Bedside pleuroscopy in the management of undiagnosed exudative pleural effusion with acute respiratory failure

O. Hean, C. Shang-Miao, L. Chien-Ming, C. Kuo-Liang, W. Jeng-Yuan, H. Nan-Yung, H. Bor-Tsung

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Pleuroscopy is indicated in patients with acute respiratory failure due to an unresolved exudative pleural effusion but it may not be possible to move such patients to the operating theatre or endoscopy room for pleuroscopy due to their critical condition. We report our experience of using flexible bronchoscopy for pleuroscopy to diagnose pleural effusion in patients with acute respiratory failure at the bedside in the intensive care unit. Before pleuroscopy patients were placed in the lateral decubitus position. We used bedside chest sonography to guide safe entry of the trocar. The skin was sterilised with povidone-iodine and local analgesia was with 2% lignocaine. Incisions were made using a knife with a width of 5 mm. A trocar 5.5 mm in diameter was then inserted, followed by a bronchoscope. The pleural cavity was inspected and biopsies were performed under direct vision in all suspected areas. A 16 Fr pigtail catheter was inserted for drainage after the pleuroscopy. Chest radiographs were routinely obtained after the procedure. In summary, this modified pleuroscopy technique can be performed at the bedside in an intensive care unit.

Original languageEnglish
Pages (from-to)473-475
Number of pages3
JournalAnaesthesia and Intensive Care
Volume41
Issue number4
Publication statusPublished - Jul 2013
Externally publishedYes

Fingerprint

Thoracoscopy
Pleural Effusion
Respiratory Insufficiency
Surgical Instruments
Intensive Care Units
Thorax
Povidone-Iodine
Bronchoscopes
Pleural Cavity
Bronchoscopy
Lidocaine
Analgesia
Endoscopy
Drainage
Ultrasonography
Catheters
Biopsy
Skin

Keywords

  • Flexible
  • Pleural effusion
  • Pleuroscopy

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Hean, O., Shang-Miao, C., Chien-Ming, L., Kuo-Liang, C., Jeng-Yuan, W., Nan-Yung, H., & Bor-Tsung, H. (2013). Bedside pleuroscopy in the management of undiagnosed exudative pleural effusion with acute respiratory failure. Anaesthesia and Intensive Care, 41(4), 473-475.

Bedside pleuroscopy in the management of undiagnosed exudative pleural effusion with acute respiratory failure. / Hean, O.; Shang-Miao, C.; Chien-Ming, L.; Kuo-Liang, C.; Jeng-Yuan, W.; Nan-Yung, H.; Bor-Tsung, H.

In: Anaesthesia and Intensive Care, Vol. 41, No. 4, 07.2013, p. 473-475.

Research output: Contribution to journalReview article

Hean, O, Shang-Miao, C, Chien-Ming, L, Kuo-Liang, C, Jeng-Yuan, W, Nan-Yung, H & Bor-Tsung, H 2013, 'Bedside pleuroscopy in the management of undiagnosed exudative pleural effusion with acute respiratory failure', Anaesthesia and Intensive Care, vol. 41, no. 4, pp. 473-475.
Hean O, Shang-Miao C, Chien-Ming L, Kuo-Liang C, Jeng-Yuan W, Nan-Yung H et al. Bedside pleuroscopy in the management of undiagnosed exudative pleural effusion with acute respiratory failure. Anaesthesia and Intensive Care. 2013 Jul;41(4):473-475.
Hean, O. ; Shang-Miao, C. ; Chien-Ming, L. ; Kuo-Liang, C. ; Jeng-Yuan, W. ; Nan-Yung, H. ; Bor-Tsung, H. / Bedside pleuroscopy in the management of undiagnosed exudative pleural effusion with acute respiratory failure. In: Anaesthesia and Intensive Care. 2013 ; Vol. 41, No. 4. pp. 473-475.
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AB - Pleuroscopy is indicated in patients with acute respiratory failure due to an unresolved exudative pleural effusion but it may not be possible to move such patients to the operating theatre or endoscopy room for pleuroscopy due to their critical condition. We report our experience of using flexible bronchoscopy for pleuroscopy to diagnose pleural effusion in patients with acute respiratory failure at the bedside in the intensive care unit. Before pleuroscopy patients were placed in the lateral decubitus position. We used bedside chest sonography to guide safe entry of the trocar. The skin was sterilised with povidone-iodine and local analgesia was with 2% lignocaine. Incisions were made using a knife with a width of 5 mm. A trocar 5.5 mm in diameter was then inserted, followed by a bronchoscope. The pleural cavity was inspected and biopsies were performed under direct vision in all suspected areas. A 16 Fr pigtail catheter was inserted for drainage after the pleuroscopy. Chest radiographs were routinely obtained after the procedure. In summary, this modified pleuroscopy technique can be performed at the bedside in an intensive care unit.

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