الفهرس 
Anatomy of bronchial treeOnly 14 pages are availabe for public view
 |  | from | 166 |  |  |
| | | from | 166 | | |
Abstract
Bronchoscope is a procedure that involves placement of a viewing instrument in to the trachea (windpipe) and bronchi (airway) to diagnose or treat lung and airway problems.
In the diagnosis of pulmonary diseases, radiography is usually used to identify the problems. However, sometimes there may be cases that chest x-ray or thoracic CT scan gives us unclear or wrong information. In order to improve the accuracy of diagnosis, bronchoscope is applied to identify the diseases and flexible bronchoscope is commonly used.
General indications of bronchoscope include stridor, foreign body removal, chronic cough, congenital tracheal stenosis, wheeze not responding to therapy, persistent atelectasis, persistent pneumonia, hemoptysis, subglottic stenosis and others such as staging papilloma, tracheal brush biopsy, respiratory distress, aspiration.
In general the majority of flexible bronchoscope can be performed under sedation that preserves spontaneous ventilation. Assessment of the airway during spontaneous ventilation is essential. Therefore, the choice between anesthesia and sedation depends both upon the patients’ clinical status, the age of the patients and the indication of the procedure.
General anesthesia will be required to perform rigid bronchoscope. The anesthetic machine and other equipment should be checked, especially suction equipment. A range of sizes of endotracheal tubes should be available, in case intubation is urgently required, bearing in mind that the presence of airway edema reduces the tracheal diameter.
Monitoring including pulse oximetry, ECG, non-invasive blood pressure and capnography should be applied. Intravenous access should be secured prior to induction, but if the child is distressed this can be performed immediately after induction.
Gas exchange in the anesthetized and paralyzed patient may be done by variety of methods: (1) apneic oxygenation; (2) rigid ventilating bronchoscope; (3) rigid bronchoscope with venture attachment; (4) high frequency jet ventilation.
Complications of bronchoscope may be attributable to the procedure, local anesthesia, sedation and general anesthesia.