{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T01:58:07Z","timestamp":1773280687406,"version":"3.50.1"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2011,7,27]],"date-time":"2011-07-27T00:00:00Z","timestamp":1311724800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2011,7,27]],"date-time":"2011-07-27T00:00:00Z","timestamp":1311724800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>Noninvasive ventilation (NIV) is a standard procedure in selected patients with acute respiratory failure. Previous studies have used noninvasive ventilation to ensure adequate gas exchange during fiberoptic bronchoscopy in spontaneously breathing hypoxemic patients, thus avoiding endotracheal intubation. However, it is unknown whether bronchoscopy can be performed safely in patients with acute hypoxemic respiratory failure already in need of NIV prior to the decision for bronchoscopy.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>We prospectively investigated 40 consecutive, critically ill, adult patients with acute hypoxemic respiratory failure (14 women, 26 men, age 61 \u00b1 15 years, partial pressure for oxygen\/fraction of inspired oxygen (PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub>) &lt; 300 under noninvasive ventilation, Simplified Acute Physiology scores (SAPS II) 47 \u00b1 9.9 points). All patients required noninvasive ventilation prior to the decision to perform bronchoscopy (median 10.5 h; range 2.2 to 114). Blood gases, heart rate, blood pressure and ventilation were monitored before, during and up to 120 minutes after bronchoscopy.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>Bronchoscopy could be completed in all patients without subsequent complications. Oxygen saturation fell to &lt; 90% in two patients (5%), and the lowest value during the procedure was 84%. The mean PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub> ratio improved from 176 \u00b1 54 at baseline to 240 \u00b1 130 (<jats:italic>P<\/jats:italic> &lt; 0.001) at the end of bronchoscopy and 210 \u00b1 79 after 120 minutes. The transient mean partial pressure of carbon dioxide in the arterial blood (PaCO<jats:sub>2<\/jats:sub>) increase was 9.4 \u00b1 8.1 mm Hg. Four patients (10%) required endotracheal intubation during the first eight hours after the procedure. Bronchoalveolar lavage yielded diagnostic information in 26 of 38 (68%) patients.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>In critically ill patients with acute hypoxemic respiratory failure requiring noninvasive ventilation, bronchoscopy can be performed with an acceptable risk. Since these patients <jats:italic>per se<\/jats:italic> have a high likelihood of subsequent endotracheal intubation due to failure of NIV, bronchoscopy should only be performed by experienced clinicians.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/cc10328","type":"journal-article","created":{"date-parts":[[2011,7,28]],"date-time":"2011-07-28T06:19:08Z","timestamp":1311833948000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Fiber optic bronchoscopy in patients with acute hypoxemic respiratory failure requiring noninvasive ventilation - a feasibility study"],"prefix":"10.1186","volume":"15","author":[{"given":"Hans J\u00f6rg","family":"Baumann","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans","family":"Klose","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel","family":"Simon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarik","family":"Ghadban","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan A","family":"Braune","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan K","family":"Hennigs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Kluge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2011,7,27]]},"reference":[{"key":"9613_CR1","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/S0140-6736(09)60496-7","volume":"374","author":"S Nava","year":"2009","unstructured":"Nava S, Hill N: Non-invasive ventilation in acute respiratory failure.\n                           Lancet 2009, 374: 250-259. 