GLOBAL PERSPECTIVES ON BRONCHOSCOPY Edited by Sai Praveen Haranath and Samiya Razvi Global Perspectives on Bronchoscopy Edited by Sai Praveen Haranath and Samiya Razvi Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Jana Sertic Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published May, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Global Perspectives on Bronchoscopy, Edited by Sai Praveen Haranath and Samiya Razvi p. cm. ISBN 978-953-51-0642-5 Contents Preface IX Section 1 Basics of Bronchoscopy 1 Chapter 1 Role of Flexible-Bronchoscopy in Pulmonary and Critical Care Practice 3 Gilda Diaz-Fuentes and Sindhaghatta K. Venkatram Chapter 2 Monitoring, Sedation, and Anesthesia for Flexible Fiberoptic Bronchoscopy 35 Michael J. Morris, Herbert P. Kwon and Thomas B. Zanders Section 2 Bronchoscopic Investigations 55 Chapter 3 Role of Broncoalveolar Lavage in Diagnosis 57 Mohammad Shameem Chapter 4 Lung Cancer – CT Vs Bronchoscopy 71 António Saraiva and Christopher Oliveira Section 3 Bronchoscopy in Special Situations 89 Chapter 5 Bronchoscopy in Mechanically Ventilated Patients 91 Angel Estella Chapter 6 Bronchoscopy in Bronchiectasis and Cystic Fibrosis 107 Aditya Kasarabada, Mark E. Lund and Jeffrey B. Hoag Section 4 Evolving Therapeutic Uses of Bronchoscopy 125 Chapter 7 Endotracheal Intubation with Flexible Fiberoptic Bronchoscope (FFB) in Cases of Difficult Airway 127 Francisco Navarro, Raúl Cicero and Andrea Colli VI Contents Chapter 8 Bronchoscopic Balloon Dilation (BBD) for Benign Tracheobronchial Stenosis 135 Masayuki Tanahashi, Hiroshi Niwa, Haruhiro Yukiue, Eriko Suzuki, Hiroshi Haneda, Naoko Yoshii and Hisanori Kani Chapter 9 Endoscopic Percutaneous Tracheotomy in Prolonged Intubation of Mechanical Ventilated Patients Admitted in Cardio-Thoracic Intensive Care Unit 151 Rosa Mastropierro, Michela Bettinzoli and Aldo Manzato Section 5 Pediatric Bronchoscopy 175 Chapter 10 Pediatric Bronchoscopy 177 Selma Maria de Azevedo Sias, Ana Cristina Barbosa Domingues and Rosana V. Mannarino Chapter 11 Manual Jet Ventilation Using Manujet III for Bronchoscopic Airway Foreign Body Removal in Children 201 Shaoqing Li, Yuqi Liu and Fang Tan Chapter 12 Utility of Pediatric Flexible Bronchoscopy in the Diagnosis and Treatment of Congenital Airway Malformations in Children 219 Yong Yin, Shuhua Yuan, Wenwei Zhong and Yu Ding Preface Bronchoscopy has become an essential part of modern medicine. Recent advances in technology have allowed integration of ultrasound with this tool. The use of lasers along with bronchoscopes has increased the therapeutic utility of this device. Globally an increasing number of pulmonary specialists, anaesthesiologists and thoracic surgeons are using the bronchoscope to expedite diagnosis and treatment. The current volume on bronchoscopy adds to the vast body of knowledge on this topic. The contributions from around the world cover the breadth of this field and include cutting edge uses as well as a section on pediatric bronchoscopy. This was a tough job for me as an editor of the book, since the authors wrote vast and extensive chapters . It was a great experience. I would request readers to review the book and suggest areas for modification or further topic additions for future versions. Every care has been taken to ensure the accuracy of information and authors are aware of the strict rules against plagiarism. The book is divided in various sections in order to make it easier for the beginner, as well as the advanced reader to have a rapid overview of this topic. The section on pediatric bronchoscopy highlights issues specific to children that are recognizably different from adults, including airway anatomy, anesthesia considerations and the emerging field of diagnostic and therapeutic procedures in this age group. A major indication for bronchoscopy in infants and young children continues to be evaluation for congenital airway malformations, and both common and uncommon disorders are reviewed with illustrations in this text. As a pulmonary and critical care physician it has been fulfilling to see the chapters on special areas like bronchoscopy in bronchiectasis as well as in the intensive care unit. Practical uses like managing and monitoring the airway during percutaneous tracheostomy performance has an entire chapter devoted to this evolving topic . In summary, this book is a great testament to the power of collaboration and is a superb resource for doctors in training, ancillary team members as well as practicing healthcare providers who have to perform or arrange bronchoscopy or the similar procedures. I would like to sincerely thank my associate editor Dr Samiya Razvi for ensuring the pediatric section to integrate well into this comprehensive book. I am grateful to InTech as well as Jana Sertic, my coordinator, for her patient yet firm requests for expediting this book. I hope the readers will find this book enjoyable for X Preface reading and that they will recignize a contemporary source of knowledge in our book. Dr. Sai Praveen Haranath Consultant Pulmonologist and Critical Care Medicine Specialist, Axon Anesthesia Associates, Hyderabad, Apollo Hospitals, Jubilee Hills, Hyderabad, India Dr. Samiya Razvi Consultant Pediatric Pulmonologist, Apollo Hospitals, Jubilee Hills, Hyderabad, India . on bronchoscopy reveals that the most common indications for bronchoscopy are the evaluation of suspicious lesions (nodules and masses), hemoptysis, pneumonia and infections, diffuse pulmonary. GLOBAL PERSPECTIVES ON BRONCHOSCOPY Edited by Sai Praveen Haranath and Samiya Razvi Global Perspectives on Bronchoscopy Edited by Sai Praveen. independent lung ventilation Table 1. Indications for Diagnostic Bronchoscopy Indications for therapeutic bronchoscopy are listed in Table 2. Often, bronchoscopy is done for diagnostic and therapeutic