Acute Respiratory Failure, Fibrosis Lung, Interstitial Lung Disease, Lung Cancer, Pneumonia
Conditions
Keywords
Bronchoscopy
Brief summary
The current practice of oxygenation and/or ventilation supports in patients undergoing Fiberoptic Bronchoscopy is very heterogeneous among studies published in the literature; in addition, clear outcomes advantages of one strategy over another currently lack. The goal of this observational study is to describe the current practice of oxygenation and/or ventilation supports in patients undergoing Fiberoptic Bronchoscopy (FOB), stratified by baseline respiratory condition, co-morbidities, type of procedure and hospital settings. Investigators will enroll all adult patients undergoing any fiberoptic bronchoscopy in any clinical settings (from outpatients to critically ill patients). No specific exclusion criteria are indicated for enrollment in this study. Investigators will record the following data: * Patient's baseline data. * Type of FOB procedure: toilet bronchoscopy (for secretions, blood, mucus plugs removal), broncho-aspirate (BAS), bronchoalveolar lavage (BAL), brushing for cytology, biopsy, endobronchial ultrasound (EBUS). The type and size of bronchoscope (with or without an internal/external camera) and the time of the procedure will be also recorded. * Type of supportive strategy: no support, Standard Oxygen Therapy, High Flow Nasal Cannula, Continuous Positive Airway Pressure and or non invasive ventilation trough mask or helmet, invasive mechanical ventilation. * Sedation * Intra-procedural vital parameters * Occurrence of adverse events: desaturation (i.e. SpO2\< 90% for at least 10 seconds), severe desaturation (i.e. SpO2\< 80%), need for procedure interruption, hypotensive (systolic blood pressure \<90 mmHg) or hypertensive (systolic blood pressure \>140 mmHg) events, new onset of cardiac arrhythmias (specify the rhythm) or myocardial ischemia or electrocardiographic ST-alterations, neurological events (i.e. severe sensorium depression, psychomotor agitation). * Post-procedural vital parameters (15 minutes after the procedure). * Clinical outcomes: need for support escalation, need for admission to ward (for outpatient) or ICU (for outpatients and ward-admitted patient).
Interventions
DIAGNOSTIC_TESTBronchoscopy
Patients will undergo to the bronchial endoscopy procedure required for their clinical condition: toilet bronchoscopy (for secretions, blood, mucus plugs removal), broncho-aspirate (BAS), bronchoalveolar lavage (BAL), brushing for cytology, biopsy, endobronchial ultrasound (EBUS).
Sponsors
University Magna Graecia
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Need for any procedure with flexible FOB * Either outpatients in dedicated ambulatories, and admitted to any hospital ward or Intensive Care Unit (ICU)
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Type of oxygenation strategy adopted | Through the endoscopy completion, an average of 30 minutes | The type of oxygenation strategy (standard oxygen therapy, high flow nasal cannula, continuous positive airway pressure, non invasive ventilation or invasive mechanical ventilation) adopted during the bronchoscopy will be recorded. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Lowest peripheral oxygen saturation | Through the endoscopy completion, an average of 30 minutes | The lowest peripheral oxygen saturation recorded during the procedure |
| Lowest heart rate | Through the endoscopy completion, an average of 30 minutes | The lowest heart rate recorded during the procedure |
| Highest heart rate | Through the endoscopy completion, an average of 30 minutes | The highest heart rate recorded during the procedure |
| Lowest systolic blood pressure | Through the endoscopy completion, an average of 30 minutes | The lowest systolic blood pressure recorded during the procedure |
| Highest systolic blood pressure | Through the endoscopy completion, an average of 30 minutes | The highest systolic blood pressure recorded during the procedure |
| Duration of the procedure | From the beginning to the end of the endoscopy procedure | The time duration of the procedure in minutes, from the beginning to the end of the endoscopy procedure |
| Type of sedation strategy adopted | Through the endoscopy completion, an average of 30 minutes | The type of sedation strategy (topical anesthesia, midazolam, propofol, remifentanil, fentanyl, dexmedetomidine, neuromuscular blocking agents) adopted during the bronchoscopy will be recorded. |
| Severe desaturation events | Through the endoscopy completion, an average of 30 minutes | Occurrence of peripheral oxygen saturation \< 80% |
| Hypotensive events | Through the endoscopy completion, an average of 30 minutes | Occurrence of systolic blood pressure \<90 mmHg |
| Hypertensive events | Through the endoscopy completion, an average of 30 minutes | Occurrence of systolic blood pressure \>140 mmHg |
| Need for support escalation | Through the endoscopy completion, an average of 30 minutes | Need to escalate the oxygenation/ventilation support from from standard oxygen therapy (lowest support) to High Flow Nasal Cannula, Continuous Positive Airway Pressure, Non Invasive Ventilation or invasive Mechanical Ventilation (highest grade of support) |
| Admission to ward or intensive care unit | At the end of the endoscopy completion, after an average of 30 minutes from study start | Need for admission to ward or intensive care unit after the endoscopy completion |
| Desaturation events | Through the endoscopy completion, an average of 30 minutes | Occurrence of peripheral oxygen saturation \< 90% for at least 10 seconds |
Countries
Italy
Contacts
Primary ContactFederico Longhini, MD
Outcome results
None listed