10.1016\/S0140-6736(09)60496-7","journal-title":"Lancet"},{"key":"9613_CR2","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1007\/s00101-008-1449-0","volume":"57","author":"B Sch\u00f6nhofer","year":"2008","unstructured":"Sch\u00f6nhofer B, Kuhlen R, Neumann P, Westhoff M, Berndt C, Sitter H: [Essentials from the non-invasive ventilation as treatment for acute respiratory insufficiency: new S3 guidelines].\n                           Anaesthesist. 2008, 57: 1091-1102. [Article in German] 10.1007\/s00101-008-1449-0","journal-title":"Anaesthesist"},{"key":"9613_CR3","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1007\/s00134-005-2626-0","volume":"31","author":"S Kluge","year":"2005","unstructured":"Kluge S, Baumann HJ, Kreymann G: Intrahospital transport of a patient with acute exacerbation of chronic obstructive pulmonary disease under noninvasive ventilation.\n                           Intensive Care Med 2005, 31: 886. 10.1007\/s00134-005-2626-0","journal-title":"Intensive Care Med"},{"key":"9613_CR4","first-page":"8","volume":"71","author":"N Facciolongo","year":"2009","unstructured":"Facciolongo N, Patelli M, Gasparini S, Lazzari Agli L, Salio M, Simonassi C, Del Prato B, Zanoni P: Incidence of complications in bronchoscopy. Multicentre prospective study of 20,986 bronchoscopies.\n                           Monaldi Arch Chest Dis 2009, 71: 8-14.","journal-title":"Monaldi Arch Chest Dis"},{"key":"9613_CR5","doi-asserted-by":"publisher","first-page":"1666","DOI":"10.1001\/jama.1974.03240120034016","volume":"230","author":"RE Albertini","year":"1974","unstructured":"Albertini RE, Harrell JH, Kurihara N, Moser KM: Arterial hypoxemia induced by fiberoptic bronchoscopy.\n                           JAMA 1974, 230: 1666-1667. 10.1001\/jama.230.12.1666","journal-title":"JAMA"},{"issue":"Suppl 1","key":"9613_CR6","first-page":"i1","volume":"56","author":"British Thoracic Society","year":"2001","unstructured":"British Thoracic Society: British Thoracic Society guidelines on diagnostic flexible bronchoscopy.\n                           Thorax 2001,56(Suppl 1):i1-21.","journal-title":"Thorax"},{"key":"9613_CR7","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1007\/s00134-002-1554-5","volume":"29","author":"M Antonelli","year":"2003","unstructured":"Antonelli M, Pennisi MA, Conti G, Bello G, Maggiore SM, Michetti V, Cavaliere F, Proietti R: Fiberoptic bronchoscopy during noninvasive positive pressure ventilation delivered by helmet.\n                           Intensive Care Med 2003, 29: 126-129.","journal-title":"Intensive Care Med"},{"key":"9613_CR8","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.1378\/chest.121.4.1149","volume":"121","author":"M Antonelli","year":"2002","unstructured":"Antonelli M, Conti G, Rocco M, Arcangeli A, Cavaliere F, Proietti R, Meduri GU: Noninvasive positive-pressure ventilation vs. conventional oxygen supplementation in hypoxemic patients undergoing diagnostic bronchoscopy.\n                           Chest 2002, 121: 1149-1154. 10.1378\/chest.121.4.1149","journal-title":"Chest"},{"key":"9613_CR9","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1378\/chest.110.3.724","volume":"110","author":"M Antonelli","year":"1996","unstructured":"Antonelli M, Conti G, Riccioni L, Meduri GU: Noninvasive positive-pressure ventilation via face mask during bronchoscopy with BAL in high-risk hypoxemic patients.\n                           Chest 1996, 110: 724-728. 10.1378\/chest.110.3.724","journal-title":"Chest"},{"key":"9613_CR10","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1016\/S0300-2896(05)70725-0","volume":"41","author":"E Chiner","year":"2005","unstructured":"Chiner E, Llombart M, Signes-Costa J, Andreu AL, Gomez-Merino E, Pastor E, Arriero JM: [Description of a new procedure for fiberoptic bronchoscopy during noninvasive ventilation through a nasal mask in patients with acute respiratory failure].\n                           Arch Bronconeumol 2005, 41: 698-701.","journal-title":"Arch Bronconeumol"},{"key":"9613_CR11","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.1164\/ajrccm.162.3.9910117","volume":"162","author":"B Maitre","year":"2000","unstructured":"Maitre B, Jaber S, Maggiore SM, Bergot E, Richard JC, Bakthiari H, Housset B, Boussignac G, Brochard L: Continuous positive airway pressure during fiberoptic bronchoscopy in hypoxemic patients. 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