantly but transiently decreased due to sedation, and the procedure yielded diagnostic information in all nine patients.<br> Conclusion FOB-BAL using LMA and CPAP appears to be safe and effective in patients who develop severe acute hypoxaemia.<br>
収録刊行物
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- Internal Medicine
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Internal Medicine 54 (7), 731-735, 2015
一般社団法人 日本内科学会