How do you manage bronchopleural fistula?
Bronchopleural fistula (BPF) is a sinus tract between the main stem, lobar, or segmental bronchus and the pleural space. Treatment for BPF ranges from medical management to bronchoscopic procedures for critically ill patients and surgical intervention for those deemed at the highest risk.
How do you ventilate a bronchopleural fistula?
You place a BVM with a PEEP valve set to 10 cm H20 on the left bronchial lumen, while continuing to ventilate the right lung with the ventilator on the tracheal lumen.
What kind of anesthesia is used for a bronchoscopy?
Propofol. It is a short acting anaesthetic agent used in bronchoscopy for moderate sedation. It has a rapid onset of action and rapid recovery. It is used for its hypnotic, antiemetic and antipruritic effects.
How can bronchopleural fistula be prevented?
The best treatment of a BPF is prevention. Prevention centers around meticulous surgical technique and the liberal use of prophylactic, pedicled muscle flaps for the patient at increased risk. Survival of BPF depends on a high index of suspicion, early diagnosis, and aggressive surgical intervention.
What causes a bronchopleural fistula?
A bronchopleural fistula may be caused by: (1) rupture of a lung abscess, bronchus, bulla, cyst, or parenchymal tissue into the pleural space; (2) the erosion of a bronchus by carcinoma or chronic inflammatory disease; or (3) stump dehiscence of a bronchial suture line after pulmonary resection.
Why is pleurodesis performed?
Pleurodesis is used as a possible treatment for complications from lung cancer, but it may also be recommended for other health conditions that cause difficulty breathing. It’s a medical procedure designed to stop fluid or air from collecting in the pleural space—the space between the lung and chest wall.
What is talc pleurodesis?
Talc pleurodesis is a specific form of chemical pleurodesis. Talc is the most effective sclerosant available for pleurodesis in malignant pleural effusion [1]. As compared to indwelling pleural catheter placement, talc pleurodesis has been shown to be equally effective in relieving dyspnea [2].
Why is atropine given before a bronchoscopy?
Abstract. Objective: Atropine premedication is widely used for fiberoptic bronchoscopy and may help by drying secretions, producing bronchodilatation, or preventing vasovagal reactions.
What is decortication surgery?
Decortication is a type of surgical procedure performed to remove a fibrous tissue that has abnormally formed on the surface of the lung, chest wall or diaphragm. Generally, there is a space (called pleural space) in between the lungs and the chest wall, which is lined with a very thin fluid layer for lubrication.
What is the best treatment for fistula?
A fistulotomy is the most effective treatment for many anal fistulas, although it’s usually only suitable for fistulas that do not pass through much of the sphincter muscles, as the risk of incontinence is lowest in these cases.
What is empyema bronchopleural fistula?
Pleural Effusion and Empyema A bronchopleural fistula (BPF) is a communication between the pleural space and the bronchial tree. Although rare, BPF can be associated with high morbidity and mortality. 134. Postoperative complications for lobectomy, and especially pneumonectomy, are the most common causes.