Rigid bronchoscopy: Intubation techniques
- Henri G Colt, MD
Henri G Colt, MD
- Professor of Medicine
- University of California Irvine
The rigid bronchoscope, which is a hollow stainless steel tube through which a rigid telescope is placed, provides access to the central airways. External diameters and lengths vary depending upon the manufacturer. The distal end of the rigid bronchoscope is usually beveled to facilitate intubation and lifting of the epiglottis; the proximal portion is equipped to accommodate attachments, provide side port ventilation, and permit insertion of ancillary instruments.
Intubation with the rigid bronchoscope usually prompts the following questions:
●What anesthesia and patient preparation techniques are commonly used?
●How is direct intubation performed?
●Is laryngoscopically-guided intubation possible?
Subscribers log in hereLiterature review current through: Jul 2017. | This topic last updated: Sep 24, 2015.References
- Bolliger CT, Mathur PN, Beamis JF, et al. ERS/ATS statement on interventional pulmonology. European Respiratory Society/American Thoracic Society. Eur Respir J 2002; 19:356.
- Conacher ID. Anaesthesia and tracheobronchial stenting for central airway obstruction in adults. Br J Anaesth 2003; 90:367.
- Perrin G, Colt HG, Martin C, et al. Safety of interventional rigid bronchoscopy using intravenous anesthesia and spontaneous assisted ventilation. A prospective study. Chest 1992; 102:1526.
- Ernst A, Silvestri GA, Johnstone D, American College of Chest Physicians. Interventional pulmonary procedures: Guidelines from the American College of Chest Physicians. Chest 2003; 123:1693.
- Ernst A, Feller-Kopman D, Becker HD, Mehta AC. Central airway obstruction. Am J Respir Crit Care Med 2004; 169:1278.
- Natalini G, Cavaliere S, Seramondi V, et al. Negative pressure ventilation vs external high-frequency oscillation during rigid bronchoscopy. A controlled randomized trial. Chest 2000; 118:18.
- PATIENT PREPARATION
- DIRECT INTUBATION
- INTUBATION WITH LARYNGOSCOPY
- INTUBATION VIA TRACHEOSTOMY
- Damage to structures of the mouth and oropharynx
- Laryngeal swelling
- Spinal cord injury
- Airway perforation and injury to the vocal cords and arytenoids
- SUMMARY AND RECOMMENDATIONS