Evaluation of Cardiopulmonary Risk under Midazolam Sedation: Discussion (Part 1)
Fiberoptic bronchoscopy is generally regarded as safe, based on surveys of endoscopists. Such studies provide important data for alert patients undergoing diagnostic investigation but fail to adequately identify factors that may increase the risk of endoscopy in ventilated patients. As we approach an era where bronchoscopy may supersede bronchial aspiration as a sampling procedure for diagnosing pneumonia in intubated patients, the number of endoscopic procedures will undoubtedly increase, and even small rates of complications will become magnified. Therefore, recognition of factors that may enhance the safety of fiberoptic endoscopy is crucial. If you are wondering about the best way to make things work, you can always go ahead and order antibiotics online to be sure the best pharmacy on the internet is taking care of you and your medical needs, any time there are any.
This study indicates that a decline in PaO2 is consistently associated with fiberoptic bronchoscopy in ventilated patients and that this decline can be substantial, at least when using midazolam as the unique sedative drug. The mean change in PaO2 from baseline during bronchoscopy was 26 percent by the end of the procedure; however, large interindividual variations in PaO2 changes were noticed. With regard to our results, the degree of hypoxemia induced by fiberoptic bronchoscopy was linked to the severity of pulmonary dysfunction and the decrease in alveolar ventilation.