Page 83 - ECBIP 2021_Program

MODERATED e-POSTER SESSION 09:
Miscellaneous and Rare Diseases
PP57
Background: The past few decades has witnessed development of new tools to support the respiratory system. Extracorporeal membrane oxygenation (ECMO) and the high flow nasal cannula (HFNC) have been utilized more frequently due to their expanding indications. With their increasing use, pulmonologists are to expect to encounter clinical situations where performing bronchoscopy is absolutely necessary.
Aim: We aim in this case series to illustrate the feasibility of bronchoscopy in the following population: 1-patients with sever hypoxemia that require HFNC usage.
2-patients with sever hypoxemia that were rescued by ECMO.
We describe the clinical data, procedure related outcome as well as the final patients outcomes.
Method: We reviewed the electronic medical files of all patients underwent bronchoscopy from 01/09/2019 until 01/11/2020. All bronchoscopy that was performed for patients while on ECMO and/or HFNC were included. Indication, clinical parameter and laboratory tests at the day of bronchoscopy were recorded. Procedure related data and the patients final outcome were recorded as well.
Result: 7 bronchoscopy were performed for 5 patients while on ECMO or HFNC (5 for ECMO and 2 for HFNC). Indication of bronchoscopy were massive bleeding and total lung collapse for the ECMO cases; while, investigating for possible hospital acquired infection in immune compromised patients for HFNC cases.The procedure achieved its diagnostic and/or therapeutic purpose in all cases. Patients management was adjusted based on the results of the bronchoscopy in 2 out of 3 diagnostic procedures. For the therapeutic bronchoscopy, the effect was transient in one procedure. No procedure related complication recorded despite presence of important coagulation abnormalities in 3 out of 7 procedures. 2 out of the 5 patients have died later during the course of their illness due to the underlying disease.
Conclusion:
- Bronchoscopy for both diagnostic and therapeutic indications is feasible in patients receiving respiratory support by ECMO and/or HFNC.
- Therapeutic bronchoscopy was successful to re-establish the airway patency in all cases, however, the effect was transient in one procedure.
-Diagnostic bronchoscopy, identified the underlying pathogen in all cases, however, in one case that did not lead to an important adjustment of therapy.
Table 1: Summarized clinical data and procedure related outcome for patients underwent bronchoscopy while receiving ECMO or HFNC support.
BRONCHOSCOPY FOR PATIENTS ON ECMO OR HFNC
A SINGLE CENTER EXPERIENCE
Abdelfattah Touman, Rajaa Alsaggaf, Eid Al-Qurashi, Nabil Ghalib, Ahmad Al-Dobyany King Abdulla Medical City, Makkah, Saudi Arabia
ECBIP 2021 83
6th European Congress
for Bronchology and Interventional Pulmonology
OCTOBER ECBIP 15 - 17
ATHENS - GREECE 2021
Book of Abstracts