Fiberoptic endoscopy has brought about significant progress in the management of so-called difficult intubations. We describe the techniques applied and results in one hospital service performing intubation guided by fiberoptic bronchoscope (FB). A total of 512 consecutive intubations (64.18% men and 35.15% women) performed over the past 18 years were analyzed. Non-tumor related disease of the cervical column (28.91%) was the most frequent cause of difficult intubation requiring FB guidance, followed by trauma (18.16%) and technical difficulties (17.39%). A nasal route was used most often (80.86%). In 93.16% of cases, intubation was needed for surgery. Thirty-five (6.84%) complications of various types were recorded, and intubation was impossible in 3 (0.59%) cases. Intubation in patients under general anesthesia presented special technical difficulties due to loss of muscle tone and the need to maintain ventilation. We recommend intubation only in patients who are breathing spontaneously through the nose, using lidocaine as a local anesthetic and a large caliber endotracheal tube with as small a tip as possible.

Adolescent↗

PubMed1991

[Congestive heart failure as the form of presentation of mediastinal actinomycosis].

Explore the source record for details and available documents.

Actinomycosis↗

PubMed1990

[Pseudotumoral bronchial tuberculosis].

We analyse our own experience of a rare tuberculosis presentation that we call pseudotumoral bronchial tuberculosis. 9 cases were studied, which due to radiological, endoscopic and clinical features, a diagnosis of bronchogenic carcinoma was made. The median age was 63.7 years, 7 were male and 2 were female. The hilar or mediastinic radiological pattern was frequent. The bacterial diagnosis was made through the study of the samples obtained by bronchoscopy, except in 2 cases which were diagnosed through post-bronchoscopy sputum examination. The bronchial biopsy showed the typical necrotic granulomas of tuberculosis in only one case. Supported by the bad evolution of our patients treated without steroids, the possible efficacy of early use of steroid is suggested to avoid the most important sequelae, bronchial stenosis.

Adult↗

PubMed1989