Iatrogenic bleeding during flexible bronchoscopy: risk factors, prophylactic measures and management.
- Bernasconi M Division of Pulmonology, Dept of Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
- Koegelenberg CFN Division of Pulmonology, Dept of Medicine, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa.
- Koutsokera A Division of Pulmonology, Dept of Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
- Ogna A Division of Pulmonology, Dept of Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
- Casutt A Division of Pulmonology, Dept of Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
- Nicod L Division of Pulmonology, Dept of Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
- Lovis A Division of Pulmonology, Dept of Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
- 2017-06-29
Published in:
- ERJ open research. - 2017
English
Significant iatrogenic bleeding during flexible bronchoscopy is fortunately rare and usually self-limiting. Life-threatening bleeding, however, can occur, especially after conventional or cryoprobe-assisted transbronchial biopsy. The aim of this review is to provide the practising pulmonologist with a concise overview of the incidence, severity and risk factors for bleeding, to provide sensible advice on prophylactic measures and to suggest a plan of action in the case of significant bleeding. Bronchoscopy units should have a standardised approach and plan of action in the case of life-threatening haemorrhage. Wedging the bronchoscope in the bleeding segment, turning the patient in an anti-Trendelenburg position and onto the side in order for the bleeding lung to be in the dependent position, installing vasoconstrictors and using a tamponade balloon early are the recommended first-line strategies. Involving a resuscitation team should be considered early in the case of massive bleeding, desaturation and haemodynamic instability.
- Language
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- English
- Open access status
- gold
- Identifiers
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- DOI 10.1183/23120541.00084-2016
- PMID 28656131
- Persistent URL
- https://sonar.ch/global/documents/82952
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